University of Alabama Repository :: Browsing by Author "Yerby, Lea G."

Browsing by Author "Yerby, Lea G."

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Application of the diffusion of innovations theory and the health belief model to describe EMR use among Alabama family medicine physicians: a rural and urban analysis
(University of Alabama Libraries, 2009) Tucker, Melanie Tara; Higginbotham, John C.; University of Alabama Tuscaloosa
The Alabama Black Belt region consists of twelve counties which are characterized by a high percentage of African Americans, acute poverty, rural decline, inadequate education programs, and significantly poor health outcomes. The Alabama Black Belt region suffers significantly with health disparities which, in part, may be attributed to low physician/patient ratio and physician isolation. These physicians tend to practice in private, solo establishments, which often lead to limited communication with other physicians and medical educators. Without continued communication and continuing medical education, rural physicians could lag behind their urban counterparts. In fact it has been shown that some physician practices lag as far as two decades behind their urban counterparts due to such things as limited access to new technologies. With the advent of the electronic medical record (EMR) this lag is likely to decrease exponentially for those in rural areas and could lead to an increase in quality of care for the rural communities. The purpose of this study was to evaluate the adoption and implementation of electronic medical records (EMR) by rural and urban Alabama Family Medicine physicians. The Diffusion of Innovations Theory and Health Belief Model were used to guide the study and develop the survey questions. EMR adoption was assessed in rural areas and compared to their urban counterparts while evaluating the individual characteristic (gender, race, age, and years of practice), organizational characteristics (practice size, patients seen per day, practice location) and individual perceptions regarding adoption (perceived threat, perceived barriers and self-efficacy). Thirty percent (30%) of the 1,205 Alabama Family Medicine physicians responded to the electronic or paper survey. Almost half (49.3%) of the physicians surveyed reported having EMR in their practice; however, 16.3% reported using it to its fullest capacity. Significant differences emerged with respect to EMR use among physicians based on age, years in practice, patients seen per day, practice size and with respect to elements of perceived threat, barriers to adoption and the self-efficacy. Throughout the analysis, differences emerged between Family Medicine physicians from urban Alabama settings and their counterparts from rural and Black Belt region practices.
Breast cancer knowledge, beliefs, and screening behaviors of college women: utilization of the health belief model
(University of Alabama Libraries, 2011) Guilford, Kendra; Turner, Lori W.; University of Alabama Tuscaloosa
Aside from skin cancer, breast cancer is currently considered the most common cancer and the second leading cause of cancer death among women in the U.S. It is unique from other cancers in that it presents extreme financial costs, coupled with both physiological and psychological consequences for the impacted women and their families. Lifestyle factors are known contributors to rates of breast cancer, and knowledge is essential to its prevention. Women who are classified as "emerging adults" offer a vital window of opportunity for intervention, as lifestyle patterns are often set during this time. This cross-sectional, descriptive study examined the level of breast cancer knowledge, beliefs, and screening behaviors among a sample of emerging adult college women (n = 342) in the southeastern U.S. by measuring participants' confidence, health motivation, perceived susceptibility, perceived severity, perceived benefits, and perceived barriers, in addition to their degree of worry in relation to breast cancer. Participants responded to a written, self-report 86-item questionnaire. All analyses were conducted using SAS® 9.0. Results of the study showed participants had a low level of perceived susceptibility towards breast cancer, as well as relatively low overall breast cancer knowledge. Findings also revealed a significant association between ethnicity, year in school, and family history of breast cancer and participants' general degree of breast cancer-related worry. Of the Health Belief Model constructs, confidence and perceived barriers were found to significantly predict breast self-examination. The college years provide a great opportunity for health intervention strategies. Health program planners should aim to develop interventions that are adapted to address the unique needs of women who are transitioning from adolescence to adulthood. These interventions should center on enhancing self-efficacy of breast cancer screening and reducing barriers. Education-based programs are also needed to increase women's overall knowledge and awareness of breast cancer-related issues. Such strategies have great potential to enhance women's quality of life and positively influence those with whom they closely interact.
