Dissertations / Theses on the topic 'Public health-based prevention'
To see the other types of publications on this topic, follow the link: Public health-based prevention.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Public health-based prevention.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Brooks, Billy, Brian Martin, Paula Masters, and Robert Pack. "Tennessee Public Health Workforce Needs Assessment: A Competency-Based Approach." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/3188.
Full textAbstract:
Maintaining the health of Tennesseans depends heavily on a well-trained, efficient public health workforce that can work effectively in a complex environment. In order to assess the training needs of this group, the Tennessee Public Health Training Center-LIFEPATH administered a survey to all governmental public health employees in Tennessee during the summer of 2012. This instrument was modeled after previous assessments conducted by health agencies outside of Tennessee which utilized as their rubric the Core Competencies for Public Health Professionals developed by the Council on Linkages between Academia and Public Health Practice. The goal of this research was to inform and streamline educational efforts of the Tennessee Department of Health (TDOH), LIFEPATH and their partners across the state by identifying specific competency driven training opportunities within the workforce. Participants were recruited via email and directed to SurveyMonkey, an online survey toolkit, where they could complete the questionnaire. Of the 5178 TDOH employees who received the recruitment email, 3086 individuals completed at least one of the competency questions for a response rate of 59.6%. The survey assigned questions pertinent to the eight core competency areas to respondents based on one of three Tiers – Tier 1: Entry Level, Tier 2: Management Level, Tier 3: Leadership Level. Once the data were collected, responses from all three tiers were dichotomized to generate a “Needs Score” which when summarized represented the percentage of responses indicating a lack of knowledge or proficiency in a competency area. Tier 1 respondents had an average needs score of 60.46% in each of the eight core competency areas. Tier 2 had an average needs score of 49.50%, and Tier 3 respondents had an average needs score of 28.91%. This trend shows that individuals in leadership positions within TDOH were more likely to be knowledgeable or proficient in the eight core competency areas. Prior to administering the survey, TDOH job classifications were submitted to an expert panel within the health department. This body was tasked with assigning tiers to specific job classifications. Previous needs assessments that used the eight core competencies had respondents self-select their tier. As a test of validity the LIFEPATH survey asked TDOH employees to select their job classification in addition to tier. A Kappa test of agreement between self-selection of tier and their actual tier determined by TDOH leadership showed moderate agreement (Kappa=0.5089), suggesting that while most respondents selected the correct tier; there remained some confusion regarding tier definitions. This must be considered when evaluating the results of previous studies that utilize only the self-selected tiers to drive their survey. This data has already begun to direct training goals at the state, regional and local levels across Tennessee and will serve as a baseline measure for future evaluations of educational programing’s impact on workforce competency.
2
Vilches, Silvia L., Beth S. McDaniel, Haley Sherman, Brianna Burks, Allie Merritt, Terra Jackson, and Synithia W. Flowers. "Engaging with a Prevention Approach: System Supports Needed in Child Abuse and Neglect Prevention." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/secfr-conf/2020/schedule/13.
Full textAbstract:
Public policy has been shifting from child abuse and neglect (CAN) intervention toward prevention, using public health style frameworks, which emphasize shared community and legislative responsibilities to support families (Browne, 2014; CDC, 2014). Analysis of qualitative data from statewide focus groups held in 2019 in Alabama with 99 community-based CAN prevention workers shows strengths in community collaboration, but also, struggles to help families meet basic needs because of lack of community resources, such as transportation and quality child care, and other barriers, including stigma. The results demonstrate confusion between prevention, which is intended to build family resilience to avert crisis, and intervention, meant to reunite families after child protection services involvement. We recommend researchers consistently link CAN research to prevention frameworks so as to build meaningful understanding how to create better prevention programs. Future practitioners should understand prevention, and be prepared to document their work so as to demonstrate need.
3
Park, John Jinoh. "The Strategic Prevention Framework: Effectiveness of Substance Abuse Prevention System." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3914.
Full textAbstract:
The strategic prevention framework (SPF) is a data-driven operating system to assist designing evidence-based substance abuse prevention programs. The study performed here was to assess the effectiveness of the SPF as a prevention planning system. One purpose of this study was to determine the implementation fidelity of the programs that used the SPF process; the other purpose was to assess effectiveness of the SPF process. This study utilized a set of data collected by the national cross site evaluation team on all jurisdictions that implemented the SPF. A subset of communities collected and reported at least 2 pre-implementation and at least 2 post implementation outcomes data. The minimum sample size for the study was determined by using Cohen's d criteria. The assessments were performed using both qualitative and quantitative methods by using data collected from multiple levels with a quasi-experimental design. The qualitative data were analyzed using qualitative software with key word searches to examine implementation processes, and the quantitative data were analyzed using descriptive statistics and inferential methods such as Student t tests to examine and compare outcomes. Results show that the communities in the study implemented the SPF process with fidelity and that there were changes in desired directions. Factors related to improvements include sufficient internal resources and monitoring follow-through. This research has important implications for social change since substance abuse is a major social issue that has consequences across life span. Recent studies have shown that many behavioral problems have similar risk factors and that improvements for some behavioral problems will most likely have beneficial effects on other related problems.
4
Thibodeaux, Lee A. "Measuring the Diffusion of a Federal Drug Policy: Implementation of the Principles of Effectiveness in Ohio Public School Districts." University of Akron / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=akron1217258495.
Full text
5
Hopkins, Laura Lee, and Laura Lee Hopkins. "Using RE-AIM to Evaluate the Potential Public Health Impact of a Community-Based Family-Focused Diabetes Prevention Program." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/621180.
Full textAbstract:
Overweight and obesity in U.S. children has reached epidemic proportions, affecting one in three of children and adolescents (ages 2 to 19). Chronic diseases such as type 2 diabetes, previously linked with adult obesity, are now observed in youth. Early intervention is key to reversing this trend. However, successful translation of clinical obesity prevention interventions to the broader community remains a major challenge, in part, due to ineffective adaptation of interventions from controlled clinical settings to more diverse settings. A process evaluation framework - RE-AIM - was used to guide "real world" translation of a family-focused diabetes prevention trial at the YMCA for overweight and obese 9-12-yr-olds (E.P.I.C. Kids), with particular attention paid to factors influencing adoption, implementation, and maintenance by the program by this established community organization. Preliminary evaluation suggested a moderate to high potential for successful implementation and dissemination of the E.P.I.C. Kids program on a larger scale, thereby laying the foundation for replication in other community settings.
6
Armstead, Terra. "The Opioid Epidemic: Assessment of Primary Prevention Interventions in Muskingum County Public Schools." Otterbein University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1596204955483026.
Full text
7
Gavine, Anna J. "The primary prevention of violence in secondary school pupils in the West of Scotland." Thesis, University of St Andrews, 2014. http://hdl.handle.net/10023/6544.
Full textAbstract:
Violence is a leading cause of morbidity and mortality amongst young people. Public health approaches are now being increasingly utilised to reduce the risk of young peoples' involvement in violence. One such programme is Medics Against Violence (MAV), which aims to reduce pro-violent attitudes and enhance empathy in secondary school pupils. This thesis aims to investigate whether this approach can be effective in tackling youth violence in secondary school pupils. A mixed-methods approach was adopted to conduct both an outcome and process evaluation of MAV. Four schools took part in the outcome evaluation, which examined whether there was a change in attitudes towards violence or empathy in pupils receiving the MAV programme. The process evaluation consisted of focus groups with school pupils, and open-ended questionnaires and semi-structured interviews with MAV volunteers. There was a small but significant reduction in pro-violent attitudes immediately post-intervention. However, this was not sustained at three months and there was no significant increase in empathy scores. Pupils generally demonstrated anti-violent attitudes, although were more likely to support the use of reactive violence. The pupils appeared to enjoy and generally engage well with the programme. In particular, the use of real footage, interviews with those affected by violence and the Glasgow setting provided a sense of realism for the pupils. Moreover, pupils valued the opportunity to discuss the issues raised by MAV with the volunteers. Volunteers felt engagement was occasionally an issue in the most affluent areas. However, some volunteers adapted the programme to focus on victimisation prevention in the most affluent schools. Further development is therefore needed in terms of establishing who the programme is aimed at (i.e. potential victims or perpetrators), focusing on reactive violence and increasing the sustainability of its effects.
8
Kvist, Lindholm Sofia. "The Paradoxes of Socio-Emotional Programmes in School : Young people’s perspectives and public health discourses." Doctoral thesis, Linköpings universitet, Tema Barn, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-122457.
