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Title: "What We Eat Matters": Perspectives on Food and Health in the Mexican Im/migrant Farmworker Communities in Indian River County, Florida.
Creator: Puerto, Hugo, Reyes-Foster, Beatriz, Mishtal, Joanna, Matejowsky, Ty, University of Central Florida
Abstract / Description: The dramatic increase of type-2 diabetes within the Latino community is of great concern in the U.S., especially among Mexican im/migrant farmworkers. Anthropological scholarship shows that health issues within im/migrant groups in the U.S. are poorly understood from a sociocultural and local perspective. In Indian River County, Florida, farmworker leaders created a community garden in response to health problems in this community. This initiative was launched to educate families about the...
Show moreThe dramatic increase of type-2 diabetes within the Latino community is of great concern in the U.S., especially among Mexican im/migrant farmworkers. Anthropological scholarship shows that health issues within im/migrant groups in the U.S. are poorly understood from a sociocultural and local perspective. In Indian River County, Florida, farmworker leaders created a community garden in response to health problems in this community. This initiative was launched to educate families about the health and economic benefits of growing their own food. The Indian River County Health Department and the local leaders are working collaboratively to inform the community about the risks of type-2 diabetes by providing educational lectures about health, food, and nutrition, in an effort to engage the farmworkers to actively participate in community gardens. However, little engagement to this initiative has been observed within the farmworker community. This ethnographic investigation examines the challenges of involving Mexican im/migrant farmworkers in community-based solutions to health problems. Based on participant observation, survey, and interview data with farmworkers and key informants from the Farmworkers Association of Florida, this project examines the perspectives of health concerns and the role of grassroots initiatives in addressing health needs. Specifically, it analyzes barriers to healthy eating and explores how community gardens can improve health outcomes in farmworker communities. This research contributes to the understanding of Mexican im/migrant farmworkers' health in Indian River County, and it has the potential to guide health-related policies pertaining to im/migrant communities in general.
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Date Issued: 2015
Identifier: CFE0005692, ucf:50114
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005692

Title: A Faith-Based Primary Diabetes Prevention Intervention for At-Risk Puerto Rican Adults: A Feasibility Study.
Creator: Torres-Thomas, Sylvia, Chase, Susan, Covelli, Maureen, Gonzalez, Laura, Yan, Xin, Miller, Ann, University of Central Florida
Abstract / Description: Diabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a...
Show moreDiabetes is a serious health threat that disproportionately affects Hispanics of Puerto Rican heritage. Current evidence supports diabetes prevention programs to change health behaviors in people who are at risk and thus prevent the development of type 2 diabetes. However, few interventions exist for Hispanics, and even fewer have been designed for Puerto Rican adults. A literature review of community-based diabetes prevention programs involving at-risk Hispanics was conducted using a cultural sensitivity framework to determine the state of the science and identify gaps in knowledge regarding diabetes prevention for Puerto Ricans. An integrated theoretical framework was developed using constructs from the extended parallel process model (perceived severity and susceptibility) and social cognitive theory (self-efficacy) to design program components aimed to educate and motivate positive dietary behavior change in Puerto Rican adults. The two key components were a diabetes health threat message and dietary skill building exercises that incorporated spirituality and relevant faith practices, and were culturally-tailored for Puerto Ricans. A pretest-posttest, concurrent mixed methods design was used to test the impact and evaluate feasibility of a diabetes health threat message and skill-building exercises in a sample of Puerto Rican adults. A total of 24 participants enrolled in the study and attended six-weekly meetings that included baseline data collection, a health threat message, dietary skill building exercises, focus group interviews, posttest data collection, and an end-of-study potluck gathering. All of the study participants were Puerto Rican and a majority were female (70.8%), with a mean age of 55.5 years (SD 13.71). Most had a family history of diabetes (n = 21, 87.5%) and believed they were at-risk for the disease (n = 16, 66.7%). Using Wilcoxon matched-pairs signed rank test, significant increases or improvements were found in perceptions of diabetes severity (p (<) .01), dietary self-efficacy (p = .002), and dietary patterns (p = .02) at posttest in comparison to baseline. Spearman's rank correlations found moderate to strong relationships between the following variables: perceived severity and weight (rs = -.44, p = .03), dietary self-efficacy and dietary patterns (rs = .43, p = .04), dietary self-efficacy and fasting blood glucose levels (rs = - .45, p = .03), and American acculturation and weight (rs = .51, p = .02). The qualitative themes that emerged contributed to our understanding of participants' perspective relative to the health threat message, dietary skill building exercises, and the importance of cultural relevance and spirituality. The data support feasibility of this faith-based intervention that had an attendance rate of 58% and no loss of sample due to attrition. Diabetes prevention interventions for at-risk Puerto Ricans adults that incorporate a faith-based, culturally-tailored health threat message and dietary skill building exercises may help educate those who are at-risk and motivate lifestyle behavior change to prevent the development of diabetes. Further faith-based, culturally-tailored diabetes prevention research is indicated for Puerto Rican adults.
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Date Issued: 2015
Identifier: CFE0005725, ucf:50124
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005725

