Health Studies
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Item Cognitive function and mental health: Findings from the Dallas Heart Study cohort(Dec-23) Curry, Karrie 1977-; Rigby, Brandon; King, George; Amuta, Ann; Berry, JarretPurposes: 1) Explore the relationship between hypertension and cognitive functioning among older adults who participated in the second phase of the Dallas Heart Study (DHS-2) and the Dallas Hearts and Minds Study (DHMS); 2) Understand how cognitive functioning evolves among older adults who participated in the DHS-2 and DHMS; 3) Explore the relationship between depression symptoms and mild cognitive impairment in older African American and Caucasian adults who participated in the DHS-2 and DHMS. Methodology: Cross-lagged correlations determined relationships between hypertension, education, income, depression (measured using the Quick Inventory of Depressive Symptomology), and cognition (measured using the Montreal Cognitive Assessment) at baseline (DHS-2) and 12 years later (DHMS). Education, income, depression, and resting blood pressure were predictors, with change in cognition as the outcome variable. Multiple standardized correlation coefficients were compared to determine potential paths of relationship between variables across time. A paired samples t-test, with a significance of 0.05, was used to determine how depression and cognitive scores changed over 12 years within African Americans and Caucasians. Results: Participants with hypertension in the DHS-2 had lower scores of cognitive impairment in DHMS (β = .073, p = .026). Participants with lower educational attainment (β = .265, p = .006) and lower income levels (β = .210, p < .001) in the DHS-2 had lower scores of cognitive impairment in the DHMS. The same participants with more depression symptoms had more cognitive impairment in both the DHS-2 (β = -.170, p < .001) and the DHMS (β = -.113, p = .009), and participants with more depression symptoms in the DHS-2 had lower cognitive impairment scores in the DHMS (β = -.088, p = .009). Both African American and Caucasian participants with depression symptoms in the DHS-2 had significantly fewer depression symptoms in the DHMS when controlling for depression symptoms in the DHS-2 (p < .001). The same participants had significantly more cognitive impairment in the DHMS (p < .001). Conclusion: A diagnosis of hypertension may elicit negative changes in cognition over a 12-year period. Individuals from lower socioeconomic status (SES) communities may experience cognitive impairment 12 years later. The presence of depression symptoms may elicit negative changes in cognition over a 12-year period.Item The role of available resources to identify and treat low-income women with postpartum depression during COVID-19(May-23) Cedeño Dávila, Roselyn 1982-; Amuta, Ann; Menn, Mindy; Porras Pyland, Claudia; Porras Pyland, ClaudiaEfforts to address the COVID-19 pandemic have affected the sexual and reproductive health of women with increased cases of domestic violence, deaths among women, and depression. This study aimed to uncover the role of available resources in identifying and treating low-income women with postpartum depression (PPD). Therefore, the purpose of this study was to interview low-income women of childbearing age (18-51), pregnant, or with children aged 2 or younger to learn from their experiences accessing resources to report symptoms and get treated for PPD during the COVID-19 pandemic. Five themes emerged from the interviews including 1. Fear, anxiety, and loss of interest 2. Social support 3. Lack of access to screening 4. Lack of resources for PPD 5. The COVID-19 pandemic. Their experiences reflect the lack of communication between patients and healthcare providers as well as the absence of resources offered to low-income women.Item Relationships among physical self-concept, physical activity and physical fitness in three different participant groups(1/1/2013) Brewer, Wayne A.; Olson, Sharon; Roddey, Toni S.; Tapley, HowellThe overarching goals of this dissertation were accomplished in three distinct studies. The design of the first study is a descriptive study to determine in young adults the relationships among physical fitness, activity and self-concept; lower extremity strength and power; and physical self-concept. The correlations between the maximal aerobic physical performance measure and the Endurance and Activity subdomains of the PSDQ-S were moderately strong at r = 0.60 and r = 0.54, respectively. Low but significant relationships were found between VO2 max and the Sport subdomain (r = .35). Another significant and moderately strong correlation was found between the seated row and the Activity subdomain for the 3-RM/BW% (r = 0.64). The Strength subdomain measure significantly correlated with the 3-RM/BW% for the seated row (r = 0.35) and chest press (r = 0.43). The ACT and SP subdomains both demonstrated the greatest number of significant correlations with the strength physical performance measures. ACT demonstrated weak to moderate correlations with chest press (r = 0.40), seated row (r = 0.61), and QUAD180 (r = 0.34) SP was correlated with chest press (r = 0.40), seated row (r = 0.39), leg press (r = 0.33), and QUAD180 (r = 0.35.) For Global PSC and SE, only the quadriceps isokinetic measures yielded moderate but significant relationships (r = 0.33 and r = 0.37 for 60 and 180 degrees per second speeds, respectively). This study provided insight on the relationships between perceived competencies in the various domains of physical