Health seeking behaviour is important in older people with hypertension and overweight, in terms of managing health factors that are related to their health and illness. However, health seeking behaviour of Thai older people is not well documented. This qualitative study aimed to describe health seeking behaviour of overweight hypertensive older people. Seven older women and three men participated in this study through purposive sampling. Qualitative data were gathered via in-depth interviews and were analyzed using content analysis. The results of this study illustrated that older people started to seek health care after understanding the need to seek health care due to the severity of their symptoms. The older people began illness management by using their knowledge to take care of themselves. If management was ineffective, they would seek health care from professional health care providers and traditional healers. Additionally, family members play important roles in the health seeking behaviour of older people. In particular, Thai older people with hypertension and overweight demonstrate various health seeking behaviours that are useful to health care providers in providing appropriate care to these older people, aiming to promote better health of the older people.

abstract: Access to testing for the human immunodeficiency virus (HIV), as well as other care services related to HIV/AIDS, have greatly improved in Tanzania over the last decade. Despite the country’s efforts to increase the number of individuals who get tested for HIV annually, it is estimated that only 52.2-70.0% of people living with HIV (PLWH) knew their HIV positive status at the end of 2017. In addition, research in Tanzania has shown that HIV-related stigma and discrimination are widespread and contribute to low uptake of HIV testing and non-adherence to antiretroviral treatment (ART). In order to achieve the goals set forth by the Government of Tanzania and the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as move towards an AIDS-free generation, a deeper understanding of the stigma-related barriers to seeking an HIV test is necessary. This research aims to better understand the relationship between HIV-related stigma and attitudes towards HIV testing among community members in Northern Tanzania. In addition, it looked at the specific barriers that contribute to low uptake of HIV testing, as well as the impact of social networks on an individual’s motivation and willingness to get tested for HIV. In this research, community members in Meru District (N = 108, male = 69.4%, female = 28.7%) were surveyed using various validated instruments that covered a range of topics, including knowledge of HIV/AIDS, testing attitudes, and perceived risk of HIV infection. The mean overall score for correct answers on the knowledge measure was 69.8% (SD = 16.4). There were no significant group differences between individuals who had ever tested and individuals who had not tested in relation to HIV/AIDS knowledge or HIV testing attitudes. The factors that were significantly associated with getting an HIV test were knowing someone who had previously tested (p = 0.003), as well as openly discussing HIV testing within one’s social group (p = 0.017). Participants also provided qualitative responses for barriers to receiving an HIV test, motivations for getting tested, and suggested interventions for improving HIV testing uptake. The goal of this research is to develop recommendations for interventions that are better informed by attitudes and motivations for testing. / Dissertation/Thesis / Masters Thesis Biology 2019

The results of this study indicate that two groups of mothers share a relatively similar socioeconomic status, knowledge of health and hygiene, and have similar health-seeking behaviors. The mothers' lack of knowledge and their local view of illnesses seemed to embody questionable newborn care related to breastfeeding practices and oil applications to newborns. Three psychosocial factors that appeared to contribute to the mother's health-seeking behaviors were attitudinal factors (this consisted of favorable or unfavorable perceptions toward services based on the mother's prior experiences or familiarity with service), social pressures (opinions from others and the mother's competing responsibilities), and self-efficacies accessibility, availability, and affordability). In addition, the external factor of poverty in the slum settlements was also a significant factor which determined the mother's health seeking behaviors. The implications of these findings are discussed in further detail, which are then followed by a set of recommendations for future health interventions designed to reduce the risk of sepsis neonatorum in urban communities. This study underscores the benefits of integrating the perspectives of anthropology and public health to further the understanding of the neonatal health problem. Finally, the need for future studies is addressed as it is necessary to further understand the existing local practices and beliefs in relation to the risks of sepsis neonatorum.