Full textAbstract:
Over the past decades socio-emotional programmes have been implemented in schools worldwide. Depression in Swedish Adolescents (DISA) and Social and Emotional Training (SET) are two socio-emotional programmes being practised in Swedish schools. The aim of the present dissertation is to explore students’ perspectives on DISA and SET, as well as the programmes’ intentions and strategies. The empirical material consists of interviews with students taking part in DISA and SET, participant observations conducted in an elementary school practising SET, participant observations of DISA and SET instructor courses, and a broad range of textual material concerning the programmes. Article I reports on an inherent contradiction in DISA, where techniques designed as treatment are practised as universal prevention for girls as a group. The girls’ accounts of DISA demonstrate why this contradiction is problematic – it was not up to the girls as course participants to define what problems they were having, but the problems were instead defined for them by the course. Taking part in DISA and SET involves exercises in which the students are expected to selfdisclose in front of their classmates. Article II reports on how this task of self-disclosure had a potential for strengthening students’ peer relations, while it at the same time entailed a risk of triggering already on-going destructive interactions, such as bullying and harassment. Article III demonstrates that the potential of self-disclosure is not equally distributed across the students, but depends on their social status within their peer group. Article III also shows that the norm conveyed by the SET programme – that showing anger is an inappropriate behaviour –functioned locally as a way to justify exclusion and negative positioning of peers who showed anger in response to ill treatment. Article IV provides an in-depth analysis of exchanges in a SET lesson concerning how students should deal with exposure to the negative actions of peers. It demonstrates how the types of questions a teacher is instructed to pose to maintain a neutral attitude in practice involve using more implicit forms of authority to construct ideals concerning desirable behaviours. These ideals were formed by discussing fictive examples, which meant stripping students’ actions of meaning and detaching them from the social and cultural context to which they belong. The present dissertation concludes by giving recommendations for policy practice.Sedan millenniumskiftet har socio-emotionella program kommit att bli allt vanligare i skolor runtom i världen. Depression in Swedish Adolescents (DISA) och Social och Emotionell Träning (SET) utgör två socio-emotionella program som används i svenska skolan. Syftet med denna avhandling är att studera elevers perspektiv på DISA och SET, samt att studera programmens målsättning och design. Analysmaterialet består av intervjuer, deltagande observationer, programmanualer och dokument som beskriver och förklarar programmens utgångspunkter. Avhandlingen innefattar fyra artiklar. Artikel I belyser en konflikt i DISA programmet. DISA programmet lär ut tekniker som har utformats för att behandla depression. Programmet riktas dock till flickor generellt med syftet att förebygga att de utvecklar depression. Flickornas beskrivningar av DISA visar varför denna konflikt i programmet är problematisk. De fick inte själva definiera vilka problem de upplevde, istället var de tvungna att jobba med de problem som programmets övningar tillskrev dem. Övningarna som ingår i DISA och SET innebär moment där eleverna förväntas öppna sig inför varandra. Artikel II och III belyser hur detta fenomen hade potential att stärka elevernas sociala relationer, samtidigt som det också riskerade att leda till mobbning. I SET programmet tränas elever på att kontrollera sin ilska. Artikel III belyser hur normen – att visa ilska är ett olämpligt beteende – användes av eleverna för att rättfärdiga uteslutning av elever som visade ilska. Artikel IV består av en djupanalys av lektionen ’Vad kan du göra’ som handlar om hur elever bör agera om de utsätts för negativa handlingar från kamrater. Artikeln tar utgångspunkt i det dilemma som lärare ställs inför i SET programmet: att å ena sidan träna barnen i att anta socialt accepterade beteenden, och å andra sidan följa programmets krav på neutralitet. Analysen visar att de frågor som SET lärare använder för att åstadkomma en neutral hållning i praktiken medför mer implicita former av styrning där programmets ideal om önskvärda beteenden reproduceras. Önskvärda beteenden konstrueras genom att diskutera fiktiva fall utan att relatera dem till den sociala och kulturella kontext där barnen agerar och hanterar aktuella problem. Avhandlingen avslutas med en diskussion om hur ’barns psykiska hälsa’ och ’barns behov’ förstås och bemöts genom dessa program och vilka slutsatser som kan dras för utformandet av framtida insatser i skolan.
9
Nilsen, Per. "Opening the Black Box of Community-Based Injury Prevention Programmes : Towards Improved Understanding of Factors that Influence Programme Effectiveness." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7001.
Full text
10
Boye-Doe, Sylvia B. "Improving Fall Prevention Strategies in an Acute-Care Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3337.
Full textAbstract:
Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program with multifactorial and interdisciplinary components, and an evaluation plan to help decrease falls in acute care settings. The Safe Five falls prevention program was implemented on the acute care nursing unit in an effort to decrease the inpatient falls rate on the unit. The inpatient falls data were collected retrospectively, 2 years pre implementation of the Safe Five program, and 8 to 10 months post implementation. Data were collected from the Safe Five checklists, recorded inpatient fall rates, and high fall risk chart audits provided by staff and nurse manager; they were then analyzed using the RE-AIM evaluation tool. The long-term effects of the Safe Five program include an 18% increase in patients' awareness of the importance of preventing falls, an 18% increase in staff compliance with the program, and a 14% decrease in inpatient fall rate on the unit. It is projected that the decrease in inpatient falls will result in decreased healthcare costs and improved patient satisfaction with the healthcare system, communication among the interdisciplinary team, and health outcomes for the patients.
11
Shelver, Amy. "The AIDS of aid?: long-term organisation challenges of a CBO dealing with HIV/AIDS, poverty and donor aid." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1012321.
Full textAbstract:
The following treatise first frames the role of CBOs in responding to the HIV/Aids crisis in relation to their position in the global health governance system through a literature survey that moves from an analysis of the global structures down to the local. The survey covers the role of international organisations, international NGOs (INGOs), national governments, local NGOs and CBOs and outlines the context in which Masizakhe is working within the global health governance structure. Secondly the research design and methodology are outlined focusing on the longitudinal, case study and participant--‐observation approaches. Hypotheses, conceptualisation, definitions, key variables are described and data collection methods and fieldwork practice extrapolated upon. Following that data capturing, editing and analysis are discussed in conjunction with shortcomings and sources of error. In the fourth chapter the research discusses the history, structure and outlines the research findings by comparing what has changed within the organisation over time, presenting and discussing the results. The outcomes of this research have shown that existing problems in this particular CBO are very difficult to overcome without committed, sustained support from donors, government, community and the organisation’s members. CBOs are often hamstrung by a series of intersecting factors which hamper their ability to problem--‐solve, even when the route to overcoming the problem is clear, particularly when the capacity and will to do so is not always present from both within the organisation and from outside support systems. These challenges then impact on the overall quality of and ability to deliver the services the organisation is structured to deliver. The major challenge for the organisation remains the inconsistent donor cycle and resultant instability thus created within an organisation already working in a highly volatile, unstable situation marked by poverty and disease. Thus the title, The Aids of Aid?, captures the essence of Masizakhe’s struggle with its own syndrome of problems. It summarises a comment made by the project secretary said that: “Sometimes it feels like we are not only fighting for the health of our people – We are fighting for the health of our organisation. We are a sick organisation trying to help sick people. All we need is donors and funding –we can’t live without them, and when they don't give, we get sick” (Stamper, Pers Comm, 2011). The other emergent challenges were a battle internally with ‘founder syndrome’, lack of management transparency and a dysfunctional board.
12
Vujcich, Daniel Ljubomir. "Where there is no evidence, and where evidence is not enough : an analysis of policy-making to reduce the prevalence of Australian indigenous smoking." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:f2d8fbe9-b506-4747-993a-0657cb1df7bf.
Full textAbstract:
Background: Evidence-based policy making (EBPM) has become an article of faith. While critiques have begun to emerge, they are predominately based on theory or opinion. This thesis uses the 2008 case study of tobacco control policy making for Indigenous Australians to analyse empirically the concept of EBPM. Research questions: (1) How, if at all, did the Government use evidence in Indigenous tobacco control policy making? (2) What were the facilitators of and barriers to the use of evidence? (3) Does the case study augment or challenge the apparent inviolability of EBPM? Methods: Data were collected through: (1) a review of primary documents largely obtained under the Freedom of Information Act 1982; and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates and academics. Results: Historically, Indigenous smoking was not problematised because Indigenous people faced other urgent health/social problems and smoking was considered a coping mechanism. High prevalence data acquired salience in 2007/08 in the context of a campaign to reduce disparities between Indigenous and non-Indigenous health outcomes. Ensuing policy proposals were based on recommendations from literature reviews, but evidence contained in those reviews was weak; notwithstanding this, the proposals were adopted. Historical experiences led policy makers to give special weight to proposals supported by Indigenous stakeholders. Moreover, the perceived urgency of the problem was cited to justify a trial-and-evaluate approach. Conclusion: While the policies were not based on quality evidence, their formulation/adoption was neither irrational nor reckless. Rather, the process was a justifiable response to a pressing problem affecting a population for which barriers existed to data collection, and historical experiences meant that evidence was not the only determinant of policy success. The thesis proposes a more nuanced appraoch to conceptualising EBPM wherein evidence is neither a necessary nor a sufficient condition for policy. The approach recognises that rigorous evidence is always desirable but that, where circumstances affect the ability of such research being conducted, consideration must be given to acting on the basis of other knowledge (e.g. expert opinion, small-scale studies). Such an approach is justifiable where: (1) inaction is likely to lead to new/continued harm; and (2) there is little/no prospect of the intervention causing additional harm. Under this approach, non-evidentiary considerations (e.g. community acceptability) must be taken into account.
13
Ducore, Susan Elizabeth. "FALL PREVENTION SERVICES FOR OLDER ADULT, AMERICAN INDIANS/ALASKA NATIVES: AN EXAMINATION OF KNOWLEDGE, ATTITUDES, AND PRACTICES OF HEALTH CARE PROVIDERS." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp152581877516155.
Full text
14
Baker, Mary K. "Preventing Skin Cancer in Adolescent Girls Through Intervention with Their Mothers." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etd/1163.
Full textAbstract:
Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year.
The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This study evaluated a strategy designed to prevent skin cancer in adolescent girls by using mothers as change agents to effectively communicate the risks of IT and to encourage teens to avoid high risk IT behaviors.
Mother-daughter dyads were recruited over the telephone, randomly assigned to the intervention or control group, and surveyed on IT risk constructs including tanning-specific knowledge and communication.
Forty-two mother-daughter dyads completed baseline surveys in the summer of 2012. Mothers in the intervention group were given a handbook educating them on the dangers of IT and how to convey information about skin cancer prevention to their daughters and encouraged to talk with their daughters about the issues covered in the handbook over a 1-month period. Participants completed follow-up assessments in October 2012 and January 2013.
Among teens, past 3-month IT frequency, intentions, and willingness decreased in intervention group teens, while intentions and willingness increased among control teens. Intervention teens exhibited lower IT attitudes and higher levels of perceived susceptibility to appearance damage and health effects from IT when compared to control teens. Intervention teens reported higher levels of maternal monitoring and lower levels of maternal permissiveness toward IT.
Qualitative data indicated mothers responded positively to the handbook, and it encouraged tanning-specific discussions with their daughters. Mothers provided suggestions on how to improve the handbook, that once incorporated, should lead to improved intervention efficacy. Overall, study results indicated this intervention strategy is feasible, as mothers did communicate with their teens and were able to convey the antitanning messages.