Title: Structural Health Monitoring using Novel Sensing Technologies and Data Analysis Methods.
Creator: Malekzadeh, Seyedmasoud, Catbas, Fikret, Yun, Hae-Bum, Tatari, Mehmet, Moslehy, Faissal, Gul, Mustafa, University of Central Florida
Abstract / Description: The main objective of this research is to explore, investigate and develop the new data analysis techniques along with novel sensing technologies for structural health monitoring applications. The study has three main parts. First, a systematic comparative evaluation of some of the most common and promising methods is carried out along with a combined method proposed in this study for mitigating drawbacks of some of the techniques. Secondly, non-parametric methods are evaluated on a real life...
Show moreThe main objective of this research is to explore, investigate and develop the new data analysis techniques along with novel sensing technologies for structural health monitoring applications. The study has three main parts. First, a systematic comparative evaluation of some of the most common and promising methods is carried out along with a combined method proposed in this study for mitigating drawbacks of some of the techniques. Secondly, non-parametric methods are evaluated on a real life movable bridge. Finally, a hybrid approach for non-parametric and parametric method is proposed and demonstrated for more in depth understanding of the structural performance. In view of that, it is shown in the literature that four efficient non-parametric algorithms including, Cross Correlation Analysis (CCA), Robust Regression Analysis (RRA), Moving Cross Correlation Analysis (MCCA) and Moving Principal Component Analysis (MPCA) have shown promise with respect to the conducted numerical studies. As a result, these methods are selected for further systematic and comparative evaluation using experimental data. A comprehensive experimental test is designed utilizing Fiber Bragg Grating (FBG) sensors simulating some of the most critical and common damage scenarios on a unique experimental structure in the laboratory. Subsequently the SHM data, that is generated and collected under different damage scenarios, are employed for comparative study of the selected techniques based on critical criteria such as detectability, time to detection, effect of noise, computational time and size of the window. The observations indicate that while MPCA has the best detectability, it does not perform very reliable results in terms of time to detection. As a result, a machine-learning based algorithm is explored that not only reduces the associated delay with MPCA but further improves the detectability performance. Accordingly, the MPCA and MCCA are combined to introduce an improved algorithm named MPCA-CCA. The new algorithm is evaluated through both experimental and real-life studies. It is realized that while the methods identified above have failed to detect the simulated damage on a movable bridge, the MPCA-CCA algorithm successfully identified the induced damage. An investigative study for automated data processing method is developed using non-parametric data analysis methods for real-time condition maintenance monitoring of critical mechanical components of a movable bridge. A maintenance condition index is defined for identifying and tracking the critical maintenance issues. The efficiency of the maintenance condition index is then investigated and demonstrated against some of the corresponding maintenance problems that have been visually and independently identified for the bridge.Finally, a hybrid data interpretation framework is designed taking advantage of the benefits of both parametric and non-parametric approaches and mitigating their shortcomings. The proposed approach can then be employed not only to detect the damage but also to assess the identified abnormal behavior. This approach is also employed for optimized sensor number and locations on the structure.
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Date Issued: 2014
Identifier: CFE0005207, ucf:50648
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005207

Title: LOW-INCOME HEALTH CARE NETWORKS: INITIAL CONDITIONS, EXTENT, AND INTENSITY RELEVANT TO COUNTY GOVERNMENT PARTICIPATION.
Creator: Knepper, Hillary, Feldheim, Mary Ann, University of Central Florida
Abstract / Description: Contemporary health care systems in the United States are not equitable. Indeed, as the literature indicates, there are substantial differences in the variety and scope of service delivery based on age, income, and other socio-economic indicators. The recent passage of health care reform in the United States illustrates that Americans are seeking to bring balance and equity to health care. However, as learned in this study, county governments across the country have been working in their...
Show moreContemporary health care systems in the United States are not equitable. Indeed, as the literature indicates, there are substantial differences in the variety and scope of service delivery based on age, income, and other socio-economic indicators. The recent passage of health care reform in the United States illustrates that Americans are seeking to bring balance and equity to health care. However, as learned in this study, county governments across the country have been working in their communities to ensure some balance and equity, by making a safety net available for those citizens who are unable to access health care. Perhaps this is because health care quickly becomes a local government problem. In this current economic climate, county governments are being pinched between declining revenues and rising demands for services (Eaton, 2009; Phaup, 2009). The Orange County Primary Care Access Network is one example studied here that provides clear evidence of how organizations can work together to develop and maintain a sustainable health care safety net for the underinsured and uninsured. This study is the first of its kind to examine county government influences, environmental pressures, and community resources in the context of health care network performance. The methodological research question for this study is what determinants (exogenous constructs) contribute to a health care network and its performance (endogenous construct) within the framework of county government participation? Further, is the model supported by the data and can prediction, direction, and strength of relationships among the variables be identified? The simple answer is yes. For this study, the responses from 123 counties were analyzed with a variety of statistical techniques, culminating in structural equation modeling. The outcome of these analyses provided a reasonable explanation for the variation among the variables leading to network performance improvement in meeting the health care needs of uninsured and underinsured people. These quantitative data were also supported in their results with the inclusion of a case study analysis of a particular health care safety-net, the Orange County Primary Care Access Network in Orange County, Florida. Ultimately, this study learned three valuable lessons that can be used by county government decision-makers and health care providers alike. First, county involvement in community based health care networks results in a benefit that reverberates during economic stress- the leveraging of resources. Second, public-private initiatives are fundamental to reducing disparities in health care access. Third, health care networks improve access to health care for uninsured and underinsured people. Ultimately, county government participation is the largest predictor of network performance in this study.
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Date Issued: 2010
Identifier: CFE0003341, ucf:48475
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003341