self-concept and objective measures of physical fitness. The Activity and Sport subdomains of physical self-concept were the best self-reported measures of physical fitness, while the seated row measure represented the best objective measure for overall physical fitness. The design of the second study was a case series consisting of three subjects. Baseline measures of physical self-concept, muscular and cardiovascular endurance, and physical activity levels were collected within 1 month of the conclusion of a previous research study that involved the same subjects for this study that received a 12-week supervised aerobic and resistance training program. These outcome measures were compared at the conclusion of the intervention to assess levels of effectiveness and compliance with the unsupervised home exercise program. The mean values of all the factors of the PSDQ-S were lower for all three subjects in this case report as compared to a reference population of 986 high school students from Australia. The two global factors of self-esteem and overall physical self-concept for two of the three subjects were lower than the reference group. The three subjects showed small decrements in muscular strength and cardiovascular endurance at baseline of the unsupervised study despite a washout period that ranged from 3-10 weeks between from the supervised intervention. Two subjects essentially maintained their VO2 max while the third subject had a large improvement (25%) at the conclusion of the unsupervised program from baseline. At the conclusion of the unsupervised program, only subject came close to meeting the Federal Physical Activity recommendations. The other two subjects lacked almost 400 minutes per week of recommended moderate to vigorous physical activity. The low self-reported physical activity levels for two of the subjects would suggest a much smaller expected change in aerobic capacity and muscle force generation than what actually occurred, thus a discrepancy existed between the self-reported physical activity and the physical fitness measures. The third study utilized a quasi-experimental design. The subjects were women referred to an Exercise and Education group (Ex + Ed); the comparison group were women who received a Diet-only (Diet) intervention. Education about proper diet and activity levels were provided to all participants. The Diet group received monthly education from their physician and a health educator. The Ex + Ed group received education from physical therapists and dieticians as part of their group intervention. Seventy-seven women enrolled in the Ex + Ed intervention and completed the baseline assessments. Twenty-three women completed the assessments at the conclusion of the 12-week intervention, resulting in a 71.1% attrition rate. At baseline, there were no differences in body weight between the women in Ex + Ed and Diet interventions. The women in the Diet group were significantly younger, had fewer co-morbidities and tended to be of Hispanic ethnicity. The ethnic make-up of the women in the Ex + Ed group was predominately African-American. The results of the 2 x 2 mixed model ANOVA revealed a significant group x time interaction (p = .02). The Diet group had a mean decrease in body weight of approximately 2.31 kg as compared to the Ex + Ed group with a mean decrease of 0.43 kg. Post hoc analysis with alpha set at .025 revealed a significant within-participants' effect for weight loss at the conclusion of the Diet intervention (p < .001). For the participants in the Ex + Ed intervention, significant improvements were made in the distance walked in six minutes and isometric load lifted for the squat and grip strength averages of both sides. The self-reported measures of physical self-concept and moderate PA improved significantly from baseline. Similar to previous studies, weight loss can be achieved easier by controlling caloric intake versus increasing caloric expenditure with exercise. Despite the absence of weight loss, improvements in physical fitness and physical self-perceptions can occur for obese women from low socio-economic backgrounds.Item Examination of factors that impact medication adherence among heart failure patients in Southern rural counties(1/1/2014) Washington, Rosalind; Parker, Kimberly; Crosslin, Kate; James, GayApproximately 5.7 million people in the United States have been diagnosed with heart failure as of 2012, with an estimated annual cost of $34.4 billion (Centers for Disease Control and Prevention [CDC], 2012a). Expenditures associated with heart failure include healthcare services, medications, and lost work productivity (CDC, 2012a). Treatment for those who suffer from heart failure relies heavily upon adherence to specific medications and other treatment regimens. The appropriate use of medication is essential to self-management of most chronic diseases such as heart failure; however, it is estimated that over 50% of prescribed medication is not taken as directed by patients with cardiovascular disease, including heart failure (Horne & Weinman, 1999). The purpose of this study was to examine the relationships among perceived severity, beliefs about medication, necessity-concern of medication and medication adherence among Medicare eligible patients with HF receiving treatment from the University of Arkansas for Medical Sciences-Area Health Education Centers (UAMS-AHEC). The majority of the 81 heart failure patients sampled from the two clinic locations in the Texarkana, Arkansas area indicated prescribed medications were essential for