15
Medina, Maldonado Venus Elizabeth [Verfasser], M. [Akademischer Betreuer] Landenberger, A. [Akademischer Betreuer] Wienke, and M. [Akademischer Betreuer] Camacaro. "Public health program based on the evidence of nursing for prevention and assistance of gender-based violence in collaboration with specialized personnel and community members / Venus Elizabeth Medina Maldonado. Betreuer: M. Landenberger ; A. Wienke ; M. Camacaro." Halle, Saale : Universitäts- und Landesbibliothek Sachsen-Anhalt, 2014. http://d-nb.info/1052893848/34.
Full text
16
McConnell-Smith, Sharon Lacretia. "School Administrator and Staff Member Perceptions of a Teenage Pregnancy Prevention Program." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/757.
Full textAbstract:
Mississippi is among the states with the highest teenage pregnancy rates, and the study site is among the high schools with the highest teenage pregnancy rates in the state. The purpose of this qualitative case study was to identify successful practices and areas for improvement in the implementation of a teenage pregnancy prevention program (TPPP) at the study site based on the perspectives of school administrators and staff members. Bandura's social cognitive theory provided a conceptual framework for considering behaviors and the social contexts in which they occur. Twelve participants were interviewed, including 3 administrators and 9 staff members. Data were analyzed using open coding to identify themes. Findings indicated that, according to the perspectives of the 12 participants, the evidence-based TPPP positively influenced the students by providing a structured curriculum for classroom teaching; promoting small-group discussions; and implementing an abstinence approach to prevent teenage pregnancy, HIV, and STDs. Strengths identified included the use of various instructional techniques and a general support for communication. Areas for improvement included scheduling, school staff and parent buy-in, and knowledge about specific problems related to risk-taking behaviors. Social change implications of this study include increased awareness among adult stakeholders of practices that support successful implementation of a TPPP and enhanced ability to make positive decisions about sexual behaviors among students. School officials could apply the findings to strengthening the effectiveness of the school's TPPP. Students may benefit from improved TPPP instruction by being better prepared to prevent teenage pregnancy, HIV, and STDs.
17
Holm, Tilda, and Patrik Svensson. "Vegansk kost och typ 2-diabetes." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-20206.
Full textAbstract:
Introduktion: Kardiovaskulära sjukdomar är en av de vanligaste sjukdomarna världen över och står årligen för 18 miljoner dödsfall, en tredjedel av alla dödsfall. En av dessa sjukdomar är diabetes som en av elva i världen har i någon form och mörkertalet är stort. Typ 2-diabetes (T2D) kan vara ärftlig men är också påverkbart. Riskfaktorerna kan förebyggas genom en hälsosam livsstil som innefattar fysisk aktivitet och hälsosam kost, som kan reducera övervikt. En skyddsfaktor är frukt och grönsaker, något som en vegansk diet till stora delar består av. Syfte: Syftet med denna studie är att genom två perspektiv (primär- och sekundärprevention) undersöka om en vegansk kost minskar risken för T2D. Metod: Med en strukturerad litteraturstudie har datainsamling skett via databaser PubMed och Cochrane Library. Vald analysmetod var innehållsanalys. Resultat: Från 21 granskade artiklar framkom sex olika kategorier: 1) Prevention, prevalens och incidens av T2D (veganer löper lägre risk att drabbas av T2D); 2) Vikt, BMI och kroppsmått (en vegansk kost främjar viktnedgång och sänkt BMI vid övervikt); 3) Blodvärden och blodtryck (både systoliskt och diastoliskt blodtryck, HbA1c, glukos, c-peptid, betacellsfunktion och insulinkänslighet förbättras av en vegansk kost); 4) Hormoner (GLP-1, GIP, PYY och amylin optimeras av en vegansk kost); 5) Metabolism (TMAO minskar medan och postprandial metabolism stärks av vegansk kost); och 6) Kolesterol (vegansk kost förbättrar värden för LDL, HDL samt triglycerider). Slutsats: I sin helhet visade resultatet på att en vegansk kost kan minska risken för T2D bland vuxna (≥18 år) på både primär och sekundär nivå.Introduction: Cardiovascular disease (CVD) is one of the most common diseases worldwide and accounts for 18 million deaths annually, which is one-third of all deaths. One risk factor for CVD is type 2 diabetes (T2D). Globally, one in eleven persons has T2D and undetected cases are high. T2D can be hereditary but people can also be susceptible to T2D. The risk factors can be prevented through a healthy lifestyle including physical activity and healthy diet, which can reduce obesity. A protective factor is dietary intake of fruits and vegetables, something that a vegan diet largely contains. Aim: The aim of this study is to investigate through two perspectives (primary and secondary prevention) whether a vegan diet reduces the risk of T2D. Methods: A systematic literature review accomplished data collection using two databases, PubMed and the Cochrane Library. The analysis method chosen was content analysis. Results: Of 21 articles reviewed, six different categories emerged: 1) prevention, prevalence and incidence of type 2 diabetes (vegans are at lower risk of developing T2D); 2) body weight, body mass index (BMI) and body measurements (a vegan diet promotes weight loss, decreased BMI); 3) Blood values and blood pressure (systolic and diastolic blood pressure, HbA1c , glucose, c-peptide, beta cell function and insulin sensitivity are enhanced by a vegan diet); 4) Hormones (GLP-1, GIP, PYY and amylin are optimized by a vegan diet); 5) Metabolism (TMAO decreases and postprandial metabolism is enhanced by vegan diet); and 6) Cholesterol (vegan diet improves LDL, HDL and triglycerides). Conclusion: The results showed that a vegan diet can reduce the risk of type 2-diabetes among adults (≥18 years) at both primary and secondary levels.
18
Triantafyllou, Marouso. "School-based Interventions or Prevention Programs regarding Alcohol, Smoking and Drug Use among Adolescents with Disabilities or Physical Impairments : A Systematic Literature Review." Thesis, Högskolan i Jönköping, Högskolan för lärande och kommunikation, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-44161.
Full textAbstract:
Introduction Substance use in adolescents with disabilities is rising, containing the prevalence of substance-related disorders (SRD) such as addiction, mental or health disorders, cancer, accidents and mortality. Yet little is known about the existing substance use prevention programs among adolescents with dosabilities or physical impairments. The aim of this systematic review was to investigate the effects of school-based interventions or prevention programs directed at the reduction of alcohol, tobacco and drug use in young adolescents with disabilities or physical impairments. Method Five scientific databases were explored mainly for school-based randomized controlled trials (RCTs) and prevention programs examining the effects of substance use interventions and prevention programs on adolescents with disabilities or physical impairments. Guided by the NICE guidelines, eligible articles were detected from which data were collected. A systematic literature review was performed for many diverse outcomes such as, substance use knowledge, substance use, modelling social environment, intention to quit smoking, peer pressure, etc. Results The primary literature search resulted in 821 articles. Five studies were incuded in the systematic literature review. Most of the collected studies were about adolescents with intellectual disabilities (MBID or MMID). The review's sample group ranged from 12-to 18-year-old adolescents. Included studies had a total sample of 981 out of which 13 were teachers. Studies measured both primary and secondary outcomes like modelling smoking, substance use and frequency of alcohol use. Conclusion This review summarized evidence about interventions and prevention programs aimed at decreasing or preventing substance use in adolescents with various types of disabilities or physical impairments. Substance use education increases knowledge about alcohol, tobacco and drug use and the health-related harms in teenagers with disabilities. Additional research is required especially among teenagers with intellectual disabilities and other types of disabilities.
19
Masiano, Steven P. "Family Planning and HIV Interventions among Women in Low-income Settings." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5688.
Full textAbstract:
This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.
This dissertation comprises three discrete papers. Paper 1 (chapter 1) examines the effectiveness of a national scale-up of community-based distribution of family planning services on contraceptive use in Malawi’s rural areas during the period 2005-2016. The national-scale up of the intervention followed the success of a pilot of a similar intervention implemented in the period 1999-2004. As in the pilot, the scaled-up program distributed condoms and oral contraceptives and provided family planning education. Further, because education and income are important determinants of individual contraceptive use, the paper also examines whether the effectiveness of the national scale CBDs varies over these dimensions. The paper uses the Malawi Demographic and Health Surveys. The study finds that the intervention increased contraceptive use by 6.8 percentage points and the effects were greater among uneducated and low-income women.
Paper 2 (chapter 2) conducts a cost-effectiveness analysis of a trial of cash incentives aimed at increasing the uptake of services for the prevention of mother-to-child transmission (PMTCT) of HIV. The trial was conducted in the Democratic of the Congo (DRC) as part of an effort to find ways of increasing uptake of PMTCT services in sub-Saharan Africa where uptake of these services remains low. The study is conducted from the societal perspective, relies on multiple sources within and outside of the DRC for cost data, and reports economic costs in 2016 International Dollars (I$). At a threshold of 3*GDP per capita for the DRC (I$2409), the study finds that the intervention is cost-effective.
Paper 3 (chapter 3) examines the guideline concordance of the time to follow-up anal cancer screening in women living with HIV at high risk for anal cancer. In the US, the incidence of anal cancer in women living with HIV has increased significantly in the past 2-3 decades. However, early detection of anal cancer, through regular screening, can lead to effective secondary prevention of the disease. While guidelines for anal cancer screening exist, very little is known about the guideline concordance of the time to follow-up anal cancer screening in women at high risk of acquiring anal cancer. Hence this study. The study uses Medicaid Analytic eXtract files which compile claims of individuals enrolled in Medicaid—a public health insurance program largely for eligible low-income adults and the largest single payer for HIV/AIDS in the US. The study finds that time to follow-up screening is not guideline-concordant for most women living with HIV, particularly those with one of the two risk factors for anal cancer: a history of abnormal cervical test results or a history of genital warts.
20
Uhrig, Lana K. "Feasibility of a long-term food-based prevention trial with black raspberries in a post-surgical oral cancer population: Adherence and modulation of biomarkers of DNA damage." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1416961549.
Full text
21
Richards, Justin A. "Evaluating the impact of a sport-for-development intervention on the physical and mental health of young adolescents in Gulu, Uganda - a post-conflict setting within a low-income country." Thesis, University of Oxford, 2011. http://ora.ox.ac.uk/objects/uuid:9632dcfc-94e6-45ac-a4c1-ad63113f9b59.