Breast cancer risk factors in a sexual minority population: an examination of the 2014 and 2015 Behavioral Risk Factor Surveillance System
(University of Alabama Libraries, 2017) Carter, Vicky L.; Simon, Cassandra E.; Pryce, Josephine G.; University of Alabama Tuscaloosa
This study is a secondary data analysis of the 2014 and 2015 Behavioral Risk Factor Surveillance System (BRFSS). Using a sample of 3,082 respondents, in three racial categories- White, African American, and Hispanic, this study examined sexual orientation and breast cancer risk factors. The sample size included 1,544 randomly selected heterosexual and 1,534 self-identified lesbians. The overall aim of this study is to explore behavioral and non-behavioral/demographic breast cancer risk factor differences between heterosexual women and lesbians. Chi-square analysis revealed significant demographic differences between heterosexual women and lesbians in age, educational attainment, employment status, household income, and having health insurance. Race was not found to be significant. Analysis of behavioral factors also indicated higher rates of alcohol consumption and tobacco use, lower mammogram use, and lower fruit intake in the lesbian population compared to heterosexual women. Physical activity, obesity, and diet-vegetable intake were not significantly different between the two populations. Loglinear analysis indicated that the introduction of race when examining these significant demographic non-behavioral and behavioral findings, had little effect on previous chi-square analysis findings. Sexual orientation was found to be the main effect on the findings with the exception of educational attainment and health insurance. Findings from this study may be used to develop comprehensive, appropriate, culturally competent, interventions, in addition to advocating in areas of public policy to address the breast cancer risks of lesbians.
Development and validation of an instrument to assess college students' oral health knowledge, beliefs, and behavior
(University of Alabama Libraries, 2010) Aubuchon, Stellina Marie; Turner, Lori W.; University of Alabama Tuscaloosa
Oral health education emphasizes the importance of brushing, flossing, and getting regular dental exams. Some examples of oral health problems that can occur without proper oral hygiene and dental care are dental caries and gingivitis. Research has shown that a relationship exists between oral health and other health related problems. The lack of awareness, education, and services regarding oral health and hygiene can cause severe unfavorable outcomes later in life. Unique oral health issues that affect today's college students include the use of smokeless tobacco, sexually transmitted diseases, and oral piercing. Although there are many studies conducted on oral health, few are targeted towards the college aged population. The purpose of this study was to develop a valid instrument based on constructs from the Health Belief Model to measure the knowledge, beliefs, and behaviors of college students' regarding oral health and hygiene. The present study utilized a review of the literature and an eight-step process to develop and validate College Students Oral Health Knowledge, Beliefs, and Behaviors (OHKBB). The most effective way to treat oral health related problems is through prevention. Oral health education is needed to ensure that college students are aware of not only the risks but also the prevention of oral diseases. The proposed research will pave the way for programs to help individuals improve their oral hygiene and reduce their risks of oral health related problems through education by identifying the specific oral health related knowledge, beliefs, and behaviors that affect college students oral health.
Exploring personal values, attitudes, perceived injunctive and descriptive norms, and intrapersonal value-attitude relationships in relation to alcohol use and alcohol-related problems among college students
(University of Alabama Libraries, 2011) Sheppard, Meg E.; Usdan, Stuart L.; University of Alabama Tuscaloosa
Alcohol use among college students continues to be a public health issue in spite of health promotion activities and programming. College alcohol use literature regularly examines the impact of perceived norms on alcohol use; however, little research has been done on the influence of personal values on alcohol use and alcohol-related problems. The purpose of this study was to examine the relationships between personal values, attitudes, perceived injunctive and descriptive norms, alcohol, and alcohol-related problems. The study also conceptualized and tested an idea termed intrapersonal value-attitude relationship, which was an interaction between values and attitudes. The current study employed a cross-sectional design utilizing a paper-and pencil survey administered to college students (n=910) within the classrooms. Personal attitudes and perceived descriptive norms of alcohol-related problems consistently predicted alcohol use and alcohol-related problems even after controlling for potential confounding variables. The exploration of the innovative concept of intrapersonal value-attitude relationship is a first step to examine the complex relationships between values and attitudes. Findings from this study suggest that the examination of values, attitudes, injunctive and descriptive norms are relevant and worth investigating further in regard to alcohol use and other health behaviors.
Mental health policy outcomes: an examination of older adults' mental health service use, 2002-2012
(University of Alabama Libraries, 2018) Ford, Katy Lauren; Kim, Giyeon; Allen, Rebecca S.; University of Alabama Tuscaloosa
The underutilization of mental health services (MHS) by older adults – and especially by racial/ethnic minority elders – is a well-recognized problem. Though several national-level mental health policies have been enacted and implemented over the past decade, rates of underutilization remain high. Guided by the Socio-Ecological Theory of public health policy, we aimed to examine individual- and community-level factors that have fostered the most successful implementations of national mental health policies in recent years. This dissertation conducted a multilevel growth curve analysis in order to examine older adults’ MHS use using a large, nationally-representative panel survey (the Medical Expenditure Panel Survey – Household Component, or MEPS-HC). We considered MHS use in the MEPS-HC for the period of 2002-2012, during which members of MEPS Panels 6-17 provided responses. This analysis revealed that rates of older adults’ MHS use did not increase significantly over our examination period, regardless of race/ethnicity or rurality of location. Only insurance status was a significant predictor of change in MHS use rates over the years 2002-2012. Our findings highlighted several important issues for policy implementation and future research of MHS use and mental health policy, and we make suggestions for ensuring greater efficiency and efficacy of efforts to improve older adults’ MHS use in the coming decade.