Title: Factors Influencing Hypoglycemia Care Utilization and Outcomes Among Adult Diabetic Patients Admitted to Hospitals: A Predictive Model.
Creator: Kattan, Waleed, Wan, Thomas, Ramirez, Bernardo, Gurupur, Varadraj, Stevenson, Robyne, Pratley, Richard, University of Central Florida
Abstract / Description: Diabetes Miletus (DM) is one of the major health problems in the United States. Despite all efforts made to combat this disease, its incidence and prevalence are steadily increasing. One of the common and serious side effects of treatment among people with diabetes is hypoglycemia (HG), where the level of blood glucose falls below the optimum level. Episodes of HG vary in their severity. Nevertheless, many require medical assistance and are usually associated with higher utilization of...
Show moreDiabetes Miletus (DM) is one of the major health problems in the United States. Despite all efforts made to combat this disease, its incidence and prevalence are steadily increasing. One of the common and serious side effects of treatment among people with diabetes is hypoglycemia (HG), where the level of blood glucose falls below the optimum level. Episodes of HG vary in their severity. Nevertheless, many require medical assistance and are usually associated with higher utilization of healthcare resources such as frequent emergency department visits and physician visits. Additionally, patients who experience HG frequently have poor outcomes such as higher rates for morbidities and mortality.Although many studies have been conducted to explore the risk factors associated with HG as well as others that looked into the level of healthcare utilization and outcomes among patients with HG, most of these studies failed to establish a theoretical foundation and integrate a comprehensive list of personal risk factors. Therefore, this study aimed to employ Andersen's health Behavior Model of health care utilization (BM) as a framework to examine the problems of HG. This holistic approach facilitates enumerating predictors and examining differential risks of the predisposing (P), enabling (E) and need-for-care (N) factors influencing HG and their effects on utilization (U) and outcomes (O). The population derived from the national inpatient sample of the Healthcare Cost and Utilization Project (HCUP) database and included all non-pregnant adult diabetic patients admitted to hospitals' Emergency Departments (EDs) with a diagnosis of HG from 2012-2014. Based on the BM framework, different factors influencing HG utilization and outcome were grouped under the P, E, or N component. Utilization was measured by patients' length of stay (LoS) in the hospital and the total charges incurred for the stay. Outcome was assessed based on the severity ranging from mortality (the worst), severe complications, mild complications, to no complications (the best). Structural Equation Modeling (SEM) followed by Decision Tree Regression (DTREG) were performed. SEM helped in testing multiple hypotheses developed in the study as well as exploring the direct and indirect impact of different risk factors on utilization and outcome. The results of the analysis show that N is the most influential component of predictors of U and O. This is parallel to what was repeatedly found in different studies that employed the BM. Regarding the other two components, P was found to have some effect on O, while E influences the total charge. Interaction effects of predictors were noted between some components, which indicate the indirect effect of these components on U and O. Subsequently, DTREG analysis was conducted to further explore the probability of the different predictor variables on LoS, total charge, and outcome. Results of this study revealed that the presence of renal disease and DM complications among HG patients play a key role in predicting U and O. Furthermore, age, socio-economic status (SES), and the geographical location of the patients were also found to be vital factors in determining the variability in U and O among HG patients.In conclusion, findings of this study lend support to the use of the BM approach to health services use and outcomes and provide some practical applications for healthcare providers in terms of using the predictive model for targeting patient subgroups (HG patients) for interventions among diabetic patients. Moreover, policy implications, particularly related to the Central Florida area, for decision makers regarding how to approach the growing problem of DM can be drawn from the study results.
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Date Issued: 2017
Identifier: CFE0006611, ucf:51304
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006611

Title: Mobile Phone Short Message Service (SMS) to Improve Malaria Pharmacoadherence in Zambia.
Creator: Steury, Elinda, Sole, Mary Lou, Bushy, Angeline, Conner, Norma, Haiduven, Donna, University of Central Florida
Abstract / Description: ABSTRACTMalaria significantly contributes to morbidity and mortality rates in Zambia. The currently accepted malaria treatment is artemisinin-based combination therapy (ACT); it is more than 97% effective when the regimen is strictly adhered to. However, the mean ACT adherence rate in sub-Saharan Africa is only approximately 38-48%. Poor pharmacoadherence remains a significant barrier to malaria control and elimination.The purpose of this study was to determine if adherence rates to a six...
Show moreABSTRACTMalaria significantly contributes to morbidity and mortality rates in Zambia. The currently accepted malaria treatment is artemisinin-based combination therapy (ACT); it is more than 97% effective when the regimen is strictly adhered to. However, the mean ACT adherence rate in sub-Saharan Africa is only approximately 38-48%. Poor pharmacoadherence remains a significant barrier to malaria control and elimination.The purpose of this study was to determine if adherence rates to a six-dose ACT antimalarial treatment differ between patients in Zambia who received short message service (SMS) reminders and those who did not. An experimental, randomized, controlled trial was conducted to collect data from a sample of 96 adult patients with malaria who presented to Fisenge Clinic in the Copperbelt Province of Zambia. Participants were randomly assigned to a control or intervention group. The intervention group received SMS messages to remind them to take their medication according to the regimen. An electronic pillbox was used to measure pharmacoadherence for both groups, and patients were classified as probably adherent or probably non-adherent.Data were analyzed using Chi-square for association between the SMS intervention and pharmacoadherence, and logistic regression used for predictors of adherence. No significant association was found between SMS reminders and pharmacoadherence among malaria patients being treated with ACT when evaluated with respect to those who received the SMS reminders and those who did not (?2=0.19, df=1, p=0.67). Binary logistic regression indicated that there were no variables associated with adherence (p(>)0.05).Findings from this study contribute to the research regarding the use of mobile phones to promote adherence. This is the first study of its kind using SMS directly to the patient for ACT adherence in sub-Saharan Africa known to the author. It is possible that the use of the electronic pillbox and/or the novelty of participating in a research study contributed to higher levels of adherence than previously found in this geographical area. While data suggested that there was no association between SMS and adherence, further research is needed to explore the value of this intervention.
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Date Issued: 2014
Identifier: CFE0005421, ucf:50430
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005421