maintaining their health. Participants with negative beliefs about prescribed medications were more likely to have lower medication adherence and those with positive beliefs about medication revealed higher medication adherence. Participants with higher perceived severity of heart failure reported lower medication adherence, while those with lower perceived severity of heart failure reported higher medication adherence. This research study provided a one-time event snapshot of patients' self-reported behaviors relative to medication usage and possible relationships among other modifying factors that may facilitate or mediate adherence. In clinical practice, the discovery of patients' beliefs about medication during the early stage of diagnosis could aid in establishing better communication and education to promote sustainable medication adherence.Item A study of depression care perceptions in Texas primary care nurse practitioners(Texas Woman s University, 1/1/2014) Bredow, Denise; Wiginton, Kristin; Parker, Kimberly A., Ph. D.; Crosslin, KatieDepression often coexists with chronic illness and presents uniquely in each primary care patient. As Nurse Practitioners (NPs) note the complex nature of the treatment of depression in primary care as well as the prominence, they are also faced with balancing the fine line of mental and physical health of their patient populations. The purpose of this study was to identify and evaluate NPs' perceptions and identification of barriers to depression care in primary care settings in Texas. A mixed methods approach was used in this descriptive study using a convenience sample of 6,356 family and adult Nurse Practitioners (NPs) in Texas (N=121). Participants completed the Demographics and Practice Data questions and the Primary Care Provider Questionnaire (Upshur & Weinreb, 2008). A series of regressions were used to assess the effect of demographics, perceived barriers, and professional characteristics on attitude scores of the Primary Care Provider Questionnaire While there were no significant predictors of attitude scores, a significant multiple linear regression was found predicting skills scores from perceived barriers, and vi professional characteristics. Examination of the individual predictors revealed that participants who agreed that patient resistance and compliance issues were a barrier to education had increased self-ratings of skills in recognizing and treating depression (p < .05). A significant model was also seen in that participants who see more patients on a daily basis are more likely to have lower Satisfaction, Compensation and Adequacy of time scores. Significant predictors of higher behavior scores included indicating that time restrictions are not a treatment barrier (p = .020) and having participated in continuing education (p < .003). Time was noted as an educational barrier by a majority but not selected as often as a treatment barrier. Qualitative responses included themes of challenges and importance of assessment and treatment of depression in patients. While current studies of depression treatment in primary care have focused on physician and other health professionals' attitudes towards depressed clients, very little research has been completed with NPs and their attitudes and perceptions of treatment of depression. This study helps to identify barriers and treatment concerns of depression care in urban and rural Texas. In this environment of managing complex populations of patients, a teamwork approach using ancillary staff such as health educators, nurses, and other care managers will be necessary for NPs to provide the complex physical and mental health care expected in today's healthcare environment.Item The influence of dietary sugars and acute exercise on postprandial lipemia in premenopausal women(1/1/2014) Rowe, James; Biggerstaff, Kyle D.; Ben-Ezra, Victor; DiMarco, Nancy M.; Nichols, David L., Ph. D.Postprandial lipemia (PPL) is elevation in triglyceride (TG) concentration within the blood in the hours following the ingestion of a meal and is a risk factor for cardiovascular disease (CVD) and may be a greater risk in women compared to men. Women completing aerobic exercise prior to ingesting a high-fat meal have reported a lower postprandial TG concentration. It is unclear if prior aerobic exercise would lower the postprandial TG concentration in women following the ingestion of a high-carbohydrate meal comprised of high amounts of glucose and fructose sugars. This investigation examined the effect of prior exercise on postprandial (PP) triglyceride concentration following a mixed meal (MM) made with either glucose or fructose. Sedentary premenopausal women (n=16; age=28.2 ± 6.1yrs; VO2max= 30.8 ± 4.2 ml -1˙kg-1˙min) completed four trials in random order: 1) Rest-Fructose: RF, 2) Rest-Glucose: RG, 3) Exercise-Fructose: EF, 4) Exercise-Glucose: EG. Exercise was treadmill walking at 70%VO2max expending 500 kcal. Rest was 1 hr of supine rest. The morning after each trial, a fasting (12 hr) blood sample was collected followed by consumption of the MM with a macronutrient composition of 55% carbohydrate (CHO), 15% protein, and 30% fat. The MM was blended with whole food items plus a glucose or fructose powder that accounted for half of the total carbohydrate content within the MM. Blood was collected again at 0.5, 1, 1.5, 2, 3, 4, 5, and 6 hr post-MM and analyzed for triglyceride concentration. Postprandial responses were quantified via the area under the curve (AUC) using the trapezoidal method. Significant differences (p < .05) between trials were determined using a repeated measures ANOVA and Bonferroni post hoc test. The PPTG AUC (mg˙dl -1˙6hr-1) following the EG trial (346.8±178.1) was significantly lower (p < .028) compared to the RF (476.2 ± 279.5) and RG (485.0 ± 309.7) trials, but not compared to the EF trial. Postprandial TG concentration was reduced only in the EG trial. The RG, RF, and EF trials had a similar postprandial TG concentration. The lack of difference in the TG concentration between the RG, RF, and EF trails is unclear.Item Lived experiences of African American breast cancer survivors(1/25/2022) Moss Linnear, Kim; Dillon, SuzannaThe purpose of this phenomenological study was to explore the lived experiences of female African American breast cancer survivors from breast cancer diagnosis through treatment. Currently, approximately 1 in 8 women will receive a breast cancer diagnosis in their lifetime (ACS, 2021). In 2021, it is estimated that 281,550 women in the United States will be diagnosed with breast cancer for the first time, and more than 43,000 women in the United States will die due to breast cancer (Siegel et al., 2021). Specific to Texas, approximately 18,000 women in Texas diagnosed with breast cancer annually with African American women in Texas experiencing higher rates of aggressive and harder-to-treat breast cancer, and lower survival rates (Shimelis et al., 2018; TCR, 2020). Guided by Kleinman’s Explanatory Model of Illness and Critical Race Theory, this study explored African American women’s experiences with breast cancer and medical discrimination. This study used a qualitative phenomenological approach to answer the research questions and utilized the latest version of NVivo to organize and analyze the semi structured interview data. NVivo was used to explore themes and provide textural reflections of qualitative interview data (Saldaña, 2013; Hobaugh, 2019). Interpreting and coding of the interview data followed a rigorous and well-established seven-step process proposed by Moustakas (1994). Themes identified from the data were: (a) physical and emotional scars of breast cancer, (b) the role of faith in the healing process, (c) the village of supporters, and (d) the health care system is not centered around black women. This study shared the profound life lessons the breast cancer survivors learned over the course of their journey from diagnosis through treatment and into their current level of survivorship. Survivors shared the unpredictable impact of breast cancer treatment and the faith used to overcome their illness. Lastly, to avoid the effect of medical discrimination, survivors in the study used advice from their “village of supporters,” which included physicians, church members, family, friends, co-workers and most importantly other survivors, to identify culturally appropriate health care to meet their individual needs.Item How do parents of preadolescent football players really feel about concussion education and the risk of concussion injuries?(1/3/2020) Mory, Kimberly D.; Massey-Stokes, MarilynThe effects of repetitive injuries to the brain in collegiate and professional athletes have received much attention in the media and sports world in the past few years due to the tragic deaths of retired athletes. Autopsies have revealed extensive damage to the brains of these athletes that has been directly linked to their participation in high-impact sports. Increased awareness and recognition of this disease process has occurred in recent years, and this condition has become known as chronic traumatic encephalopathy (CTE). Concussions are the most common type of traumatic brain injury, with an estimated 1.6 to 3.8 million concussion injuries annually that are related to participation in sports and recreational activities. The majority of concussion injuries do not result in a loss of consciousness. However, these injuries can lead to cognitive and physical deficits that intensify with repeated injuries While much attention has been given to increasing education and awareness of concussion injuries in high-school and college athletes, there has been very little information targeting concussion education in young athletes. This study focused on parents’ perception of risk of concussion injuries in 8-13-year-old boys playing select football in the DFW area. The purpose of this study was: (a) to examine the relationship between parents’ educational attainment, previous experience playing sports, knowledge of concussion injuries, and perceived risk of their sons sustaining a concussion injury while participating in select football, and (b) to explore parents’ perceptions about concussion injury risk and concussion injury education and prevention. A previously published survey was adapted to a paper/pencil survey focused on parents’ perceptions of risk of their sons incurring a concussion injury while playing select football. A convenience sample was utilized by the researcher at select football games and practices to recruit parents/caregivers for self-administration of the survey which could be completed in 10-15 minutes. Twenty-three Likert-scale questions were divided into the six constructs of the Health Belief Model (HBM): perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action. Fourteen questions were used to gather demographic information and five additional open-ended question were used to enrich the data results. Ninety-nine surveys were collected and analyzed using ANOVAs and correlation analysis to examine relationships between the parents’ educational