Relationships between religiosity, spirituality and health behaviors among college students
(University of Alabama Libraries, 2010) Harcrow, Michelle Senter; Turner, Lori W.; University of Alabama Tuscaloosa
The influence of religion and spirituality on factors relating to an individual's health behaviors has emerged as an area of interest for researchers, in recent years. Religiosity (formal and informal religious practice, both public and private) and spirituality (individual's relationship to something sacred; meaning and values of one's purpose) are regarded as having extensive influence on an individual's cognitions, emotions and behaviors. The purpose of this study was to examine the association between religion, spirituality, and social support in relation to physical activity and intakes of dietary fat among a sample of college students (n = 914) from a large, public university in the southeastern United States. Data of interest were collected via a classroom-based assessment battery and analyzed. Most relationships between religiosity, spirituality, physical activity and dietary fat intake were not statistically significant. Intakes of dietary fat were found to be higher in students that reported greater levels of behavioral and functional religiosity. Greater levels of reported social support were found to be significantly related to higher levels of both moderate and vigorous physical activity. The magnitude of the relationships between the variables did not appear to be affected after controlling for demographics and social support. Overall, a few significant relationships were identified between religiosity, spirituality, physical activity and dietary fat intake, suggesting that the influence and function of religiosity and spirituality on the development and maintenance of health behaviors among college students may be small. This research has several implications for researchers and other college health professionals, with an interest in promoting chronic disease prevention through physical activity and dietary behaviors. This research provides a better understanding of the religious and spiritual landscape, as well as, the physical activity behaviors and intakes of dietary fat of college students. Thus, this examination of religiosity, spirituality, physical activity, and dietary fat intake among college students should be of interest to researchers of chronic disease prevention and to entities fostering programs to support these health-promoting behaviors.
The rotavirus vaccine in a medicaid population: series completion and health care utilization
(University of Alabama Libraries, 2018) Henderson-Mitchell, Randi J.; Higginbotham, John C.; University of Alabama Tuscaloosa
Coverage estimates for the complete rotavirus vaccine series are considerably lower than the Healthy People 2020 target, as well as for other vaccinations routinely recommended in early childhood. Regardless, routine rotavirus vaccination in infants has been extremely effective in reducing rotavirus-associated illness in the United States. There are racial and socioeconomic disparities in rotavirus vaccine coverage, as well as lower rates of coverage among rural children. Furthermore, there is evidence of disproportionate disease burden among Medicaid-enrolled children. Further reductions in rotavirus disease burden are possible with improvements in coverage rates, although coverage may not reflect the full of the impact of rotavirus vaccination. Both the receipt of the complete rotavirus vaccine series, as well as receipt of a partial series, have been shown effective in the prevention of severe illness. Therefore, the present study was conducted within a Medicaid-enrolled population to 1) Examine the association between rural residence and rotavirus vaccination 2) Examine demographic and provider characteristics as potential predictors of rotavirus vaccine series initiation and completion, and 3) Examine differences in rotavirus-associated health care utilization by the status of rotavirus vaccine series completion. The study population included 293,458 children enrolled in Medicaid between 2010-2017. Nearly 77% of infants received at least one rotavirus vaccine dose; however, only 56% completed the full series. Infants who resided in rural areas were more likely to initiate the vaccine series, but rurality of residence had mixed impact on series completion. The receipt of ≥1 dose of the diphtheria, tetanus, and pertussis (DTaP) vaccine was strongly associated with rotavirus vaccine series initiation. The strongest predictors of series completion were the receipt of all age appropriate doses of DTaP and receipt of the Rotarix® (RV1) (GlaxoSmithKline Biologicals) vaccine. Analysis of health care utilization found that receipt of any dose of rotavirus vaccine was effective in the prevention of severe illness; however, completion of the series maximized protection against severe cases of rotavirus-associated illness.

Browsing by Author "Yerby, Lea G."

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