Title: CLAIMS OF MISTAKEN IDENTITY:AN EXAMINATION OF U.S. TELEVISION FOOD COMMERCIALS AND THE ADULT OBESITY ISSUE.
Creator: Delgado, Cristina, DeLorme, Denise, University of Central Florida
Abstract / Description: Obesity is one of the major public health issues in the United States, often regarded as part of a global crisis. Companies invest billions of dollars each year towards television advertising campaigns aimed at convincing audiences how their ground-breaking discovery 'battles the bulge' or somehow offers an increased health benefit. This study examined how advertisers presented health-related claims, including health and nutrient-content claims, in U.S. adult-targeted television food...
Show moreObesity is one of the major public health issues in the United States, often regarded as part of a global crisis. Companies invest billions of dollars each year towards television advertising campaigns aimed at convincing audiences how their ground-breaking discovery 'battles the bulge' or somehow offers an increased health benefit. This study examined how advertisers presented health-related claims, including health and nutrient-content claims, in U.S. adult-targeted television food commercials. The claims were compared to FTC, FDA, and USDA laws, regulations, and recommendations. A content analysis of food advertising was conducted of commercials from major and cable network programs broadcast during prime-time in the first quarter of 2009. The majority of claims match current regulations when compared to Federal references. The results show that Nutrient and Wellness claims were the most frequently cited. The type of benefit, Healthy Eating, emerged almost 3 times more than any other benefit type. This is also similar to those results which suggest advertisers' intentions were to promote overall wellness in their content delivery. As such, the Wellness Approach was identified and conceptualized, leading towards full development of a Wellness Effect theory. Implications and future research opportunities are discussed on both a theoretical and practical level.
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Date Issued: 2009
Identifier: CFE0002565, ucf:48260
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002565

Title: PERCEPTIONS OF SENIOR CITIZENS IN CENTRAL FLORIDA REGARDING QUALITY OF CARE UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA).
Creator: Nieves , Rafael, Sumner, Jennifer, University of Central Florida
Abstract / Description: On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their...
Show moreOn March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their perceived effects on the healthcare quality provided to them under this law. Four sections of PPACA bill, thought to specifically pertain to the elderly, were selected for this study; respondents were asked their opinions regarding PPACA's aspects of: (1) the reform on preventive healthcare services; (2) Medicare Part D [prescription drugs]; (3) Medicare; and (4) Medicaid. This thesis employed both qualitative and quantitative methodologies; data were collected and analyzed with findings presented and discussed.
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Date Issued: 2013
Identifier: CFH0004468, ucf:45112
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004468

Title: Health Literacy Intervention to Influence Choices Made by Students in a Title I School Who Receive Free Lunch.
Creator: Kent, Melissa, Levin, Judith, Quelly, Susan, Szente, Judit, University of Central Florida
Abstract / Description: This study seeks to influence choices made by Kindergarten students in a Title I school who receive free breakfast and lunch through a health literacy intervention with the intent of decreasing daily added sugar consumption. Fruit and milk choices, either with naturally occurring sugar (NOS) or added sugar (AS), were recorded for 70 Kindergarten students among six classes in a Title I school for ten days before a four-week health literacy intervention. Three of the classes were randomly...
Show moreThis study seeks to influence choices made by Kindergarten students in a Title I school who receive free breakfast and lunch through a health literacy intervention with the intent of decreasing daily added sugar consumption. Fruit and milk choices, either with naturally occurring sugar (NOS) or added sugar (AS), were recorded for 70 Kindergarten students among six classes in a Title I school for ten days before a four-week health literacy intervention. Three of the classes were randomly selected to learn about 'sometimes' and 'anytime' choices through the Healthy Habits for Life curriculum delivered by representatives from Nemours Children's Hospital. Following the intervention, milk and fruit choices were recorded for ten more school days to determine differences among the control and intervention groups. Pearson Chi Square test results concluded that the health literacy intervention lead to statistically significant improvements in milk choices for the intervention group, but fruit choices were inconclusive due to inconsistencies in significance. Hierarchical loglinear analyses were run to determine if there was a difference in response to intervention between male and female students, and the results indicated that the effectiveness of the intervention was not moderated by gender. The success of this intervention for milk choices will help students who receive free school breakfast and lunch to decrease their daily consumption of added sugars, and additional research needs to be done to help students make choices that will further decrease their daily added sugar consumption.
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Date Issued: 2019
Identifier: CFE0007662, ucf:52466
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007662

Title: PERCEPTIONS AND THEIR ROLE IN CONSUMER DECISION-MAKING.
Creator: Khaddaria, Raman, Gerking, Shelby, University of Central Florida
Abstract / Description: This dissertation is an empirical investigation into the roles that different quantifiable and measurable perceptions play in defining individual behavior across a variety of decision-making contexts. In particular, the focus lies on smokers and the choices they make with regard to smoking and beyond. Chapter 1 analyzes a nationally representative sample of adults (23 years and older) in the United States, pertaining to the Annenberg Perception of Tobacco Risk Survey II (1999-2000). It is...
Show moreThis dissertation is an empirical investigation into the roles that different quantifiable and measurable perceptions play in defining individual behavior across a variety of decision-making contexts. In particular, the focus lies on smokers and the choices they make with regard to smoking and beyond. Chapter 1 analyzes a nationally representative sample of adults (23 years and older) in the United States, pertaining to the Annenberg Perception of Tobacco Risk Survey II (1999-2000). It is observed that three dimensions to smoking behavior viz., risk, temporality and addiction, interact to determine the smoking status of an individual. Although previous studies mostly looked into each of these dimensions in isolation, in this chapter, we empirically illustrate how perceptions on risk, time dimensions and addiction, jointly influence the smoking behavior of adults. Chapter 2 casts the smoker in the role of a parent and explores parental behavior towards the general health-risks facing their children. Using the dataset from a survey (2009), conducted in Orlando, Florida, on parents, having at least one child aged between 1 and 16 years, the chapter arrives at two findings relevant for policy: i) In each of the 'smoker' and 'non-smoker' parent categories, parents exhibit equal concern for themselves and their children, and ii) the level of concern shown by smoker-parents, towards health-risks faced by their children, is the same as that shown by their non-smoking counterparts. The analysis in this chapter also affirms the need to incorporate subjective risk assessment in willingness-to-pay (WTP) exercises to facilitate a deeper behavioral analysis of health risk valuation. Lastly, in Chapter 3, we focus on the issue of quantitative assessment of the perception of health risks from smoking. Particular interest lies in understanding how variants of a metric - namely, a survey question - have been employed in academic studies and industry-surveys, in order to measure smoking-related risk-perceptions. In the process of reviewing select tobacco-industry survey records, we analyze the implications of different features of this metric, (e.g., use of a 'probe', the 'Don't Know' option), and various interview modes (e.g. telephonic, face-to-face), for the estimates of perceived risk arrived at in these studies. The review makes clear that two aspects of health risks from smoking - the risk of contracting a smoking-related disease, as against the risk of prematurely dying from it conditional upon getting affected - have not been jointly explored so far. The dataset obtained from the Family Heart Disease and Prevention Survey (November 2010-March 2011), provides a unique opportunity to explore these two kinds of probabilities, particularly with regard to the risks of lung-cancer from smoking. Chapter 3 concludes by illustrating how individuals evaluate both these aspects of health-risks. While the probability of getting lung-cancer is found to be overestimated in conjunction with previous studies, the conditional probability of premature death is severely underestimated. Additionally, it is found that individuals' subjective assessments of either of these risk aspects predict smoking behavior in an identical manner. This calls into question the so-called 'rationality' of smoking decisions with implications for policies designed for the control of tobacco consumption.
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Date Issued: 2011
Identifier: CFE0003918, ucf:48736
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003918