Full textAbstract:
Introduction: Physical inactivity is thought to contribute to the emergence of non-communicable diseases in post-conflict settings of low-income countries. Sport-for-development (SfD) organisations in these regions claim to improve the health of programme participants. However, there is a paucity of supporting evidence. I assessed the impact of a voluntary community-based SfD intervention on the physical activity (PA), physical fitness (PF) and mental health (MH) of adolescents in Gulu, Uganda. Methods: The Acholi Psychosocial Assessment Instrument (APAI), standing broad jump (SBJ), multi-stage fitness test (MSFT) and BMI-for-age (BFA) were adapted to the local context. I tested their feasibility and reliability with a repeat-measures design (n=70). A cross-sectional analysis of a random sample was used to assess the local needs and establish the PF and MH of the adolescents reached by the intervention (n=1464). This was also the baseline assessment for the impact evaluation. It comprised a randomised control trial (n=144) nested within a cohort study (n=1400) and triangulated by cross-sectional assessment of PA using accelerometry (n=54). Results: The adapted PF and MH measures demonstrated good intra-tester reliability (ICC>0.75). Adolescents in Gulu predominantly had “healthy” BFA (>90%). They performed better than global norms for the SBJ (p<0.001), but worse for the MSFT (p<0.05). The girls who registered for the intervention had higher PF at baseline (p<0.05) and experienced no significant benefits when compared to the community. The aerobic capacity of the boys intervention group increased relative to the community (p<0.01), but was not significantly different to the trial control group whose PF also improved. The PA results concurred with this finding. Boys in the intervention group experienced a deterioration in MH relative to their peers (p<0.05). Implications: It is feasible to apply rigorous evaluation methods to SfD interventions. Although adolescents in Gulu have poor aerobic capacity, a voluntary programme may not reach those at risk. Interpreting the impact evaluation was limited by a lack of programme development theory, but suggested that opportunities for non-competitive play may confer PF benefit without harming MH. Further investigation is warranted.
22
Yatchyshyn, Todd. "Educational Stakeholders' Perspectives on School-Based Obesity Prevention Programs." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1141.
Full textAbstract:
Childhood obesity is a worldwide problem that can lead to adverse health conditions. In several rural Pennsylvania communities, over one third of elementary students are characterized as overweight, having a body mass index above the 85th percentile. The purpose of the study was to investigate educational stakeholders' perspectives about school-based obesity-prevention programs. The conceptual framework focused on cognitive theory, the theory of planned behavior, and the trans-theoretical model of health behavior change, which postulates that an individual's readiness to change is the most important factor of intervention programs. Qualitative interview data were gathered from 18 educational stakeholders. Inductive code-based analysis led to categories and themes. Key findings revealed a variety of barriers that limited and prevented effective student-wellness initiatives: students' physical activity; family dynamics, schedules, and socioeconomic factors; lack of transportation limiting children's participation in physical activities; parental engagement and input on obesity-prevention initiatives; and cafeteria environment and meal offerings. Findings informed the development of a policy recommendation for a research-based nutrition education program for schools and a strategy to communicate students' cafeteria habits to parents. Recommendations include a heightened awareness on factors contributing to obesity, as well as better educator-led planning to make improvements to school-based programs. Implications for positive social change may be the potential to increase awareness of healthy behaviors and improved student health through obesity-prevention methods, exercise patterns, and dietary habits of youth. These healthy habits may reduce adverse health effects in adulthood, which could hold the potential to improve the health of the next generation.
23
Beechey, Riley Tegan Anne. "Pharmacist Utilization of Opioid Misuse and Abuse Interventions: Acceptability Among Pharmacists and Patients in Detox." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1499974262218499.
Full text
24
Welch, Philip J. "State Legislators' Support for Evidence-based Obesity Reduction Measures." University of Toledo / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1320940976.
Full text
25
Alfailakawi, Noor Khaled. "The effectiveness of a knowledge-based health promotion intervention on multiple health behaviours in adolescent females." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8184/.
Full textAbstract:
Background: Kuwaiti female adolescents have a substantial prevalence of physical inactivity and unhealthy diet leading to epidemic proportions of obesity. Additionally, rates of tobacco smoking and substance abuse are increasing among them. There is a lack of health promoting interventions to deter such behaviours in this population and therefore a knowledge-based intervention in a school setting was investigated. Methods: The study included 128 adolescent females between the ages of 14 and 18. They were randomly selected and allocated to an intervention group (n= 64) and a control group (n= 64). The intervention consisted of six educational sessions for each of the following: physical activity (PA), healthy nutrition, prevention of tobacco smoking, prevention of substance abuse, bone health, and sun protection. Both groups were assessed before and after the intervention in weight measurements, physical fitness, PA by accelerometry in a subsample, and self-reported behaviours. The self-reported behaviours included PA, dietary behaviours, tobacco smoking, substance abuse, and sun exposure and protection. In addition, the knowledge of each health topic was assessed immediately before the session and a week after. A mixed model repeated measures analysis of variance (ANOVA) was used for analysis following an intention-to-treat approach. Results: Physical fitness including flexibility, abdominal muscles strength, body balance and cardiorespiratory endurance (VO2max) were significantly improved in the intervention group compared to the control group. The intervention group also had significantly increased energy expenditure, light PA, walking time, moderate PA, and moderate-to-vigorous PA, while had decreased sedentary time and elevator use. They also had improved a range of dietary practices by increasing consumption of breakfast, dairy, and water. Furthermore, their health knowledge of each topic was significantly increased. Weight measurements did not show any significant change. Tobacco smoking and substance abuse were scarcely reported which could be due to cultural sensitivity. Conclusion: A health promotion intervention in school was successful in increasing physical activity and physical fitness, and improving dietary practices in adolescent females in Kuwait. Thus, such interventions are promising and should be invested in and expanded in this population. These interventions should also be supported by socio-environmental changes including families, youth organisations, and health policies.
26
Noordali, Farhan. "Mindfulness-based interventions for diabetes treatment and prevention in South Asian young adults." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8141/.
Full textAbstract:
This thesis addressed gaps in the literature regarding the effects of Mindfulness-based interventions (MBIs) for Type 2 diabetes (T2D) and sought to investigate the acceptability and feasibility of an MBI for a group at high risk for T2D, South Asians. A mixed-methods approach was utilised to produce four studies: 1) a systematic review evaluating the psychological and physiological effects of MBIs applied to T2D; 2) a modelling phase to gauge interest in, and cultural considerations for, a modified MBI for young adult South Asians as a diabetes prevention strategy; 3) an examination of the acceptability and feasibility of a modified MBI; and 4) a comparison of the perceived and objective effects of the modified MBI. The review found evidence for psychological benefits and mixed results for physiological effects. The modelling phase indicated that Mindfulness is acceptable to young South Asians pending minor adaptations. The subsequent feasibility study found the modified MBI to be acceptable and feasible, warranting a future full-scale trial. Across these studies, Mindfulness bore psychological benefits, and to a lesser degree physiological and behavioural benefits. The final study’s triangulation approach (using quantitative and qualitative methods) suggests the intervention has a potential positive impact on stress, anxiety, energy levels, emotional wellbeing, and systolic blood pressure in this sample.
27
James, Janet. "Preventing childhood obesity : a school-based intervention trial - CHOPPS - the Christchurch Obesity Prevention Programme in Schools." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/385141/.
Full text
28
Grandahl, Maria. "Prevention of Human Papillomavirus in a school-based setting." Doctoral thesis, Uppsala universitet, Vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-263252.
Full textAbstract:
The overall aim of this thesis was to examine beliefs about human papillomavirus (HPV) prevention, especially vaccination, among parents, immigrant women, adolescents and school nurses, and to promote primary prevention among adolescents. The methods used in the thesis were focus group interviews, individual interviews, a web-based questionnaire, and finally, a randomised controlled intervention study. The immigrant women were largely in favour of HPV prevention, although barriers, such as logistic difficulties, and cultural or gender norms were found. Parents’ decision concerning vaccination of their daughters depended on several factors. Regardless of their final choice, they made the decision they believed was in the best interest of their daughter. The benefits outweighed the risks for parents choosing to vaccinate while parents declining made the opposite judgement. The majority of the school nurses reported that the governmental financial support given because of the vaccination programme had not been used for the intended purpose. Three out of four nurses had been contacted by parents who raised questions regarding the vaccine; most were related to side effects. The educational intervention had favourable effects on the adolescents’ beliefs regarding HPV prevention, especially among those with an immigrant background. Furthermore, the intention to use condom as well as actual vaccination rates among girls was slightly increased by the intervention. Trust in the governmental recommendations and the amounts of information given are important factors in the complex decision about HPV vaccination. Attention given to specific needs and cultural norms, as well as the possibility to discuss HPV vaccination with the school nurse and provision of extra vaccination opportunities at a later time are all strategies that might facilitate participation in the school-based HPV vaccination programme. School nurses need sufficient resources, knowledge and time to meet parents’ questions and concerns. The vaccinations are time-consuming and the governmental financial support needs to be used as intended, for managing the vaccination programme. A school-based intervention can have favourable effects on the beliefs and actual actions of young people and may possibly thus, in the long term, decrease the risk for HPV-related cancer.
29
Cook, Adam. "Cannabis use amongst individuals with severe mental health problems : reasons for use and motivational based interventions." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1454/.
Full textAbstract:
Motivational based approaches have been shown to be effective in reducing problematic behaviours in the general population. The present study reviewed 31 studies that aimed to reduce a number of problematic behaviours amongst individuals with severe mental health problems. Evidence supporting the efficacy of motivational based approaches in increasing adherence to medication was inconsistent. In the minority of studies where an increase in medication adherence was reported, the duration of effect appeared to decline over time. The evidence from the studies that aimed to reduce substance use was more consistent. A number of other positive outcomes were reported reductions in: dependence, general functioning and mental health symptomatology. The empirical paper presents a quantitative study that aimed to look at the reasons for cannabis use amongst individuals with and without severe mental health problems. It was found that the motivations for using cannabis did not differ between the two groups; both using cannabis to cope with negative affect, for pleasure and for social reasons. However, individuals with severe mental health problems differed in that they expected cannabis to be more ‘socially and sexually facilitative’. Irrespective of mental health status, participants who used cannabis more problematically endorsed more coping and pleasure motives.
