This study attempted to determine the relation between womens' anticipation of Esteem-Threat, their level of satisfaction, and their utilization of prenatal care services in the public assistance setting. One-hundred twenty-six women completed a battery of questionnaires during an initial clinic visit. Measures of patient datisfaction were completed after a minimum of four clinic visits. Results showed a significant linear relation between womens' anticipation of Esteem-Threat and satisfaction with services. No relations were found between Esteem-Threat and the timing of entry into prenatal care. A small, statistically significant relation was found between Esteem-Threat and the number of appointments kept. Results are discussed in the context of the limitations of the sample and the psychometric properties of the measures. Future applications of the Esteem-Threat model are also discussed. / Ph. D.

Corporate leaders at Dominion Bankshares Corporation established an on-site child care facility at its operations center for its Roanoke, Virginia employees. The immediate supervisors of parents of children enrolled in the Dominion Child Development Center were surveyed to determine the factors they believed affected worker productivity and their perceptions of how employees' work habits had changed as a result of the opening of the child care center. A description of the demographic characteristics of persons who supervise employees who use Dominion Bank's Child Development Center is included. The supervisors of persons using the on-site child care center were primarily white males from 36 to 45 years old with ten or fewer years experience with the corporation. These supervisors perceived that employee productivity is mostly affected by employee morale, emotional stress level, and absenteeism. Supervisors believed that employee morale, productivity, and absenteeism related to child care improved after the opening of the Dominion Child Development Center. Some corporate leaders call the lack of affordable, licensed child care an economic problem for our society. Many supervisors are not aware that their employees' child care dilemmas affect job performance. Inservice training could provide educational opportunities to improve attitudes and increase awareness. / Master of Science

This study presents findings on the dental health status of a portion of the children participating in the dental component of the Child Health Investment Partnership (CHIP). The children in the CHIP group were compared on six variables to a comparison group of children seen at one participating CHIP dental office. Analyses of the data collected from the examination of 67 CHIP children and 178 children in the comparison group ages 2-13 revealed that upon initial visit to the dental office, the mean DMF score was .83 and 2.00, respectively. Dental visits at six months, revealed mean DMF values of 1.23 for the CHIP group and 2.65 for the comparison group. At one year dental visits, the CHIP group mean DMF score was 2.00 and the comparison group mean DMF score was 2.40. At six month and one year dental visits the CHIP group, when compared to the comparison group, receives no significantly different level of treatment (F/DMF) or experiences a Significantly different level of morbidity (D/DMF). The percentage of failed appointments was not found to be significantly different at 21% (comparison group) and 20% (CHIP). A survey containing nine questions was constructed by the researcher and administered to five dentists participating in the CHIP program. Missed appointments and low reimbursement were the only areas noted for improvement. Results revealed successful progress of the dental care received by CHIP children. This research will aid CHIP staff in determining the effectiveness of the dental health component of CHIP and will provide a baseline study from which future evaluation of the program may expand. / Master of Science

Extensive research suggests linkages among low income, erratic or ineffective parenting behaviors, and impaired health and development among children. Family support programs, offering a range of comprehensive services to low income families, have demonstrated positive health and life performance outcomes, both for children and parents. One such program, the Comprehensive Health Investment Project (CHIP) in Roanoke, Virginia, works to provide primary physician care to low income young children. One of CHIP's objectives is to enhance parenting skills so that parents can help maintain good health among their children. This study attempted to assess parents' beliefs about child development among a sample of CHIP parents and a sample of parents from a similar SES group (drawn from CHIP's waiting list) using a Likert-style opinionnaire. Results from both between-group tests and within-group (CHIP sample) tests indicate homogenous and favorable reported beliefs about child development. Very little association was found between demographic variables and responses. Suggestions regarding the practical use of these findings and recommendations for future research are made. / Master of Science

Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index. A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail. / Master of Science

National health care reform proposals advocate Primary Health Care (PHC) and preventive medicine as an efficacious way to control health care costs in the United States. This study examined a community in rural, southwest Virginia and evaluated the potential for PHC success. The study used focus groups to determine how Women Users, as consumers of health care, view their health and health care problems and potential solutions. Views of Community Leaders and Service Providers, as controllers of services, were obtained using semi-structured interviews. The results were compared using the PRECEDE framework of predisposing, enabling, and reinforcing factors influencing health behavior. This study was a component of a larger project - The Dickenson County Women's Health Project. The premise of that project was that women in Dickenson County would respond to a health education intervention program and the goal was to develop such a program. This study shows that Women Users fully comprehend the health behaviors and available services that would make themselves more healthy, but feel constrained by enabling and reinforcing factors that prevent healthy lifestyles. By contrast, Service Providers and Community Leaders focus on predisposing factors and remain convinced that women in Dickenson County need more education about healthy lifestyles and available health services. The study concludes that the women of Dickenson County are valuable resources for health program development. The success of PHC in Dickenson County is wholly dependent upon developing a mechanism whereby women are given a greater voice in program development and implementation. / Master of Urban Affairs

The purposes of this study were: (1) to present a picture of the home-management aspect of a selected group of Farm Security families, {2) to picture in more detail the clothing and dietary problems of these families, (3) to determine whether family life is satisfying to this selected group of Farm Security women, (4) to ascertain the stability of the family members, and (5) on the basis of these findings, to make suggestions for helping Farm Security families to more satisfactory living. / Master of Science