Title: The Communicative Value of EMR Education: Medical Students' Perceptions of Introductions to EMRs.
Creator: Burry, Justiss, Scott, Blake, Wheeler, Stephanie, Brenckle, Martha, University of Central Florida
Abstract / Description: Research in medical education includes a number of studies that describe the complexities (Tierney et al., 2013; Gagon et al., 2009; Pippitt, Stevenson, (&) Samuelson, 2013), benefits (Milano et al., 2014; Hammoud et al., 2012; Silverman et al., 2014), and limitations (Peled, Sagher, Morrow, (&) Dobbie, 2009; Wald, George, Reis, (&) Taylor, 2014; Pelletier, 2016) of helping medical students understand and achieve fluency with electronic medical records (EMRs). In addition, studies in the...
Show moreResearch in medical education includes a number of studies that describe the complexities (Tierney et al., 2013; Gagon et al., 2009; Pippitt, Stevenson, (&) Samuelson, 2013), benefits (Milano et al., 2014; Hammoud et al., 2012; Silverman et al., 2014), and limitations (Peled, Sagher, Morrow, (&) Dobbie, 2009; Wald, George, Reis, (&) Taylor, 2014; Pelletier, 2016) of helping medical students understand and achieve fluency with electronic medical records (EMRs). In addition, studies in the rhetoric of health and medicine (RHM) have been calling to attention the effectiveness of rhetorical studies within medical contexts (Scott, Segal, (&) Keranen, 2013; Segal, 2005; Rausch, 2016; Fountain, 2014; Melocon and Frost, 2015; Graham and Herndl, 2014). However, there is not a unified idea of the best way to teach EMR fluency, nor is there any research that studies and analyzes the perceptions of students in their undergraduate medical education, including their pre-clerkship years. This thesis investigates students' perceptions of their medical education at the University of Central Florida's College of Medicine (UCF COM), specifically how 76 students who participated in surveys and focus group interviews perceive and engage with their education and ideas of EMR application and fluency. It also compares their perceptions with the goals of the module directors who designed the curriculum. In its analysis, this thesis employs classical and contemporary scholarship about stasis theory (Crowley and Hawhee, 2012; Fahnestock and Secor, 1988) to identify points of congruence and dissonance between students and module directors, as well as across cohorts of students in their first, second, and third years. Through data analysis, I found key points of congruence and dissonance between the perceptions and experiences of students and goals of module directors. I also identified key factors affecting both groups, such as the time constraints of the curriculum and the fact that hospitals use different EMR systems. The results of this study demonstrate the complexities of medical education and EMR education for both students and module directors. By understanding how rhetoric can be more beneficial to other fields, such as medical education, this study can help those creating curricula better reach outcomes that both students and licensing boards will appreciate. That said, more research needs to be conducted to understand how regulated medical education creates these points of contention between future physician curriculum designers.
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Date Issued: 2017
Identifier: CFE0006723, ucf:51887
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006723

Title: PREDICTING PATIENTS' TRUST IN PHYSICIANS FROM PERSONALITY VARIABLES, ETHNICITY, AND GENDER.
Creator: Mukhtar, Zoreed A, Negy, Charles, University of Central Florida
Abstract / Description: This study examined variables related to the doctor-patient interaction that can predict college students' trust in their physicians. Specifically, I examined if five personality variables, ethnicity, and gender were associated with attitudes toward physicians. A second aim of the study was to determine if there was a difference in the level of trust in physicians between pre-medical and non-pre-medical students. Surveys were administered to UCF students containing a series of questions...
Show moreThis study examined variables related to the doctor-patient interaction that can predict college students' trust in their physicians. Specifically, I examined if five personality variables, ethnicity, and gender were associated with attitudes toward physicians. A second aim of the study was to determine if there was a difference in the level of trust in physicians between pre-medical and non-pre-medical students. Surveys were administered to UCF students containing a series of questions compiled from the Interpersonal Physician Trust Scale, Interpersonal Trust Scale, Illness Attitude Scale, Big Five Inventory, Martin-Larsen Approval Motivation Scale-Short Form, Almost Perfect Scale-Revised and Marlowe-Crowne Social Desirability Scale-Short Form, as well as 13 original questions that I developed. The sample consisted of 211 UCF students. It was hypothesized that lower levels of mistrust of others, symptoms of hypochondria, introversion, need for approval, and perfectionism would correlate significantly with trust in medical doctors. It was also hypothesized that there would be a difference in the level of trust in physicians between pre-medical and non-premedical students. Results indicated that on average, most participants across ethnicity and gender expressed uncertainty about their level of trust in their physicians. Ethnicity was not associated significantly with trust in physician. Gender was also not associated significantly with trust in physician. For Hispanic participants, only introversion predicted trust in physician. For male participants, only hypochondria predicted trust in physician. Finally, pre-medical status was not associated significantly with a difference in physician trust.
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Date Issued: 2017
Identifier: CFH2000244, ucf:45972
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000244