30
Hamainza, Busiku. "Measurement of malaria transmission and impact of malaria control interventions using health facility and community-based routine reporting systems." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2006039/.
Full textAbstract:
Globally malaria still remains the most important parasitic disease of public health interest. In the recent past, most endemic countries have deployed and scaled up both preventive and curative interventions to reduce malaria transmission and, ideally, eliminate it. This has lead to global reductions in both mortality and incidence of malaria. These declines have been attributed to the reinvigoration of the global malaria control agenda by the explicit ambition of achieving elimination, which has lead to an increase in funding for national control programmes to increase coverage of preventive interventions, field compatible diagnostic tools for confirming parasite infection, and increased access to effective treatment. As a result of declines in malaria transmission, the focal nature of malaria transmission has become much more evident and has lead to consideration of surveillance as a key intervention for malaria control/elimination in its own right. Surveillance systems have been well established in most formal health facilities but the incorporation of these systems at community level and operationalised by community health workers (CHWs) still remains limited. Additionally, these few examples of CHW-implemented surveillance systems have been typically only reporting indicators of malaria infection burden, without capturing indicators of intervention availability, deployment, coverage and utilisation, thus representing a missed opportunity for routine monitoring and evaluation of impact of interventions in “real time” to inform program planning and implementation. The study was established as part of a multi-country study under the Malaria Transmission Consortium Project whose primary objective was to develop and evaluate new or improved methods for measuring malaria transmission. Thus the overall goal of this study was to demonstrate how malaria transmission, and impact of interventions, could be routinely measured through a novel longitudinal community based surveillance system (CBSS) operationalised by modestly paid CHWs. The CBSS included both passive and active surveillance activities using field – compatible test kits for in situ parasitological detection of malaria infections, based on which confirmed cases were treated with anti-malarial drugs, coupled with a detailed questionnaire on access and use of malaria control interventions and population characteristics. Passive surveillance was achieved conventionally whenever community members self-reported to the CHWs and active surveillance was achieved through monthly active visits to all households in their catchment populations to offer testing and treatment. In addition to recording detailed details of each patient contact in a paper patient register, weekly summaries of selected data elements were submitted by the CHWs using a mobile phone platform via short messaging system (SMS). The detailed reference data recorded in the patient register was then used to monitor malaria infection dynamics in the study population, evaluate the impact of preventative measures, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) and validate the electronic summaries submitted via SMS. Overall, the CBSS did not routinely capture all malaria infections in the study population and was insufficient to eliminate the human parasite reservoir. This was primarily due to limited study participant participation with the monthly active testing and treatment offered by the CHWs. However, the CBSS clearly demonstrated the incremental and residual impact to supplementation of pyrethroid-treated LLINs with non - pyrethroid insecticides applied by IRS in areas where the dominant malaria vector is highly resistant to pyrethroids. The adequacy of the SMS reports submitted by the CHWs confirms the great potential of mobile phone technology for facilitating and improving the effectiveness of community based reporting. Despite its limitations, the CBSS successfully provided programmatically relevant information regarding malaria infection dynamics across the large study area at a very affordable cost. The CHWs demonstrated their ability to not only provide treatment services but also adequately report their findings both electronically and on paper. CHWs are primarily tasked with providing routine health services at community level but clearly also have a valuable auxiliary role to play in “real time” surveillance of malaria, and most probably a range of other diseases. If the full potential of CHWs as agents of health surveillance can be realized, control programme progress can be measured through spatial and temporal mapping of transmission with greater sensitivity and at finer scales than is possible with health facilities alone, to enable improved, better-informed program planning, resource allocation and implementation.
31
Snyder, Nichole M. "An Examination of Coalition Functioning and Use of Evidence-Based Practices: A Case Study of Four Community Substance Abuse Coalitions." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5393.
Full textAbstract:
There has been a recent expansion of community-based coalitions to address issues related to youth substance use. Research on their overall effectiveness, however, has produced mixed results. Recommendations to improve coalition success have emphasized the high-quality implementation of evidence-based programs targeting specific community needs. Coalitions vary extensively, however, in their organization and functioning. In addition, the lack of a universally accepted theoretical framework to understand coalition functioning has led to inconsistencies in the coalition research and the specific constructs used to describe coalition functioning.
Purpose of the Study: To address these gaps, the current study used a case study approach to describe the organization and functioning of four local substance abuse coalitions and to identify factors related to coalition high-quality implementation of evidence-based programs.
Methods: Using constructs based on Community Coalition Action Theory, the current study used coalition member surveys and key leadership interviews to produce separate case study descriptions of four participating community substance abuse coalitions. An exploratory factor analysis was conducted to examine the structure of the survey measure. Univariate statistics were used to describe coalition functioning and attitudes toward evidence-based practice and implementation. One-way analysis of variance tests were employed to examine differences across the coalitions and Pearson's product-moment correlations were used to identify coalition characteristics associated with attitudes toward evidence-based practice. A thematic analysis of interview data was conducted for an in-depth examination of coalition functioning and perceptions of evidence-based practice.
Results: Coalition members and leaders reported high levels of functioning across all of the included domains. However, several differences in coalition background and structure were discussed. Community support was described as a major functioning challenge across both surveys and interviews. Interview results also revealed several different coalition belief patterns surrounding evidence-based practice and quality implementation. Coalition members and leaders generally indicated positive attitudes toward the use of evidence-based prevention programs and strategies. However, varying levels of knowledge and experience with evidence-based practices was identified across interviews. Interviews also highlighted several factors that influence coalition decision-making and identified several perceived challenges associated with the use of evidence-based practices. Results include a discussion of coalition knowledge, perceptions, and experiences with program implementation.
Conclusions and Implications: Taken together, these findings form a basis for better understanding the current environment surrounding community substance abuse coalition functioning and implementation of evidence-based practices. Several factors were shown to influence coalition decision-making processes and overall functioning. In addition, the present study highlights strengths and gaps related to coalition leadership knowledge, attitudes, and implementation of evidence-based programs and strategies. These identified relationships can be used to guide future research and community practice. With their growing popularity, it is likely that community coalitions will take on a major role in future community-based prevention efforts across the country. As such, there is a need to design substance abuse prevention programming with coalitions in mind and to identify alternative avenues to disseminate information surrounding community-focused evidence-based practices. Identifying new ways to measure and build coalition processes, leadership skills, and structures could result in greater coalition capacity to plan for and support prevention activities, including use of evidence-based practices.
32
Pearce, Natasha L. "Critical success factors for building school capacity to engage parents in school-based bullying prevention interventions." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2010. https://ro.ecu.edu.au/theses/361.
Full textAbstract:
It is evident in current health promotion literature that capacity building is advocated asa future priority for action for health promoters in designing effective interventions.Although theory and definitions, and therefore the practice of capacity building iscriticised for its ambiguity, common elements include the development of knowledge,skills, commitment, structures, systems and leadership. Capacity building must bemultileveled working at the individual, organisational, community and system levels.Capacity building is centred in the process of implementation and its methods are aboutways to improve intervention implementation to achieve sustainable health outcomes.Given the limited resources available to health and other sectors to improve healthoutcomes, mechanisms that improve implementation and sustain and multiply the health gains which result from these interventions are crucial. However, little empiricalresearch on the implementation and evaluation of capacity building approaches exists,hence hindering its practical application to health promotion interventions.
It is well accepted that the success of school health promotion interventions aredependent on effective implementation and that many barriers prevent schools fromembracing the recommended whole school approach. It is clear that school healthpromotion interventions aiming to address priority health issues must adopt a capacitybuilding approach to improve implementation efforts or risk failure. Effective capacitybuilding in schools, however, goes beyond the skills training of individuals toassessment of structures, processes, resources and leadership within the school systemto support teachers, parents and students to implement sustainable strategies over thelonger term. No matter what the level of enthusiasm or commitment is provided byschool leaders and staff, unless their school has the necessary capacity supports in place, their efforts will have limited success on student outcomes.
Whilst schools in general know they must adopt a comprehensive approach thatinvolves the whole school community to be an effective health promoting environmentfor their students, most find engaging parents in their activities challenging. Evidencesuggests the important influence parents can have on their children’s healthy lifestylechoices and how this at-home influence, partnered with whole school and classroomstrategies are vital in providing health promoting environments for children.
33
Li, Zijin. "From darkness to dawn : tackling discrimination based on health status in China." Thesis, University of Warwick, 2013. http://wrap.warwick.ac.uk/57623/.
Full textAbstract:
Discrimination based on health status is a serious problem in China, which influences the fundamental rights of millions of people. This thesis mainly discusses the nature, characteristics and reasons of discrimination based on health status in China. As a contextual and socio-legal study, this thesis employs doctrinal, empirical, historical, international & comparative law methods to provide a comprehensive and in-depth study on tackling discrimination based on health status in China. It is among the earliest researches that focus on the specific topic of discrimination based on health status in China. This thesis argues that various factors are responsible for continuing discrimination based on health status in China. Particularly, the fragmentary, incomplete, ambiguous and conflicting legislation, the ineffective, arbitrary and bureaucratic administration, the dependant and ineffective judiciary, the less active nongovernmental actors, and other relevant political, economic, medical and cultural factors, interact with one another to cause continuing discrimination. To pursue this argument, first, the thesis clarifies the necessity to prohibit discrimination based on health status by analysing relevant definitions and theories of such discrimination. Second, the thesis explores how discrimination based on health status has been tackled in international law and domestic law in various other jurisdictions, in order to reveal international responsibility China should bear and foreign lessons China can learn. Third, the thesis examines how discrimination based on health status has been tackled in Chinese history and reality to understand why such discrimination remains serious today. Fourth, the thesis discusses findings of the author’s fieldwork on tackling discrimination based on health status in China to investigate the effectiveness of the current anti-discrimination regime. Based on the above analyses, the thesis finally concludes the main reasons for continuing discrimination based on health status in China and proposes a more effective antidiscrimination regime in China to prohibit such discrimination.