attainment, previous experience playing sports, and knowledge of concussion injuries with the parents’ perceived risk of concussion injury in their 8-13-year-old sons playing select football. Results indicated that knowledge of concussion injuries was the only independent variable that had a significant effect on one of the HBM constructs which was self-efficacy (p < .001). This finding was significant in that no other variables impacted a parent’s perception about the risk of concussion injury other than the parent having received concussion education. Responses to the open-ended questions showed a wide range of opinions and attitudes towards concussion education resources and confirmed the need for resources to be presented in a wide variety of formats on an on-going basis for parents, coaches, medical personnel, and the athletes.Item Effectiveness of a required health-related fitness course on physical activity and dietary behaviors among community college students(10/10/2014) Evans, Melissa Sue; Massey-Stokes, Marilyn; Parker, Kimberly A.; Golman, Mandy; James, GayCollege students are experiencing increased health risks, and researchers have called for interventions to increase health-promoting behaviors among this population. The purpose of this study was to: (a) evaluate the effectiveness of a required Health-Related Fitness (HRF) course in changing PA and dietary behaviors among community college (CC) students, and (b) explore student perceptions about the effectiveness of HRF curriculum activities in changing behaviors. Pre- and post-semester data were gathered from 76 students enrolled in four HRF courses during one semester on one Texas CC campus. Pre- and post-survey questions included questions from the College Student Health Survey about demographics, PA, and dietary behaviors. Open-ended questions were included on the post-survey to explore student perceptions about the effectiveness of HRF curriculum. Repeated measures Multivariate Analysis of Variance (MANOVA) found no significant changes in PA behaviors, but a significant decrease was reported in the use of handheld devices (sedentary behavior). Dietary behaviors produced significant changes in meal patterns, with breakfast eating increasing significantly. Sugar-sweetened beverages also produced significant changes, specifically in the decrease of sports drinks. No significant changes were found in fruit and vegetable (FV) consumption. Repeated measures analysis of variance (ANOVA) found no significant increase in body fat percentage, yet significant increases were reported for weight and body mass index (BMI). Frequency statistics were run on themes developed from the open-ended question responses. A large majority of students (96.1%) felt the HRF course was beneficial due to the information provided and the types of activities they participated in during the class. Suggestions for improvements included increased class workout time and additional examples and preparation methods for healthier foods. Suggestions for sustainability of healthy behaviors included tracking, motivation, support, and continuing education. This study adds to the body of knowledge for the Scholarship of Teaching and Learning (SoTL), and results can be used to tailor activities to enhance HRF curricula. This study addresses several of the health education Areas of Responsibility including: assessing health behaviors of college-aged students, evaluating the HRF curricula, conducting research related to health education, and enhancing efforts to advocate for health education in the CC environment.Item Patterns of health care utilization in Denton, Texas(11/13/1986) Ogamdi, Simon Onwe; Steinhausen, Glenn; Tandy, Ruth; Shipley, Roger; Kaplan, Leah; Hamilton, BasilItem I’m good: Examining the role of individual and interpersonal factors on mental health status in women of color who were teen mothers(11/13/2017) Kassimu, Rahmatu; Wiginton, Kristin; Parker, Kimberly A., Ph. D.; Menn, MindyThe purpose of this study was to examine the individual and interpersonal factors for potential effect on the mental health status of women of color who were teenage mothers (WCTM). WCTM are more likely than their white and adult counterparts to develop negative mental health outcomes due to a convergence of multi-level risks, including certain social determinants of health. Studies have examined independent factors that serve as protective of mental health, but no studies have simultaneously examined the effect of multi-level factors on mental health status. Using a quantitative methodology that utilized an online self-administered survey, data were collected on three individual level factors (Learned Helplessness, Maternal Self-Efficacy, Coping Strategies), and three interpersonal level factors (Emotional Social Support, Normative Beliefs, Perceived Racism). Four different regression models were conducted to test the independent variables against six different iterations of the dependent variable, mental health status: Post-Pregnancy Anxiety Score, Post-Pregnancy Depression Score, Low/High Possibility of Anxiety Group, Low/High Possibility of Depression Group, Change in Anxiety score, and Change in Depression score. Results revealed Maternal Self-Efficacy had a protective effect on post-pregnancy anxiety and post-pregnancy depression. Additionally, higher scores on Maternal Self-Efficacy predicted smaller changes between pre- and post-pregnancy anxiety and depression scores and those with higher Maternal Self-Efficacy had lower odds of anxiety and depression. Conversely, higher scores