Title: THE IMPACT OF ARTHRITIS ON THE HEALTH-RELATED QUALITY OF LIFE AMONG INDIVIDUALS AT THE UNIVERSITY OF CENTRAL FLORIDA.
Creator: Garwood, Ryan E., Saleh, Suha, University of Central Florida
Abstract / Description: This purpose of the study is to examine the difference in the health-related quality of life (HRQOL) between individuals who suffer from physician-diagnosed arthritis compared with individuals who do not suffer from physician-diagnosed arthritis in a population of university students, faculty, and staff. The study sampled from a population of students, faculty, and staff at the University of Central Florida. Through the implantation of a cross-sectional ecological design, differences between...
Show moreThis purpose of the study is to examine the difference in the health-related quality of life (HRQOL) between individuals who suffer from physician-diagnosed arthritis compared with individuals who do not suffer from physician-diagnosed arthritis in a population of university students, faculty, and staff. The study sampled from a population of students, faculty, and staff at the University of Central Florida. Through the implantation of a cross-sectional ecological design, differences between the two groups were measured with a survey that measures health-related quality of life, such as the 36-Item Short Form Health Survey (SF-36). The SF-36 questionnaire was distributed to subjects through a campus-wide email system and was administered through Qualtrics, an online survey program. Literature suggests lower SF-36 scores for individuals suffering from arthritis, but is lacking in investigating the effect of arthritis on college-aged students, particularly within the 18-24 age group. The study aims to close this gap in the literature. SPSS software was used to analyze results through tests of association, like ANOVA, which measured differences in the SF-36 scores of subjects with physician-diagnosed arthritis and subjects without physician-diagnosed arthritis. Results showed a significant difference in the HR-QOL scores between individuals with arthritis and individuals without arthritis, as well as age, gender, ethnicity, and the presence of joint pain.
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Date Issued: 2017
Identifier: CFH2000189, ucf:46013
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000189

Title: SOCIAL PATHOGENIC SOURCES OF POOR COMMUNITY HEALTH.
Creator: Smith, Hayden, Wan, Thomas, University of Central Florida
Abstract / Description: The United States currently provides a health care system that is neither efficient nor equitable. Despite outspending the world on health care, over three-fourths of developed countries produce better health outcomes (Auerbach et al., 2000). Simultaneously, the "Ecological School of Thought" has documented the large impact that social, economic, and environmental circumstances play in health outcomes. Unfortunately, these 'ecological" studies are frequently conducted without theoretical...
Show moreThe United States currently provides a health care system that is neither efficient nor equitable. Despite outspending the world on health care, over three-fourths of developed countries produce better health outcomes (Auerbach et al., 2000). Simultaneously, the "Ecological School of Thought" has documented the large impact that social, economic, and environmental circumstances play in health outcomes. Unfortunately, these 'ecological" studies are frequently conducted without theoretical justification, and rely solely on a cross-sectional research design and a myriad of unrelated variables. This study represents an important step towards the development of a true theory of "ecology". More specifically, we argue that the adversity associated with socio-economic disadvantage, social disorganization, and a lack of health care resources, leads to adverse health outcomes, represented by sentinel health events. This research employs both a cross-sectional (2000) and longitudinal designs (1990 – 2000) to assess the antecedents of sentinel health events in 309 United States counties. Structural Equation Modeling was the statistical technique employed in the study. Findings revealed that socioeconomic disadvantage remains a primary contributor to sentinel health. Indeed the economic growth between 1990 and 2000 was associated with increased rates of sentinel health events. Social disorganization was identified as a primary contributor to sentinel health events at a specific time point (2000), but was not significant over time (1990 -2000). Conversely, the inadequacy of health care resources was non-significant in the cross-sectional model (2000), but significant in the longitudinal model (1990 -2000). In both models, racial characteristics were fundamentally linked to ecological predictors of health We found support for the notion that sentinel health events would be reduced through economic equity and the development of healthy environments where community ties are reinforced. Less support is found for saturating given geographical areas with health care resources in order to reduce sentinel health events. Future research should be directed by the theoretical advancements made by this study. More specifically, future studies should examine independent cross-level effects, that is, through the inclusion of behavior variables as mediating factors for ecological constructs.
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Date Issued: 2007
Identifier: CFE0001577, ucf:47108
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001577