34
Almario, David R. "The Ability of the U.S. Military’s WBGT-based Flag System to Recommend Safe Heat Stress Exposures." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7727.
Full textAbstract:
The U.S. military currently uses a flag system based on wet-bulb globe temperature (WBGT) and metabolic rate to recommend heat stress exposure limits. This paper addresses the ability of the flag system to recommend safe heat exposures in a non-military population.
Two progressive heat stress studies provided data on 528 observations of safe or unsafe exposures of 4 hours over a range of WBGT conditions and metabolic rates using 29 participants wearing woven cotton clothing. For the two studies, range of WBGT conditions was 25 to 42C, and the range of metabolic rates was 100 to 650 watts. These exposures were compared with the flag system’s recommendations of safe exposure to determine the sensitivity and specificity of the flag system. A separate study provided 62 observations with participants undergoing a time-limited protocol at constant WBGT conditions. Observed durations of safe exposure time were compared to the flag system’s recommended safe limits to determine sensitivity and specificity.
Based on the progressive protocol, sensitivity and specificity of the flag system for five ranges of WBGT and three categories of metabolic rate were 0.98 and 0.25, respectively. For the time-limited protocol, which applied only to the highest range of WBGT and light and moderate metabolic rate, both sensitivity and specificity were zero.
This study suggests that the flag system has high sensitivity but low specificity for long duration exposures, along with low sensitivity and specificity for time-limited exposures. However, the WBGT exposures in the time-limited trials were substantially higher than the threshold for the highest WBGT range in the flag system, which may account for the system’s unexpected performance in the time-limited protocol.
35
Njau, Bernard Joseph. "A multi-component theory-based behaviour change intervention to increase HIV self–testing uptake and linkage to HIV prevention, care and treatment among hard to reach adults in Northern Tanzania." Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33869.
Full textAbstract:
To achieve the WHO targets of 95–95–95 by 2030, whereby 95% of all people living with HIV (PLHIV) know their status, 95 % of all people with an HIV diagnosis receive sustained antiretroviral therapy (ART), and 95 % of all people receiving ART achieve viral suppression, it is imperative to introduce novel community–based testing approaches such as HIV self-testing (HIVST). HIV self–testing has been shown to empower non– testers in both developed and underdeveloped countries, to be aware of their HIV status. However, no studies on the uptake of HIVST have been conducted on hard to reach populations in Northern Tanzania. The hard to reach populations for this thesis were female bar workers (FBWs) and mountain climbing porters (MCPS) in Northern Tanzania, who exhibit high-risk behaviours for HIV infection and low rates of HIV testing and / or repeat testing. It is important to find ways to increase the uptake of HIV testing in these populations and HIVST is proposed as a means of improving HIV testing coverage in hard-to-reach populations in the context of a long-standing HIV testing program. Existing implementation science literature suggests that behaviour change interventions (BCIs) guided by behaviour change theories and using planning and evaluation frameworks (i.e. PRECEDE-PROCEED model) can be effective in increasing HIV-related behaviour change. However, the current evidence on the effectiveness of HIV-related BCI is from studies conducted in high-income countries. To address the low HIV testing rates and/or repeat testing, it was important to undertake a project of research to develop and evaluate a theory-based behaviour change intervention (BCI) to increase HIVST uptake and linkage to HIV prevention, care and treatment among FBWs and MCPs in Northern Tanzania. This thesis aimed to develop and evaluate a multi-component theory-based BCI to increase HVST uptake and linkage to HIV prevention, care and treatment among female bar workers and mountain climbing porters in Northern Tanzania.
36
Smock, Carissa Ruby. "Provider Acceptance, Training, and Utilization of Place-Based Exercise Prescriptions." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492008967709141.
Full text
37
Izac, Jerilyn R. "Generation of a linear epitope based multi-protein chimeric construct for prevention of Lyme disease in humans." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5968.
Full textAbstract:
Lyme disease (LD) is the most prevalent vector borne disease is North America with 300,000-600,000 human cases each year. Preventative strategies for LD in humans are poorly developed and largely inadequate. While preventive vaccines for LD are widely used in veterinary medicine, there are no vaccines available for use in humans. The goal of this study was to develop a human vaccine that can elicit antibody responses that kill spirochetes in both the tick and mammalian environments. The approach applied in this study centered on the development of chimeric epitope proteins, referred to as chimeritopes. Chimeritopes consist of a series of epitopes derived from one or more proteins or protein variants. Three chimeritope proteins designated as Chv1, Chv2 and Chv3 were designed. These proteins harbor the same set of 18 linear epitopes derived from 9 different OspC type proteins. They differ in epitope arrangement or by the presence or absence of linkers between specific protein segments. The immunogenicity of each protein was assessed in multiple animal models including mice, rats, and purpose bred beagles. Immunoblot, ELISA, and IFA analyses using sera from immunized animals demonstrated that the Chv proteins elicit IgG responses that recognize a diverse array of OspC type proteins. Anti-Chv and anti-OspA antisera displayed complement dependent bactericidal activity. To assess protective efficacy, purpose bred beagles were immunized with each vaccine formulation and then challenged by infestation with infected ticks. Efficacy was assessed by monitoring seroconversion, cultivation of tissue biopsies, clinical presentation and histopathological analysis of joints and tissues. All dogs vaccinated with the Chv2-OspA combination were fully protected. All dogs in this group were seronegative for LD, biopsy culture negative and did not develop LD associated symptoms including lameness or lesions in tissues or joints. In light of market concerns centered on the use of full length OspA in a human vaccine, epitope mapping was performed to identify a linear epitope that could be employed in development of a possible OspC-OspA chimeritope. A linear epitope, designated as OspA221-240was identified. Antisera to KLH-OspA221-240displayed potent and broad bactericidal activity. Interestingly, the OspA221-240epitope has homology to residues 244 to 263 of OspB suggesting that OspB may also be a potential candidate for inclusion in a human vaccine. This study establishes proof of principle for the use of OspC chimeritopes in LD subunit vaccines and highlights the need to employ a multi-valent, multi-antigen vaccine approach in development of a human LD vaccine.
38
Frieson, Krystal. "Saving Our Sisters: Effects of a Computer-Based Version of SISTA on the HIV-Related Behaviors of African American Women." UKnowledge, 2015. http://uknowledge.uky.edu/edp_etds/29.
Full textAbstract:
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) are infectious diseases wreaking irreparable havoc on the lives of millions all around the world. Of those infected and affected by HIV in the United States, African Americans disproportionately bear the burden of this disease, which has resulted in a major crisis within the African American community. In 2010, African Americans accounted for approximately 44% of all new HIV infections among adolescents, 13 years of age and older, and adults [Centers for Disease Control and Prevention [CDC], 2012). These statistics become even more dismal when both race and gender enter the equation. In regards to global HIV/AIDS, the leading cause of death among women of reproductive age is AIDS-related illnesses (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2012). According to the CDC (2012), 64% of estimated new HIV infections in women in the United States in 2010 were in African Americans.
This study examined the effectiveness of increasing protective HIV behaviors through the use of the SAHARA program, a computer-based, gender-specific and culturally appropriate HIV behavioral intervention program. More specifically, the SAHARA intervention was created to encourage consistent condom use during penetrative vaginal sex through mediating components of the intervention such as HIV knowledge, condom use self-efficacy, barriers to condom use, and frequency of partner communication for a population of African American women living in areas of Kentucky and Georgia. Convenience sampling was used to recruit participants from college campuses and community areas. Fifty-two African American female study participants completed surveys through the use of a quasi-experimental non-randomized pretest-posttest design.
Significant group differences were observed for scores on STD/HIV Risk Behavior Knowledge and Condom Barrier Scale. Results suggest that the SAHARA prevention intervention produced clinically significant changes in STD/HIV knowledge and perception of condom barriers in the SAHARA group compared to the control group.
39
Hughes, Karen Leigh. "Repeat adherence to colorectal cancer screening utilising faecal occult blood testing : a community-based approach in a rural setting." Thesis, Queensland University of Technology, 2006. https://eprints.qut.edu.au/16416/1/Karen_Hughes_Thesis.pdf.
Full textAbstract:
In Australia, colorectal cancer (CRC) is the most common registrable cancer affecting both men and women, and the third most common cause of cancer deaths. Clinical data from randomised, controlled trials indicate that population-based screening utilising the faecal occult blood test (FOBT) can reduce mortality from this disease. However, high adherence rates with repeated testing are required to secure these outcomes. This study examines repeat adherence with FOBT screening in a rural community two years after a first screening round was conducted. Patients, aged 50 to 74 years, registered with four local general practices were mailed a FOBT kit with a letter of invitation from their general practitioner. Following the intervention, 119 telephone interviews were conducted with adherers and non-adherers to examine knowledge and attitudes related to screening. Compliance with screening was recorded and compared with first round-data. Participation in the screening program was modest. Of the 3,406 participants eligible for both screening rounds, 34.1% and 34.7% participated in rounds 1 and 2, respectively. A majority of participants (56.8%) did not adhere to either screening, a quarter (25.7%) participated in both rounds, and 17.5% participated in one of the two rounds. First-round adherence was the strongest predictor of second-round adherence (OR=16.29; 95% CI: 13.58, 19.53) with 75.2% of first-round adherers completing a FOBT in round 2. Females were also more likely to adhere in both rounds, although the difference between females and males decreased across rounds. Knowledge and attitudes differed between adherers and non-adherers and are discussed within the context of the major findings. Results from this trial indicate that achieving high levels of compliance in a national screening program will be challenging. Strategies to increase repeat adherence are suggested.
40
Hughes, Karen Leigh. "Repeat adherence to colorectal cancer screening utilising faecal occult blood testing : a community-based approach in a rural setting." Queensland University of Technology, 2006. http://eprints.qut.edu.au/16416/.