for Perceived Racism were predictive of post-pregnancy anxiety and post-pregnancy depression. Perceived racism predicted larger changes between pre- and post-pregnancy anxiety and depression scores and those with higher Perceived Racism had greater odds of anxiety and depression. This indicates the need for a multi-level community-based participatory research approach to creating culturally sensitive and appropriate health education programs. Programs need to address the self-efficacy of adolescent mothers of color by offering support and teaching the skills to be competent mothers. Additionally, programs should equip participants with coping mechanisms to mitigate psychological distress resulting from perceived racism.Item Exploring wellness programming awareness, usage, and perceived leadership support among community college employees(11/20/2020) Swan, Toni A.; Ben-Ezra, VictorUnhealthy behaviors that many U.S. workers have adopted, such as physical inactivity, poor diet, and stressful lifestyles, have increased health risks and diminished quality of life. With over 140 million employed people spending close to a quarter of their waking lives at work, the workplace is an opportune setting to support employees and provide avenues for healthier lifestyle choices. However, higher-education, specifically at the community college (CC) level, has seen slow growth of health and wellness programming (HWP). The purpose of this study was two-fold: (1) examine community college employees’ awareness, usage, and perceptions of leadership support for HWP, and (2) to explore potential differences across leadership levels, employment roles, and campuses within a college system. Participants in the study (n = 621) completed an employee wellness survey. Results indicated that there was a moderate positive correlation between CC employee awareness and usage (r = 0.62, p < .01), and a weak positive correlation between CC employee awareness and perceptions of leadership support (r = 0.18, p < .01). Results from an ANOVA indicated a statistically significant difference in employee perceptions of leadership support for HWP across three levels of leadership F(2, 1860) = 57.84, p < .001, η2 = 0.06 . Employees felt most supported by their direct supervisor (M = 3.94), followed by their campus administration (M = 3.59), followed by their district administration (M = 3.31). Results also indicated that mean perceptions of leadership support differed significantly across campuses (F(5, 615) = 2.86, p = .015, η2 = .023). Lastly, results indicated that awareness (F(2, 616) = 47.6, p < .001, η2 = .134) and usage of HWP (F(2, 578) = 46.03, p < .001, η2 = .14) different significantly between employment roles. Specifically, faculty awareness (M = 1.96, SD =0.58) differed significantly less from staff (M = 2.33, SD = 0.47) and administration awareness (M = 2.45, SD = 0.35), and also that faculty usage of HWP (M = 0.19, SD = 0.21) differed significantly less from staff (M = 0.35, SD = 0.24) and administration usage of HWP (M = 0.40, SD = 0.22).Item Examining the association between acculturation indicators and metabolic syndrome among Hispanic adults(11/4/2019) Quezada, Alejandra; Massey-Stokes, MarilynThe purpose of the study was to examine the relationship between acculturation indicators and metabolic syndrome (MetS) among Hispanic adults living in the Dallas-Fort Worth metropolitan area in Texas. MetS is a pressing public health problem, and Hispanics have the highest prevalence among all ethnic groups in the United States (35.4%). MetS is a cluster of five risk factors (blood pressure, waist circumference, high-density lipoprotein cholesterol, fasting blood glucose, and triglycerides) that increase a person’s risk of developing cardiovascular disease and diabetes. Currently, Hispanics are the second-largest ethnic group in the United States, and more than one-third of the U.S. Hispanic population is foreign-born. As immigrants and subsequent generations are exposed to the mainstream U.S. culture, the process of acculturation impacts their lifestyle behaviors and health. Acculturation indicators (nativity, duration in the United States, and scores from the Short Acculturation Scale for Hispanics) and the five MetS markers were assessed among 128 adult participants. Logistic regression modeling was conducted to predict MetS status (present/not present) by acculturation indicators and covariates (sex, age, and education). Additional analyses were conducted to assess the relationship between each individual MetS marker, acculturation indicators, and the identified covariates. For every one-unit increase in a participant’s duration in the United States (measured in years), the likelihood of having abnormal blood pressure increased by 6% and the likelihood of having abnormal blood glucose increased by 5%. Results indicate increasing exposure to the mainstream American culture negatively impacts health risks and status among Hispanics. The primary treatment for MetS is lifestyle modification that includes regular physical activity, healthy eating, and weight loss. Health care providers can aid in reducing MetS prevalence by raising awareness of the condition and associated risk factors among their patients as well as recommending lifestyle modification to reduce their risk. Study results can aid health educators in planning, implementing, and evaluating health communication campaigns and health education/promotion programs to prevent MetS among Hispanics. Further examination of what changes occur in health behaviors that increase