Title: COUPLE PLAY AS A PREDICTOR OF COUPLE BONDING, PHYSICAL HEALTH AND EMOTIONAL HEALTH.
Creator: Vanderbleek, Linda, Robinson, Edward, University of Central Florida
Abstract / Description: Traditional couple counseling research focused on why people end relationships, with research only recently addressing what factors contribute to relationship satisfaction and stability. Yet, throughout this research, minimal attention has been paid to the role of play in couple counseling. The research available on play in couple counseling had varied definitions of couple play and was not based on current couple counseling theory. The research and anecdotal data on couple play proposed a...
Show moreTraditional couple counseling research focused on why people end relationships, with research only recently addressing what factors contribute to relationship satisfaction and stability. Yet, throughout this research, minimal attention has been paid to the role of play in couple counseling. The research available on play in couple counseling had varied definitions of couple play and was not based on current couple counseling theory. The research and anecdotal data on couple play proposed a strong relationship between couple play and the factors that predict successful, long-term couple relationships, individual physical health and emotional health. This study applied current couple counseling theory and research to define couple play and the relationship between couple play and couple bonding, physical health and emotional health. The hypotheses of the study were couple play would predict couple bonding; couple play would predict individual physical health; and couple play would predict individual emotional health. The results from a sample of 30 couples demonstrated couple play predicted measures of couple bonding, including relationship satisfaction, communication, conflict resolution, and the couple's view of the relationship. Couple play demonstrated no relationship to individual physical or emotional health. Since couple play was predictive of successful, long-term couple relationship measures, the implications were discussed for using couple play in assessment and intervention in couple counseling and future research.
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Date Issued: 2005
Identifier: CFE0000426, ucf:46403
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0000426

Title: LOCUS OF CONTROL AND SELF-EFFICACY: POTENTIAL MEDIATORS OF STRESS, ILLNESS, AND UTILIZATION OF HEALTH SERVICES IN COLLEGE STUDENTS.
Creator: Roddenberry, Angela, Renk, Kimberly, University of Central Florida
Abstract / Description: Stress has been linked to increased illness in several biologically based studies. In contrast, only a limited number of studies have assessed psychological variables related to stress, with self-efficacy and locus of control serving as potentially important variables. Thus, the current study investigated the mediating effects of self-efficacy and locus of control in the relationship between stress, psychological and physical symptoms, and the utilization of health services in college...
Show moreStress has been linked to increased illness in several biologically based studies. In contrast, only a limited number of studies have assessed psychological variables related to stress, with self-efficacy and locus of control serving as potentially important variables. Thus, the current study investigated the mediating effects of self-efficacy and locus of control in the relationship between stress, psychological and physical symptoms, and the utilization of health services in college students. Results suggested that stress was correlated positively with symptoms. External locus of control was correlated positively with stress and symptoms, and self-efficacy was correlated negatively with stress and symptoms. Further, structural equation modeling was used to test two separate models. The first model examined the relationships between stress and symptoms and between symptoms and utilization of health services. Although the path coefficients suggested that there were direct relationships, the data did not adequately fit this model. The second model examined the potential mediational effects of locus of control and self-efficacy on the relationship between stress and symptoms. The path coefficients for the second model were consistent with a mediation effect for locus of control in the relationship between stress and symptoms; however, when this model was tested for full mediation, the data did not fit the model. These results highlight the importance of having future studies examine and identify potential mediators of the stress and illness link. Implications for reducing health care costs and promoting better mental and physical health are discussed.
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Date Issued: 2007
Identifier: CFE0001831, ucf:47337
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001831

Title: THE EFFECT OF JOB STRAIN IN THE HOSPITAL ENVIRONMENT: APPLYING OREM'S THEORY OF SELF CARE.
Creator: Andrews, Diane, Wan, Thomas, University of Central Florida
Abstract / Description: The purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of...
Show moreThe purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of coping behaviors in response to workplace stressors. It was undertaken with the intention of identifying intervention strategies which will promote a healthy workforce and the retention of nurses in the workplace. An exploratory cross-sectional survey of 1235 staff nurses employed on the intensive, progressive and general medical-surgical nursing units of seven hospitals associated with a major Central Florida healthcare network tested a client-centered model in an effort to identify nurses vulnerable to the health consequences of job strain using structural equation modeling. Human subject protection was assured. An 82 item questionnaire was used to collect demographic data and measure responses to items associated with the constructs of health status, autonomy, collaboration, decentralization, coping, satisfaction, absenteeism and intent to leave. A variety instruments that were previously demonstrated as valid and reliable were used in the construction of the instrument. Subjects were also given the option of including additional written comments. A total of 325 surveys were returned, of which 308 met inclusion criteria, for a response rate of 25%. Data analysis determined that the measurement of job strain as a function of self-assessed generic health status was predictive of propensity to leave (ã = -.21). The experience of job strain shared a strong association with indicators of mental health status. Job strain was significantly influenced by coping behavior (ã = .56) which targeted activities associated with sustaining and balancing. Anecdotal remarks suggested that the need for balance influenced perceptions regarding stressors in the workplace. The professional practice environment was associated negatively with the propensity to leave (ã = -.58). Those staff nurses who experienced higher levels of autonomy expressed a greater degree of satisfaction and lower intent to leave. The variables of collaboration and decentralization contributed minimally to the construct of professional practice. Anecdotal remarks suggested that the low contribution of collaboration and decentralization contributed to a sense of powerlessness and frustration with work related circumstances. The influence of job strain, coping and the professional practice environment upon staff nurses suggests that health promotion strategies, efforts to enhance coping behavior and promotion of a professional practice environment will increase employee satisfaction and reduce intent to leave. Adoption of policies and procedures which support the health and well-being of individual staff members will benefit employees, strengthen the organizations in which they practice and promote the overall retention of nurses in the face of looming nurse shortages.
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Date Issued: 2006
Identifier: CFE0000935, ucf:46742
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0000935