Full textAbstract:
In Australia, colorectal cancer (CRC) is the most common registrable cancer affecting both men and women, and the third most common cause of cancer deaths. Clinical data from randomised, controlled trials indicate that population-based screening utilising the faecal occult blood test (FOBT) can reduce mortality from this disease. However, high adherence rates with repeated testing are required to secure these outcomes. This study examines repeat adherence with FOBT screening in a rural community two years after a first screening round was conducted. Patients, aged 50 to 74 years, registered with four local general practices were mailed a FOBT kit with a letter of invitation from their general practitioner. Following the intervention, 119 telephone interviews were conducted with adherers and non-adherers to examine knowledge and attitudes related to screening. Compliance with screening was recorded and compared with first round-data. Participation in the screening program was modest. Of the 3,406 participants eligible for both screening rounds, 34.1% and 34.7% participated in rounds 1 and 2, respectively. A majority of participants (56.8%) did not adhere to either screening, a quarter (25.7%) participated in both rounds, and 17.5% participated in one of the two rounds. First-round adherence was the strongest predictor of second-round adherence (OR=16.29; 95% CI: 13.58, 19.53) with 75.2% of first-round adherers completing a FOBT in round 2. Females were also more likely to adhere in both rounds, although the difference between females and males decreased across rounds. Knowledge and attitudes differed between adherers and non-adherers and are discussed within the context of the major findings. Results from this trial indicate that achieving high levels of compliance in a national screening program will be challenging. Strategies to increase repeat adherence are suggested.
41
Davis, Andrew J. "A Mixed-Method Study of the Effects of a Mindfulness-Based Relapse Prevention Aftercare Program on Clients with Opioid Addiction in a Court-Ordered Population." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1596059927076454.
Full text
42
Saxena, Anshul. "Theory of Gender and Power: Intimate Partner Violence, HIV Status and Sexual Risk Behaviors in Haitian Women." FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3200.
Full textAbstract:
Among women in Haiti, there are a number of factors, including intimate partner violence (IPV), childhood sexual abuse, and alcohol abuse that lead to increased vulnerability to STI/HIV and its sequelae. This study examined the factors associated with IPV and the associations between IPV and HIV in a sample of adult Haitian women.
The current study is a secondary analysis of data collected from HIV+ and HIV- women attending the GHESKIO centers in Haiti. The measures include: Self-reported Questionnaire-20 (SRQ-20); Attitudes Towards Gender Roles; Partner Violence; Alcohol Use Disorders Identification Test (AUDIT); Partner Support; Sexual Relationship Power Scale (SRPS); Centers for Epidemiological Studies Depression Scale (CES-D); the State-Trait Anxiety Inventory (STAI); and, Vaginal Episode Equivalent (VEE). Descriptive statistics were used for demographic characteristics. Pearson correlations, t-Test, Generalized linear model, Logistic regressions, and Generalized linear mixed models were used for estimating the strength of associations.
The mean (SD) age of the participants was 25.5 (5.4) years. Approximately 68.4% had some secondary school education and only 0.9% had a college or professional degree. The majority of participants (82.2%) had a partner, but did not live with them. Generalized linear mixed modelling showed that lack of family support (β = 0.28, p < 0.05), history of childhood sexual abuse (β = 0.66, p < 0.05), and traditional gender-based attitudes (β = 0.10, p < 0.001) predicted major IPV. Results from logistic regression analysis showed that age at sexual debut (AOR: 0.745; 95% CI: 0.585, 0.948) and physical violence (AOR: 3.482; 95% CI: 2.316, 5.235) were significantly associated with HIV seropositive status. Generalized linear mixed modelling analysis showed that decreased relationship control subscale scores (β = -0.26, p < 0.05) and alcohol use problems (β = 0.18, p < 0.05) were significantly associated with high levels of risky sexual behaviors over time.
In summary, a history of IPV was significantly associated with traditional gender based attitudes, history of childhood sexual abuse, and lack of family support. History of IPV and age of first sexual experience were significantly associated with HIV seropositive status. Finally, relationship control and alcohol use problems were significantly associated with sexual risk behavior. These findings indicate potential areas of further study and intervention among Haitian women.
43
Vimont, Michael P. "EXPLORING THE RELATIONSHIP BETWEEN YOUTH ASSETS AND SUBSTANCE USE AMONG RURAL YOUTHS: AN EMPIRICAL PROCESS FOR COMMUNITY BASED PLANNING." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1290018638.
Full text
44
Kaur, Ramandeep. "Impact of a Lifestyle Modification Intervention on Health Behaviors and Health Outcomes in a Mexican American population: A Mixed-methods Study." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3782.
Full textAbstract:
Metabolic syndrome (MetS), a global public health problem, is the primary cause of type 2 diabetes and cardiovascular disorders. Lifestyle modification interventions (dietary and physical activity modifications) are effective in preventing and ameliorating MetS and associated comorbidities. However, the impact of lifestyle changes on MetS among Mexican Americans has yet to be investigated, particularly due to high attrition rates in this population.
The overall goal of the explanatory mixed-methods study presented in this dissertation was to identify efficacious lifestyle modification efforts directed towards Mexican Americans to promote their retention in lifestyle modification programs, ameliorate the severity of MetS, and understand underlying behavior modification process. In particular, we examined secondary data from an extensive study Beyond Sabor to 1) examine predictors of program completion, 2) compare variation in MetS severity scores (z-scores) between intervention (Beyond Sabor) and attention control (Healthy Living) groups, over time and, 3) investigate processual development of self-efficacy in a sample of 1153 disadvantaged Mexican Americans participants.
Findings suggest that program completers were more likely to be older, had more years of education, lower fasting blood glucose levels, and participated in sites with high group cohesiveness. Results also revealed that when compared with the standard nutrition program, Healthy Living, the lifestyle modification intervention, Beyond Sabor, was more effective in ameliorating MetS severity, systolic blood pressure, triglyceride, and fasting plasma glucose levels among study participants. Qualitative results demonstrate the high acceptability of Beyond Sabor intervention. Four sub-themes emerged illustrating important underlying conditions contributing to participants’ improved self-efficacy: desire to gain knowledge about ways to improve health, development of social support, adoption of program teachings in family lifestyle, and improvement in health outcomes.
Findings of the current study may allow researchers to identify Mexican Americans at risk of non-completion and to develop strategies to improve lifestyle modification program attendance, and thus health outcomes. Qualitative findings underscore the importance of sociocultural context on individuals’ attempts to make lifestyle changes to manage their chronic illnesses. Successful adaptation of lifestyle interventions such as Beyond Sabor for at-risk populations in community-based settings will be critical in stemming the tide of MetS.
45
McKinney, Sheila Y. "Exploring Breast Health Perceptions, Behaviors, and Social Cohesion among Ethnically Diverse Black Women." FIU Digital Commons, 2017. http://digitalcommons.fiu.edu/etd/3368.
Full textAbstract:
Purpose
Study explored the relationships of ethnic identity, culture, and social cohesion to mammography, cancer screening, and preventive medical visits among African-American and Afro-Caribbean women in Broward County, FL. Purpose was to understand non-compliance to screening recommendations for breast cancer among disadvantaged Black women in an area of high prevalence.
Methods
A bounded convenience sample of 117 women (49% African-American and 51% Afro-Caribbean) completed a cross-sectional survey and a subset (n=87) participated in semi-structured discussion groups. Both measured perceptions related to breast cancer, defined ethnic identity or culture, and suggested social and cultural factors influence of ethnic identity, culture, and social cohesion on participation with mammograms and preventive medical care visits. Survey included the Multi-Group Ethnic Identity Measure (MEIM) and Other-Group Orientation Scale (OGO) for ethnic identity and the Risk Behavior Diagnosis Scale for cancer perceptions. Methods were bivariate, Mann-Whitney U, linear, and logistic regression.
Results
Half of participants (51%) self-identified as Caribbean. OGO was positively associated with overall attitudes (p< 0.01), perceived urgency (p = 0.05), and perceived benefit related to breast cancer. Linear regression indicated that Afro-Caribbean women (referent) would perceive less urgency to screen (p = 0.05) and lower risk for breast cancer (p = 0.03) than African-American women. Participants explained that personal and neighborhood cultural norms along with health perceptions along with structural factors connected to access and use of medical services influence Black women’s participation in preventive medical services and cancer screening.
Conclusions
Ethnic identity was associated with women’s perceptions of risk, urgency, and benefit for breast cancer screenings. These perceptions may have had a greater influence on the decisions of Afro-Caribbean women not to comply with screening recommendations or participate in preventive medical care actives than for African-American women. Compliance was also mediated by cultural perceptions of fear, relevance, motivation, and sense of support along with other structural factors. All had contributed to the varying degrees that Black women had sought medical care in this community. Thus, tailoring health interventions to account for variations in within-group characteristics is warranted.
[This research was supported in part by NIH/NIGMS R25 GM061347.]
46
Pattath, Priyadarshini. "Internet-based Behavior of IT Professionals: Implications for Online Ergonomic Education to Prevent Work-Related Musculoskeletal Disorders." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4933.
Full textAbstract:
INTERNET-BASED BEHAVIOR OF IT PROFESSIONALS: IMPLICATIONS FOR ONLINE ERGONOMIC EDUCATION TO PREVENT WORK-RELATED MUSCULOSKELETAL DISORDERS
By Priyadarshini Pattath, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Director: Dr. Robin Hurst, Assistant Professor of Adult Learning, Teaching and Learning,
School of Education
The purpose of this study was to explore the preferences of medium of ergonomic education and views about self-directed online training modules to prevent musculoskeletal disorders in computer professionals and understand their perspectives and experiences about online health information seeking using a self-directed learning framework. To accomplish this, a qualitative research design was used to analyze data from interviews and observation. An exploratory case study research design was employed to examine the experiences of fifteen information technology professionals. The findings revealed that the preference for the mode of delivery of ergonomic education depends on the individual attitude and on the perceived attributes of the particular mode of delivery. The findings highlighted the role of the Internet in making significant lifestyle and contextual modifications. Finally, the findings highlighted the barriers that were faced when seeking health information on the Internet. The findings of this study were limited by the nature of the research and sample size. Additional research is needed to support the findings. Implications for research and practice are discussed.