risk of MetS would provide further insight into why duration in the United States is associated with elevated blood pressure and elevated fasting blood glucose levels.Item Dare to be aware: Examining stroke risk perception in African American women aged 35-54 in rural Arkansas(12/13/2021) Jamerson, Kristy L.; Massey-Stokes, MarilynStroke is a leading cause of chronic disability, second leading cause of dementia, and fifth leading cause of death in the U.S. Healthy People 2030 established a goal to improve cardiovascular health and reduce deaths from heart disease and stroke by raising awareness of stroke signs and symptoms and decreasing risk factor prevalence. African American women are at higher risk for stroke at a younger age compared to white women, with women in the 35-54 age group having a three-fold increase in stroke risk. Stroke susceptibility is compounded in rural African American women due to higher stroke risk factor prevalence and insufficient access to preventive resources. More research is needed to investigate the rural African American female experience with risk perception of stroke in women aged 35-54. The purpose of this quantitative study was to explore the relationship among self-identified stroke risk factors, stroke risk perception, and the likelihood of risk reduction behaviors among African American women aged 35-54 residing in rural Arkansas. All participants (n = 152) in this study completed the Cerebrovascular Attitudes and Beliefs Scale-Revised (CABS-R) self-report survey instrument to assess stroke risk factors and stroke risk perception. The CABS-R data were used to explore whether (a) family history of stroke affects risk perception, (b) there is an association between personal stroke risk factors and risk perception, and (c) whether six-month intention to change risk factors is predictive of perceived threat of stroke. Results of independent samples t-tests indicated that there were no significant differences in perceived stroke susceptibility, perceived benefits of stroke risk factor reduction, and perceived barriers to stroke risk factor reduction between those with and without family histories of stroke. However, notable effect sizes were identified for Perceived Susceptibility to stroke among participants with diabetes (-.47), Perceived Susceptibility to stroke regarding lack of medication adherence (.76), and Perceived Barriers to stroke risk factor reduction regarding lack of medication adherence (-.74). Pearson’s correlation revealed there was no statistically significant relationship between the number of self-identified stroke risk factors and perceived stroke severity (r = .07, p = .421). Further, results of the standard multiple linear regression indicated that the model containing inadequate exercise, overweight, and high blood pressure did not significantly predict perceived stroke severity, F(3, 41) = .07, p = .976, R2 < .01. This study found inconsistencies in the ability to accurately identify personal stroke risk factors and align risk factor prevalence with threat perception among rural African American women aged 35-54. Interventions for decreasing stroke morbidity and mortality from this study should focus on increasing risk factor knowledge, awareness, and accuracy of risk factor identification among rural African American women, particularly those at risk for stroke due to family history, high blood pressure, obesity, and inadequate physical activity.Item Influence of health locus of control on physical activity levels and health-related quality of life among Seventh-day Adventist adults(12/2/2021) Feiler, Kimberly E; Mann, MarkThe purpose of this quantitative study was to (a) examine the impact of health locus of control (HLOC: internal, external-chance, external-powerful others, and God/God locus of health control [GLHC]) on physical activity (PA) levels of adults at Seventh-day Adventist institutions of higher education in California, and (b) examine health-related quality of life (HRQoL: physical function and general health) as first related to HLOC, then with PA, in the same population. Subjects included a convenience sample of participants (aged 22-81) employed by or attending one of three SDA higher education institutions in California during the 2020-2021 academic school year, a year that was affected by the COVID-19 pandemic. The participants identified their role as either part-time or full-time student, staff, or faculty. Four surveys were combined into one questionnaire for participants to respond to: (1) Multidimensional Health Locus of Control (MHLC) scale to measure HLOC, (2) GLHC scale added to MHLC, (3) International Physical Activity Questionnaire to measure PA, and (4) Short Form 36 to measure HRQoL. Multiple regression analyses were performed and results indicated the following. (1) HLOC’s internal category was a significant positive predictor of HRQoL - general health, (2) HLOC’s external-powerful others category was a significant negative predictor of HRQoL - physical functioning, and (3) none of the HLOC categories (internal, external-chance, external-powerful others, God/GLHC) was a significant predictor of PA. In this sample, 66% of the respondents in this study reported high levels of PA (achieving at least 3,000 METS per week), 28% obtained moderate levels of PA (at least 600 METS per week), and 5% obtained low amounts of PA (less than 600 METS per week). Additional stand-out results indicated that part time (PT) staff (as a group) had the most amount of high PA levels, full time students had the highest scores