Title: AN EXPLORATORY INQUIRY AND CREATION OF EMERGENCY ROOM DISCHARGE EDUCATION MATERIALS.
Creator: Catalano, Ivory, Heglund, Stephen, University of Central Florida
Abstract / Description: Background Each Emergency Room (ER) across the USA provides every patient with paperwork upon discharge, which commonly includes information about the patient�s diagnosis. This information will briefly describe the condition, provide information on treatment outside the ER, and possibly more, depending on the document and source. These documents are not made by hospital staff, but are generally purchased from outside providers who mass market such documents as resources for hospitals to use...
Show moreBackground Each Emergency Room (ER) across the USA provides every patient with paperwork upon discharge, which commonly includes information about the patient�s diagnosis. This information will briefly describe the condition, provide information on treatment outside the ER, and possibly more, depending on the document and source. These documents are not made by hospital staff, but are generally purchased from outside providers who mass market such documents as resources for hospitals to use to educate patients. One issue with these documents lies in their mass usage, which is not necessarily designed to target the general population�s reading and educational levels. Purpose The purpose of this research was to investigate currently used discharge education materials and evaluate them for their readability and content. From this investigation, recommendations were made and adjustments to the documents were applied in order to increase understanding for the general population. Results The documents ranged in Flesch-Kincaid grade level rankings from 7.8 to 3.6, and with Flesch Reading Ease scores of 54.7 to 85.3. The entirety of the standard documents were ranked at a minimum of 7th grade equivalents, and are, at the hardest rank, ranked at a 54.7 by the Reading Ease score. In comparison, the �easy to read� documents were ranked all below 5th grade level, and at the hardest rank, ranked at a 69.0 with the Flesch Reading Ease calculation. At a minimum, all documents included condition information and home care guidelines. The major obvious difference between the documents considered �easy to read� and the standard documents are that those considered easy to read typically had sections found on the standard document removed, and have the same overall content as the standard version remaining, only in a simpler vocabulary. Conclusions In order to provide the best educational materials to the general public, it would be in the best interest of companies manufacturing these documents to produce only one version, which would be at a level around the 6th grade or below. A document slightly below the 6th grade level would be more ideal, as the simpler the document is, the more patients it will be accessible for overall, accounting for those who are below the national standards. It is not truly necessary to separate the documents into two forms, and it helps to prevent confusion or offense by doing so.
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Date Issued: 2016
Identifier: CFH2000016, ucf:45585
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000016

Title: HEALTH INSURANCE STATUS AND DIABETES MANAGEMENT PRACTICES AMONG BLACK ADULTS IN THE U.S.
Creator: Rosier, Luderve, Wells, Brittny, University of Central Florida
Abstract / Description: The purpose of this study was to investigate the relationship between health insurance status and diabetes management (in terms of medication adherence and physical activity levels) in Black adults based on socioeconomic factors. Data were harvested from the Sample Adult Questionnaires of the National Health Interview Survey (NHIS) between the years of 2010 and 2016. The survey questions that were collected included information about the participants' income, education level, insurance status...
Show moreThe purpose of this study was to investigate the relationship between health insurance status and diabetes management (in terms of medication adherence and physical activity levels) in Black adults based on socioeconomic factors. Data were harvested from the Sample Adult Questionnaires of the National Health Interview Survey (NHIS) between the years of 2010 and 2016. The survey questions that were collected included information about the participants' income, education level, insurance status, diabetes diagnosis, medication therapy and physical activity levels. This study employed the most recent version of the Statistical Package for Social Sciences (SPSS) software. The association between diabetes management and socioeconomic factors were analyzed using chi-square analysis. It was hypothesized that Black adults who were uninsured, lower income, and less-educated would report lower adherence to medication and lower physical activity participation when compared to their insured, higher income, and higher-educated counterparts. However, there was no statistically significant relationship between health insurance status and diabetes management in people of different socioeconomic status. Too few people met the weekly recommendations for moderate exercise thus chi-square outcomes for physical activity were invalid. This study will be beneficial for future research as it has provided more generalizable information on this topic due to the use of a national dataset. This study also highlighted the importance of adequate physical activity interventions for this population and can be used for further research on Black adults with diabetes.
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Date Issued: 2018
Identifier: CFH2000303, ucf:45751
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000303

Title: INVESTIGATING A POTENTIAL RELATIONSHIP BETWEEN SIBLING GENDER COMPOSITION AND HEALTH BEHAVIOR INDICATORS IN YOUNG ADULT AND ADOLESCENT MALES.
Creator: Goss, Taylor N, Rovito, Michael J., Jasinski, Jana, University of Central Florida
Abstract / Description: The presence of siblings during childhood and adolescence has a significant impact on the behaviors and perceptions of adults later in life. Effects of mixed-gendered sibling dyads on delinquent behavior, gender typing, and romantic and sexual relationships are of interest. These behaviors can lead to notable health disparities, making it imperative to gain insight into factors associated with such behaviors in young adult and adolescent males. This project explored possible correlations...
Show moreThe presence of siblings during childhood and adolescence has a significant impact on the behaviors and perceptions of adults later in life. Effects of mixed-gendered sibling dyads on delinquent behavior, gender typing, and romantic and sexual relationships are of interest. These behaviors can lead to notable health disparities, making it imperative to gain insight into factors associated with such behaviors in young adult and adolescent males. This project explored possible correlations between gender composition of siblings and health behavior indicators for violence, competition and risk, and sexual and romantic relationships. Analysis of these variables was performed using data from the Young Adult and Adolescent Male Health Behavior Indicator Scale [YAAMHBIS]. Descriptive analyses showed YAAM understanding of abuse and successful marriage and relationship qualities, as well as a conditional acceptance of violence, competition, and risk. Means testing between those with and without sisters indicated that those with sisters acknowledged abuse, marriage qualities, and the consequences of infidelity. Additionally, those with sisters had, on average, an earlier age of sexual debut than those without supporting previous research regarding the effects of female communication in childhood on adult interactions. The correlations found between sibling gender and YAAM perceptions later in life could lay the groundwork for future studies further investigating sibling gender or split households and an association with health behaviors.
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Date Issued: 2018
Identifier: CFH2000317, ucf:45807
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000317

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health literacy (3)	+ -
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