47
Laokri, Samia. "Assessing cost-of-illness in a user's perspective: two bottom-up micro-costing studies towards evidence informed policy-making for tuberculosis control in Sub-saharan Africa." Doctoral thesis, Universite Libre de Bruxelles, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209273.
Full textAbstract:
Health economists, national decision-makers and global health specialists have been interested in calculating the cost of a disease for many years. Only more recently they started to generate more comprehensive frameworks and tools to estimate the full range of healthcare related costs of illness in a user’s perspective in resource-poor settings. There is now an ongoing trend to guide health policy, and identify the most effective ways to achieve universal health coverage. The user fee exemptions health financing schemes, which grounded the tuberculosis control strategy, have been designed to improve access to essential care for ill individuals with a low capacity to pay. After decades of functioning and substantial progress in tuberculosis detection rate and treatment success, this thesis analyses the extent of the coverage (financial and social protection) of two disease control programs in West Africa. Learning from the concept of the medical poverty trap (Whitehead, Dahlgren, et Evans 2001) and available framework related to the economic consequences of illness (McIntyre et al. 2006), a conceptual framework and a data collection tool have been developed to incorporate the direct, indirect and intangible costs and consequences of illness incurred by chronic patients. In several ways, we have sought to provide baseline for comprehensive analysis and standardized methodology to allow comparison across settings, and to contribute to the development of evidence-based knowledge.To begin, filling a knowledge gap (Russell 2004), we have performed microeconomic research on the households’ costs-and-consequences-of-tuberculosis in Burkina Faso and Benin. The two case studies have been conducted both in rural and urban resource-poor settings between 2007 and 2009. This thesis provides new empirical findings on the remaining financial, social and ‘healthcare delivery related organizational’ barriers to access diagnosis and treatment services that are delivered free-of-charge to the population. The direct costs associated with illness incurred by the tuberculosis pulmonary smear-positive patients have constituted a severe economic burden for these households living in permanent budget constraints. Most of these people have spent catastrophic health expenditure to cure tuberculosis and, at the same time, have faced income loss caused by the care-seeking. To cope with the substantial direct and indirect costs of tuberculosis, the patients have shipped their families in impoverishing strategies to mobilize funds for health such as depleting savings, being indebted and even selling livestock and property. Damaging asset portfolios of the disease-affected households on the long run, the coping strategies result in a public health threat. In resource-poor settings, the lack of financial protection for health may impose inability to meet basic needs such as the rights to education, housing, food, social capital and access to primary healthcare. Special feature of our work lies in the breakdown of the information gathered. We have been able to demonstrate significant differences in the volume and nature of the amounts spent across the successive stages of the care-seeking pathway. Notably, pre-diagnosis spending has been proved critical both in the rural and urban contexts. Moreover, disaggregated cost data across income quintiles have highlighted inequities in relation to the direct costs and to the risk of incurring catastrophic health expenditure because of tuberculosis. As part of the case studies, the tuberculosis control strategies have failed to protect the most vulnerable care users from delayed diagnosis and treatment, from important spending even during treatment – including significant medical costs, and from hidden costs that might have been exacerbated by poor health systems. To such devastating situations, the tuberculosis patients have had to endure other difficulties; we mean intangible costs such as pain and suffering including stigmatization and social exclusion as a result of being ill or attending tuberculosis care facilities. The analysis of all the social and economic consequences for tuberculosis-affected households over the entire care-seeking pathway has been identified as an essential element of future cost-of-illness evaluations, as well as the need to conduct benefit incidence assessment to measure equity.
This work has allowed identifying a series of policy weaknesses related to the three dimensions of the universal health coverage for tuberculosis (healthcare services, population and financial protection coverage). The findings have highlighted a gap between the standard costs foreseen by the national programs and the costs in real life. This has suggested that the current strategies lack of patient-centered care, context-oriented approaches and systemic vision resulting in a quality issue in healthcare delivery system (e.g. hidden healthcare related costs). Besides, various adverse effects on households have been raised as potential consequences of illness; such as illness poverty trap, social stigma, possible exclusion from services and participation, and overburdened individuals. These effects have disclosed the lack of social protection at the country level and call for the inclusion of tuberculosis patients in national social schemes. A last policy gap refers to the lack of financial protection and remaining inequities with regards to catastrophic health expenditure still occurring under use fee exemptions strategies. Thereby, one year before 2015 – the deadline set for the Millennium Development Goals – it is a matter of priority for Benin and Burkina Faso and many other countries to tackle adverse effects of the remaining social, economic and health policy and system related barriers to tuberculosis control. These factors have led us to emphasize the need for countries to develop sustainable knowledge.
National decision-makers urgently need to document the failures and bottlenecks. Drawing on the findings, we have considered different ways to strengthen local capacity and generate bottom-up decision-making. To get there, we have shaped a decision framework intended to produce local evidence on the root causes of the lack of policy responsiveness, synthesize available evidence, develop data-driven policies, and translate them into actions.
Beyond this, we have demonstrated that controlling tuberculosis was much more complex than providing free services. The socio-economic context in which people affected by this disease live cannot be dissociated from health policy. The implications of microeconomic research on the households’ costs and responses to tuberculosis may have a larger scope than informing implementation and adaptation of national disease-specific strategies. They can be of great interest to support the definition of guiding principles for further research on social protection schemes, and to produce evidence-based targets and indicators for the reduction and the monitoring of economic burden of illness. In this thesis, we have build on prevailing debates in the field and formulated different assumptions and proposals to inform the WHO Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015. For us, to reflect poor populations’ needs and experiences, global stakeholders should endorse bottom-up and systemic policy-making approaches towards sustainable people-centered health systems.
The findings of the thesis and the various global and national challenges that have emerged from case studies are crucial as the problems we have seen for tuberculosis in West Africa are not limited to this illness, and far outweigh the geographical context of developing countries.
Keywords: Catastrophic health expenditure, Coping strategies, Cost-of-illness studies, Direct, indirect and intangible costs, Evidence-based Public health, Financial and Social protection for health, Health Economics, Health Policy and Systems, Informed Decision-making, Knowledge translation, People-centered policy-making, Systemic approach, Universal Health Coverage
Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished
48
Prosser, Rina Marie. "Laying the Foundation for New Approaches in Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1208.
Full textAbstract:
The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the development of implementation and evaluation plans for the newly adopted policy. The theoretical framework was based on the social, cognitive, and behavior change theories. The program logic model served as a framework to monitor its progress. Existing peer-reviewed literature, including research studies, state and national teen pregnancy prevention projects and curriculum, and publicly available statistics, were gathered and reviewed by the project team as background to be used for developing and changing policy at the institutional level. Project monitoring involved tracking processes surrounding policy and practice guideline development and adoption, as well as implementation and evaluation plan development for the adopted policy and whether these processes progressed as the empirically-derived teen pregnancy prevention projects should when changing sex education policy at the organizational level. This project resulted in policy adoption and developing a policy implementation and evaluation plan to be disseminated within a county school system that could decrease teen pregnancy rates and demonstrate positive outcomes.
49
Rivera, Tania. "The Effects of a 12 Week Nutrition and Physical Activity Intervention Program on Mexican Americans Residing in the Lower Rio Grande Valley, TX." FIU Digital Commons, 2016. http://digitalcommons.fiu.edu/etd/2616.
Full textAbstract:
The obesity epidemic is a global health concern. In the United States alone, 68.5% of adults are categorized as overweight or obese; of these, 35.1% are considered obese. Obesity is a leading cause of morbidity and mortality from diabetes and cardiovascular disease, two diseases adversely affecting minority groups such as Mexican Americans. Yet, a modest 5% decrease in weight, through changes in diet and physical activity, can help control type 2 diabetes.
The current study extracted the dietary data and selected outcome variables from Beyond Sabor, a 12 week intervention conducted in the Lower Rio Grande Valley, Texas, a predominantly Mexican American disadvantaged community. Social Cognitive Theory, guided the design of this culturally tailored intervention. Community resources and natural helpers emerged through the utilization of community based participatory research methods. Study participants (n= 1,273) were recruited from local food bank sites and randomized into treatment and control groups. The treatment group received 12 weekly sessions focusing on healthier eating habits, cooking methods, and physical activity. The control group received 6 nutrition education sessions on similar topics. The study measured changes in several food groups including consumption of soda, fruit juice, and fruit and vegetables. A repeated measures Analysis of Variance was employed to determine changes in treatment and control groups from baseline, post intervention and 40 week follow up. The results showed a significant decrease in soda (F= 8.48, p< .001) and fruit juice (F= 3.12, p= .045) consumption for both groups, with a particular decrease in soda for the treatment group. In addition, there was a significant increase in fruit (F=15.32, p< .001) and vegetable (F=3.16, p= .04) consumption in both groups. The outcome variables selected were weight, body mass index (BMI), and fasting plasma glucose (FPG). There were significant changes for all three variables over time. The intervention resulted in changes in dietary behaviors that ultimately led to changes in weight, BMI, and FPG. It is evident from the current study, that the use of community based helpers facilitated changes in food habits. This study serves as a prognosticator for future interventions.
50
Cruz, Serena. "In Search of Safety, Negotiating Everyday Forms of Risk: Sex Work, Criminalization, and HIV/AIDS in the Slums of Kampala." FIU Digital Commons, 2015. http://digitalcommons.fiu.edu/etd/2293.
Full textAbstract:
This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for how women manage daily risks associated with sex work and criminalization. However, the dissertation also finds that women’s social connections can undermine the strategies they need to manage their HIV/AIDS prevention and treatment. This is because current HIV/AIDS policies prioritize individual behavioral change practices that undermine the complex interpersonal activities developed by women to stay alive. In response, this dissertation concludes that social networks are fundamental to the formation of sex work communities and to the survival of women in the sex trade and should be considered in future HIV policies and programs intending to intervene in the HIV epidemic of female commercial sex workers in Kampala, Uganda.