Thesis (M.S.)--University of Michigan, 1994.

Thesis (M.S.)--University of Michigan, 1994.

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.

Anyone who understands MI as a process may spontaneously think that five weeks of MI conversations may be a little short of time to be able to see a clear effect. At least that was my spontaneous thought. This was precisely the starting point of the study, which further led to the purpose of the study, i.e. to evaluate MI as a conversation method and see how effective the method is over a five-week period in a health and lifestyle-related behavior change. The aim is further specified by two questions: How has the health-related behavior changed during five weeks of MI-sessions based on the transtheoretical model? How has motivation changed over five weeks of MI-sessions? In order to answer the purpose and questions, MI- sessions with four female clients have been conducted over five weeks. In order to measure the effect of the MI-sessions, the clients during their first and last call answered scale questions intended to measure the client's motivation. In addition, each conversation has been documented in writing by me as conversation leader, where the most essential parts of the conversation have been noted to make it possible to follow the client's development in the transtheoretical model. The result showed that MI contributed to a strengthened intrinsic motivation as well as progress in the transtheoretical model as a result of a five-week period of MI-sessions. Through the study, it can be concluded that five weeks of MI-sessions are enough to strengthen the inner motivation and develop in the transtheoretical model. / Den som är införstådd i MI som process kanske spontant tänker att fem veckor av MI-samtal kan vara lite kort om tid för att kunna se en klar effekt. Det var åtminstone min spontana tanke. Just detta blev studiens utgångpunkt som vidare ledde fram till syftet med studien d.v.s. att utvärdera MI som samtalsmetod och se hur effektiv metoden är under en femveckorsperiod vid en hälso- och livsstilsrelaterad beteendeförändring. Syftet specificeras vidare av två frågeställningar: Hur har det hälsorelaterade beteendet förändrats under fem veckor av MI- samtal utifrån den transteoretiska modellen? Hur har motivationen förändrats under fem veckor av MI-samtal? För att besvara syftet och frågeställningarna har MI-samtal med fyra kvinnliga klienter genomförts under fem veckor. För att mäta effekten av MI-samtalen har klienterna under sitt första och sista samtal besvarat skalfrågor som avser mäta klientens motivation. Dessutom har varje samtal dokumenterats i skrift av mig som samtalsledare där samtalets mest väsentliga delar noterats för att göra det möjligt att följa klientens utveckling i den transteoretiska modellen. Resultatet visade att MI bidrog till en stärkt inre motivation samt framsteg i den transteoretiska modellen till följd av en femveckorsperiod av MI-samtal. Genom studien kan man dra slutsatsen att fem veckor av MI-samtal räcker gott för att stärka den inre motivationen samt utvecklas i den transteoretiska modellen.

Background: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods: 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results: BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student’s risk profile. Knowledge did not serve as a mediator for intention building. Conclusions: The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student’s risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.

The purpose of this project was to explore perceptions of effective components in adolescent suicide prevention programs among San Bernardino school counselors. The stress model and the mental health model are the two models implemented in suicide prevention programs.

Background: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods: 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results: BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student’s risk profile. Knowledge did not serve as a mediator for intention building. Conclusions: The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student’s risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.

No description available.

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.

The author of the thesis formulates theoretical starting points, which draws attention to the problems of the health care system. It emphasizes the role of the individual and describes the mechanism by which it is possible to naturally and freely intervene in the health insurance system. A key role in this mechanism is provided by health insurers, which have the potential to moderate the relationship of the insured with the health system. The health insurer can do so by segmenting their insured and product orientation. The construction of the "ideal insured" should contribute to the this segmentation. The construction is based on the active and autonomous approach of the insured, these qualities are highly valued in the theory presented and it is assumed that this approach is desirable in terms of prevention. The author has created a tool to measure this construct. The tool is in the form of a questionnaire that is systematicaly reduced to include as few items as possible so it can be easily used in practice. Practical usability is the primary goal of creating this instrument to measure "ideal insured".