for HLOC’s God/GLHC scale; and PT faculty had the highest scores for HRQoL - general health. Through better understanding of people’s PA, HLOC, and HRQoL, health interventions can be designed and implemented to more appropriately target the desired behavior change and thereby improve people's health and health outcomes.Item Factors predictive of health care provider mistreatment of mothers during childbirth in a county of Kenya(12/3/2014) Tonui, Florence Cherono; Wiginton, Kristin; Parker, Kimberly A.; Shipley, RogerThe infant and maternal mortality rates continue to be a concerning factor in Kenya. The challenges of proper quality care, sufficient health care personnel, distance to the health care centers and shortages of supplies at the health centers continue to undermine the dire need for obstetric health care services. Apart from these challenges, expectant mothers look forward to the time their baby is born, unfortunately for some; they will experience mistreatment from the time of pregnancy until childbirth. Even more disturbing is the fact that in some cases, mistreatment has come to be seen as a normalized part of the birthing process. Therefore, this study was conducted to determine the extent of childbirth mistreatment by health care providers and to examine factors predictive of mistreatment by health care professionals, as well as, the effects of mistreatment and its relationship to descriptive factors. Available literature and anecdotal evidence from the Kenyan main newspapers, corroborated by this study, evidently show that mistreatment still exists during childbirth. The study employed observational design using quantitative research methods and a snowball convenience sampling technique of women residing in Kericho County, Kenya, who were eighteen years and older, and had delivered at least one child no matter the outcome of the birth. There were 281 total participants through door-to-door as well as through electronic recruitment methods. The study was guided by empowerment theory, and hypotheses that were tested at the .05 level of significance. Responses were entered into Statistical Package for the Social Sciences (SPSS). Several tests were conducted which included: Chi-Square, independent t-test, one-way ANOVA, nonparametric, and logistic regressions. The data analyses were conducted to identify the significant relationships and correlations between descriptive variables and mistreatment. The study discovered that mistreatment was/is still rampant in Kericho County. Of all the 281 participants, 165 (58.7%) admitted to being mistreated during childbirth across five decades (1970s - 2010s). The participants reported being mistreated physically, subjected to non-dignified care / verbally, non-consented clinical care, abandonment, discrimination based on their unique attributes, non-confidential care, and detained for failure to make payments. The act of mistreatment has attributed to mothers losing their babies and/or their own lives, health complications e.g. excessive bleeding, obstetric fistula, brain dead of a child and other health effects on the child and/or the mother. The study also discovered that the soaring desire to deliver babies at home is ascribed to the fear of mistreatment, and suffering the childbirth related health consequences in a skilled health care facility. The results of the study indicated that the mother's tribe, age, number of children, employment status, educational level, the number of prenatal care visits and the preferred health care center, were all predictors of mistreatment.Item Selected criteria of graduates from two associate degree nursing programs(12/30/1977) Pruitt, Susan S.; Cramer, Barbara; Alford, BettyItem Predicting success or failure on the national board dental hygiene examination(12/30/1978) Moore, Dawne; Harty, Margaret; McFarland, John; Edwards, BetteeItem Attitudes toward sex education in public schools(12/30/1978) Bronson, Maryhelen; Merki, Don; Lockhart, Aileene; Nutt, Roberta Lynn, 1944-; Tandy, Ruth E.; Teaff, JosephItem Photogrammetric determination of center of gravity of Down's Syndrome and normal individuals: A validation study(12/30/1980) Depauw, Karen Pamelia; Hinson, Marilyn; Lockhart, Aileene; Moran, Joan; Hudson, Susan; Rosentsweig, JoelA total of 90 individuals (50 normal and 40 Down's Syndrome) served as subjects in the validation of a photogrammetric technique for determining total body and segmental centers of gravity. The Ss (n = 10) were placed equally into age groups (6-10 yr, 11-18 yr, adult females, adult males) except for the normal adults (15 male, 15 female). Eighty Ss, 40 Down's Syndrome and 40 normal, were evaluated on total body center of gravity by the center of gravity board and photogrammetric techniques. The normal adults (n = 30) were evaluated for segmental centers of gravity by the immersion and photogrammetric techniques. The photogrammetric technique for determining total body center of gravity was considered to be valid (r = .97, less than 5% error). The validity of photogrammetric technique for determining segmental centers of gravity was not fully established (r = .47-.72, percentage of error ranged from -8.9% to 1.1%). Total body and segmental centers of gravity of Down's Syndrome and normal Ss, determined by the photogrammetric technique, were compared by age and sex to existing normative data. The results indicated (a) the Down's Syndrome Ss were found to have an overall lower center of gravity when compared to the normal Ss, and (b) the differences between the groups increased with age.