Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.S.P.H.)--University of Michigan, 1939.

Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.P.H.)--University of Michigan, 1945. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.P.H.)--University of Michigan, 1947.

Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.S.P.H.)--University of Michigan, 1941.

<p> High blood pressure (HBP) is a worldwide concern in many countries (Keamey, et al., 2005). HBP is likely to be higher in underdeveloped countries, specifically in Africa (Addo, Smeeth, &amp; Leon, 2007; Kearney, et al.,2005; World Health Organization [WHO], 2015). The prevalence of HBP in South Africa is 21%, which is about 6 million individuals (Steyn, Gaziano, Bradshaw, Laubscher, &amp; Fourier, 2001). The purpose of the study is to examine the predictive factors of HBP among older adults in South Africa. This cross-sectional study used secondary data from the World Health Organization (WHO &amp; Phaswana-Mafaya, 2008). The total number of participants included in this sample was 2,145 adults age 60 and over, of which females comprise 59%. The average age was 69.50 years (<i>SD= 7.63</i>). The prevalence of reporting HBP among respondents was 37%. The multivariate analysis shows that, when other factors are controlled, being female, having a larger waist circumference, having a diagnosis of diabetes and depression, and urban residence significantly predicted HBP among older South Africans. When comparing men and women, the results of the logistic regression shows that the decrease of odds of having HBP among men who have diabetes and depression is less than the decrease of odds of having HBP among women who have diabetes and depression. These findings indicate that the risk factors, diabetes and depression, have a bigger effect on females compared to males. The results of the study will help to implement primary HBP prevention targeting South African older adult females who have been diagnosed with diabetes, depression, and who live in urban areas.</p><p>

<p> This dissertation consists of two substudies. The objectives of Substudy 1 were as follows: 1) to examine changes in obesity rates throughout elementary school in a large sample of children with respect to socioecological factors, especially trends in body mass index (BMI) and the prevalence of &ldquo;severe high obesity&rdquo; during elementary school, and 2) to explore the longitudinal effect of socioecological obesogenic factors (including individual, parental, familial, and environmental factors) on the transition from a normal/healthy weight to being overweight or obese among children aged three to 13 years old. This longitudinal panel study used the Early Childhood Longitudinal Study Program (ECLS-K). A modified socioecological model was used as a conceptual framework to guide the investigation of this study&rsquo;s research questions. Two longitudinal ordered regressions were performed to determine the associations between socioecological obesogenic variables (e.g., family activity and parental involvement) and changes in obesity rates, as well as the transition from a normal/healthy weight to being overweight, obese, or severely obese. A total of 1,264 children (representing 379,297 at the population level) were identified for this study (mean age: 5.24 years; female: 48.7% at baseline). Hispanics and other nonwhite children, children with less socioeconomic and environmental support, and children living in households with fewer family members were more likely than their counterparts to gain weight (all <i>p</i>s &lt; 0.05). This study revealed multiple dimensions of how sociological obesogenic factors influence children&rsquo;s weight increases and transitions in a longitudinal setting. Unhealthy BMI status among children was affected not only by individual factors but also by parents, family, and environments. Parents and family play a crucial role in children&rsquo;s physical activity and nutrition, and obtaining family and environmental support is critically important for maintaining a healthy BMI status. The findings suggest that a greater focus on family and social support is necessary to help children maintain a healthy weight over time. </p><p> Substudy 2 aimed to investigate the association between the Head Start Program and children&rsquo;s BMI status, as well as their quality of life with respect to socioecological obesogenic factors. This cross-sectional study employed the ECLS-K as well. A propensity-score matching analysis was performed to examine the association between the Head Start Program and children&rsquo;s BMI status, as well as the quality of life, controlling for socioecological obesogenic factors. A total of 3,753 children (representing 1,284,209 at the population level) were recruited for this study (mean age: 13.69 years; female: 49.42%). In the final matched model, the Head Start Program did not have a statistically significant effect on children&rsquo;s obesity. Children who were African American, had less participation in school-sponsored activities, perceived themselves as overweight, lived in a household with fewer family members, and had less strict TV regulations were more likely to be overweight than their counterparts (all <i>p</i>s &lt; 0.05). Evidence suggests that multiple dimensions of sociological obesogenic factors&mdash;including individual as well as parental, familial, and community support factors&mdash;affect the weight of children from low-income families and should be considered when establishing behavioral and policy interventions to thwart the childhood obesity epidemic.</p><p>

<p> While obesity is a nationwide phenomenon, African Americans &ndash; especially women &ndash; continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss program. Questions were asked about the cultural, environmental and social barriers to weight loss, and the components of effective church-based weight loss programs. Using a phenomenological approach, this study was designed to capture new data for the development of sustainable church-based weight-loss programs. The theory of social support was used as a theoretical framework. The major themes arising from the data concerned the importance of: (a) social support on all levels; (b) the involvement of the pastor, his spouse, or other church leadership; (c) the inclusion of weight-loss participants in program design; (d) a holistic program design to meet the needs of the entire family; and (e) a culturally sensitive program. The inclusion of all these elements is recommended for future programs. The social change implication is that these recommendations could be helpful in the design, development, and implementation of sustainable church-based weight-loss programs for African American women.</p><p>