Disparities exist in the health-seeking behavior of African American (AA) women in the United States. Specifically, AA women 40 years and older often do not adhere to guidelines for breast cancer screening because of demographic and socioeconomic factors that have impacted health disparities. The purpose of this study was to research negative health-seeking behavior toward early-stage breast cancer detection in AA women 40 years and older. The main research questions addressed whether there is a relationship between negative health-seeking behavior, operationally defined as lack of a personal doctor, lack of health insurance, and lack of doctor visits within the past 12 months, and early-stage breast cancer detection, operationally defined as lack of mammogram screening within the past 2 years, in AA women 40 years and older. This quantitative study was guided by the health belief model. A cross-sectional design was used along with secondary data from the 2016 Behavioral Risk Factor Surveillance System survey. Wald chi-square was used to examine the relationship between the dependent variables and the independent variable. The relationship between lack of a personal doctor, lack of health insurance, lack of doctor visits within the past 12 months, and lack of mammogram screening within the past 2 years was statistically significant at p < .05. The findings based on the significance between the variables confirmed that negative health- seeking behavior affects early-stage breast cancer detection in AA women 40 years and older. The results of this study may inform the development of educational programs that are instrumental in promoting and improving mammogram screening and early-stage breast cancer detection among AA women age 40 years and older.

Malaria in pregnancy remains a public health challenge in Nigeria despite the fund appropriation for malaria control. The health challenges of malaria in pregnancy vary with populations and there is limited knowledge on the impact of the socioeconomic status and health-seeking behavior on malaria in pregnancy in Nigeria. The objective of this cross-sectional quantitative survey was to examine whether socioeconomic status and health-seeking behavior predict malaria in pregnancy in Nigeria using the social cognitive theoretical model. The data from a 2015 Nigeria Malaria Indicator Survey was used in this study. Data were analyzed using chi-square, binary, and multivariate logistics regression analyses. The study demonstrated that socioeconomic status (wealth index/income [Poorest: OR 2.709, 95% CI 1.869-3.928, p 0.000; Poorer: OR 1.791, 95% CI 1.256-2.555, p 0.00] and no education: OR 2.868, 95% CI 1.761-4.671, p 0.000) made significant contributions in predicting malaria in pregnancy. The research results also showed that socioeconomic status is a predictor of health-seeking behavior (wealth index/income [Poorest: OR 0.414, 95% CI 0.244-0.705, p 0.001], no education: OR 0.329, 95% CI 0.174-0.622, p 0.001 and primary education: OR 0.348, 95% CI 0.191-0.636, p 0.001). Additionally, the study findings showed that malaria in pregnancy determined the choice of formal health-seeking behavior by pregnant women (malaria in pregnancy: OR 0.551, 95% CI 0.469-0.648, p 0.000). The results of this research might guide Nigeria's Ministry of Health to develop approaches on women empowerment that would focus on socioeconomic status and health-seeking behavior of women such as programs to improve women's education and income generation.

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive African Americans had improved since 2008 following the introduction of new treatment options, as compared to other HCV-positive racial/ethnic groups, using secondary data analyses with survey datasets from the National Health and Nutrition Examination Survey, 2005-2012. Using chi-square test of difference and logistic regression analyses, the study did not identify a statistically significant relationship between health care seeking behavior and responses from health care providers for HCV-positive African Americans before (2005-2008) and after (2009-2012) the introduction of new treatment options as compared to other HCV-positive racial/ethnic groups. Given the ongoing development of new and improved drugs to treat HCV infection, further research might focus on the HCV-infected population as a whole to ascertain whether differences exist as compared to earlier therapies before 2013. This study may drive social change within the health care community by raising awareness of the risks of HCV infection resulting in less provider bias and the introduction of resources into the African American and underserved communities that will improve outcomes and reduce barriers to care.

The purpose of this current study was to determine the role of acculturation, ethnic identity, and religious fatalism regarding attitudes towards seeking psychological help among Coptic (Egyptian Christian) Americans. In addition, differences between groups of gender and generational status, first-generation adult immigrants versus U.S.-born second-generation Copts, were analyzed. The study had a total sample of 91 individuals that self-identified as Coptic by race and/or Coptic Orthodox by religion, who voluntarily completed an anonymous online questionnaire. Results indicate that ethnic identity and acculturation are strong predictors of religious fatalistic beliefs, and those who identified as having more Arab ethnic identity and less assimilation to dominate culture have stronger religious fatalistic beliefs than those who identified with more western culture and an American ethnic identity. However, religious fatalism and ethnic identity were not significant predictors of attitudes towards seeking psychological help, and other variables such as stigma, language barriers, and skepticism of western psychology may be better predictors of attitudes towards seeking psychological help. Between groups comparisons identified subtle differences between males and females, and between first and second-generation Coptic Americans on acculturation, ethnic identity, and religious fatalism, but the groups were not statistically significant from one another. Clinical implications and directions for future research will also be discussed.