Thesis (Ph.D.) - University of Queensland, 2003. / Includes bibliography.

Thesis (M.S.)--University of Michigan, 1992.

Background: Oral health is crucial for overall health. Oral health care need is the most prevalent unmet health care need among children and adolescents in the United States. Youth characteristics and socio-demographic factors are known to influence dental health service utilization. While there have been studies listing the factors contributing to the oral health disparities in the Appalachian region, very few studies have inspected the risk behaviours of the youth and their association with dental health care utilization. Methods: A structured questionnaire was administered to high school students in five counties of South-Central Appalachia. The survey included a question on a recent dental visit. The students provided information on socio-demographic characteristics and risk behaviours. Descriptive analysis was performed and the association between recent dental visit as the outcome variable and sociodemographic factors and health risk behaviours as independent variables were analyzed using logistic regression analysis. The analysis was performed using SAS 9.4. Results:80.1% (N= 129) of the adolescents who had admitted to using tobacco products or electronic vapour products reported having visited the dentist in the past 12 months. 87.5% (N= 168) of the females and 80.3% (N=127) of the males reported having visited the dentist in the past 12 months and 81.43% (N=114) of the adolescents who received free or reduced lunch reported having visited the dentist in the past 12 months. Use of tobacco products was the only health risk behaviour significantly associated with dental visit in the past 12 months (p=0.04) after adjusting for covariates with OR=0.5 (95% C I:0.312 -1.01). Conclusion: The findings suggest that health risk behaviours such as using tobacco products may be associated with dental health care utilization and future research should focus on adolescents with health-risk behaviours with the goal of identifying interventions for at-risk populations. Keywords: Oral health, health disparities, youth, health risk behaviours

Hypertension is a global public health issue affecting many people in the United States. African American women remain the highest in percentage by race and ethnicity for developing hypertension with poor risk awareness. Hypertension has costly implications for the health care system. Through lifestyle modifications in the form of a nutrition plan called Dietary Approach to Stop Hypertension and increased physical activity, hypertension could be prevented. Among African Americans, the incidence of hypertension increases in their late thirties. The purpose of the project was to develop a toolkit of resources for African American women between the ages of 20 to 45 years as a reference guide to reduce the risk of developing hypertension through lifestyle modifications. The clinical question for the project examined the effectiveness of a lifestyle modification toolkit as an evidence-based strategy to prevent and manage hypertension among African America women. Pender's health promotion model guided the planning and development of the project. The readability of the toolkit was at a 5th grade level for easy comprehension. A 5-item survey was given to 2 content experts and 3 members from the target population to evaluate the toolkit. Data were analyzed using descriptive statistics to obtain a content validity index score of 1.00. Findings suggested universal agreement on the content of the toolkit which was developed as a resource tool to provide culturally-based educational materials from scholarly literature. This toolkit will promote positive social change by improving the outcomes of African American women with hypertension.

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.

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), which is used to measure 6 different subscales of health promotion behavior. A quantitative approach was used to examine the relationship between hypertensive status and health promotion behavior. With a sample size of 204, this study found that while there was no significant difference in overall HPLP-II scores, the normotensive group scored higher on physical activity (p = 0.001) and stress management (p = 0.004). These differences remained significant even when controlling for body mass index (BMI). Additionally, the study found high smoking rates and elevated BMI across both samples. These results suggest that interventions that target stress management and physical activity and use the cultural strengths of interpersonal relationships and spiritual growth may be the most effective. This information may be used as a foundation in future interventional studies and may create significant social change by decreasing hypertension among the Armenian American population and increasing awareness of risk factors and prevention.

No description available.

BACKGROUND: Weight misperception has been documented among children although the impact on health risk behaviors is less understood, particularly among middle school students. The goals of this study were to describe sociodemographic differences in actual and perceived weight, correspondence between actual and perceived weight, and weight-related health risk behaviors, as well as to examine weight misperception and interactions with sociodemographic variables in explaining weight-related health risk behaviors. METHODS: Participants were recruited at 11 public school districts participating in the Tennessee Coordinated School Health (CSH) pilot program. A total of 10,273 middle school students completed the Centers for Disease Control and Prevention's Youth Risk Behavior Survey administered by teachers in the school setting. RESULTS: Findings revealed sociodemographic differences in actual and perceived weight as well as weight misperception. Although overestimating one's weight was significantly related to greater likelihood of weight-related health risk behaviors, significant interactions showed this relationship to be especially pronounced in females. Additional distinctions based on sociodemographic variables are indicated. CONCLUSIONS: Results highlight the importance of screening for health risk behaviors including weight misperception among middle school students. The CSH program offers an opportunity to understand health risk behaviors among students while also informing and evaluating methods for intervention. © 2014, American School Health Association.

Human-Computer Interaction (HCI) research typically studies behavior change by measuring behavior outcomes, but this is not always feasible nor the only way to study persuasive technologies. Understanding how users interact with and integrate persuasive systems into their daily lives can also guide the evaluation of such systems. Often times, theories about behavior change in persuasive systems lack contextual specificity, which is why this study explores the online courses of Lifted to understand behavior change within the context of online health coaching. Four coaches and eight users were interviewed about their interactions and perceptions of Lifted’s online health coaching platform to help understand which features of the course platform support user retention. Key features identified as persuasive were those that supported personalization, sense of community or users’ commitment to the course. In the future the identified themes and features can tentatively guide the development and design of online health coaching platforms. / Forskning inom människa-dator interaktion (MDI) brukar fokusera på beteendeförändring genom att mäta utfallet av ett beteende. Detta är inte alltid möjligt att tillämpa eller det enda sättet att studera persuasiva teknologier. Att förstå hur användaren interagerar med persuasiva system och integrerar dem i sina vardagliga liv kan också styra utvärdering av sådana system. De flesta beteendeteorier är inte kontextspecifika, vilket är ett skäl till varför den här studien utforskar onlinekurser av Lifted för att förstå beteendeförändring i kontexten av online hälsocoaching. Fyra tränade och åtta användare intervjuades om deras interaktioner och uppfattning av Lifteds hälsocoaching för att förstå vad de är på plattformen som gör att användarna återvänder. Nyckelfunktioner som identifierades som persuasiva var sådana som stödde personifiering, gemenskapen eller användarnas engagemang i kursen. De identifierade funktionerna kan komma till användning vid utvecklingen av hälsocoachingplattformar.

Information on the overall health risk behaviors of college students is limited and it is unknown if being enrolled in an elective or a required health course affects behavior change among the students. There are mixed reports on whether or not health education courses affect behavior change. Factors that may affect change are self-efficacy and the constructs that build the Health Belief Model (i.e. perceived susceptibility and perceived barriers). A sample of convenience was gathered for the current study using two universities in the state of Virginia. Virginia Tech students within the sample were enrolled in an elective health course (n = 375) and James Madison University students within the sample were enrolled in a required health course (n = 202). The National College Health Risk Behavior Survey (NCHRBS) and the Self-Efficacy Scale survey were used to gather information on overall health risk behaviors, health behavior changes, and self-efficacy levels of the students. To acquire health behavior change data, the NCHRBS was administered at the beginning of the Fall 2003 semester and again at the end of the semester. The results of the study indicated that, overall, the type of course a student was enrolled in and self-efficacy did not have a significant effect on health behavior change. However, possible trends were identified with alcohol use, tobacco use, and dietary behaviors, indicating that further research should be performed to analyze underlying factors, not analyzed in this study, which may be affecting health risk behaviors. / Ph. D.