Theses and Dissertations - Department of Health Science

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Osteoporosis knowledge, beliefs, and behaviors of college students: utilization of the Health Belief Model
(University of Alabama Libraries, 2009) Edmonds, Ellen; Turner, Lori W.; University of Alabama Tuscaloosa
The purpose of this study is to determine the level of osteoporosis knowledge, beliefs and behavior among college students. In addition, this study will examine perceived susceptibility, severity, benefits, barriers and self-efficacy related to osteoporosis prevention. Women and men of all ethnicities at the University of Central Arkansas were asked to participate in the study. The Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale, and Osteoporosis Preventing Behaviors Survey were utilized. Correlations were used to determine the degree of relationship between variables. After determining which independent variables were significant, a multiple regression was completed to determine prediction. Participants did not perceive themselves as susceptible to osteoporosis and perceived minimal barriers to physical activity and calcium intake. Their knowledge was minimal concerning alternate sources of calcium and less traditional forms of physical activity. Physical activity was correlated with perceived barriers, health motivation, and calcium intake. Calcium intake was correlated with perceived barriers, health motivation, and knowledge. Prevention programs should aim to increase osteoporosis knowledge of risk factors and preventing behaviors and to decrease high risk factor behaviors in adolescence when bone health can be increased. Health professionals can attempt to decrease perceived barriers to physical activity in college age individuals by providing comprehensive programs based on supported factors shown to influence behavior, including social support and self-efficacy.
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.
Development of a theory based instrument to predict the influence of sexually-oriented music lyrics on the sexual attitudes, beliefs, and intentions of African-American adolescents
(University of Alabama Libraries, 2010) Gordon, Brian C.; Perko, Mike; Turner, Lori W.; University of Alabama Tuscaloosa
Early sexual initiation among American adolescents represents a major public health problem. African-American adolescents (AAas) report earlier age of sexual initiation, which places them at an increased risk of ill health outcomes. Approximately 3 million adolescents are infected with a STI yearly, with the highest incidence occurring in African Americans from impoverished, inner city environments. A relationship among media exposure and media's influence on adolescents' sexual perceptions, attitudes, and intentions has been suggested. However, answers as to whether sexually-oriented music lyrics influence adolescent sexual initiation are unclear. The purpose of this study was to develop a reliable and valid instrument based on the Theory of Reasoned Action to enable researchers to predict the influence of sexually-oriented music lyrics on the sexual attitudes, beliefs, and intentions of AAas. A nine step process was followed to develop a survey to enable researchers to predict the influence of sexually-oriented music lyrics on the sexual attitudes, beliefs, and intentions of African-American adolescents. The steps were: 1) identify the attitudinal object, 2) collect a pool of opinion items, 3) submit pool of items to expert panel for review, 4) pilot test draft of the survey, 5) administer item pool to a group of respondents, 6) score each item for each respondent, 7) sum respondents' item scores, 8) correlate item scores with total scale scores for all respondents, and 9) apply statistical criteria for elimination of test items. One hundred eighty-five (n =185) AAas in grades 6-8 residing in rural and urban communities in Alabama participated in the study. An initial pool of items (n =95) was developed based on the TRA, a review of the literature, and input received through focus group interviews with the target audience. Items were eliminated through expert panel review (n =49), item response discrimination, factor analysis (1), and Cronbach's alpha (3). Four subscales were identified with reliability statistics ranging from .722-.940. The final instrument consisted of 44 items with a Cronbach's alpha of .846. Future research should utilize this survey to determine the influence sexually-oriented music lyrics may have on the sexual attitudes, beliefs, and intentions of African-American adolescents.
An investigation of materialistic values and physical activity participation, location, and experience
(University of Alabama Libraries, 2010) Baller, Stephanie L.; Usdan, Stuart L.; University of Alabama Tuscaloosa
In spite of clear and much publicized health benefits, the majority of American adults do not participate in enough physical activity to satisfy established public health recommendations. In recent years, attention has been paid to social position and consumption as they are related to health and well-being. In light of increases in chronic disease and health risks associated with insufficient activity, as well as increased consumptive patterns associated with decreased well-being, studies aimed at understanding the confluence of these trends are essential. The purpose of this study was to gain a better understanding of how materialistic values interact with the social and physical environments to influence physical activity participation, location, and the experience of being active. The present study utilized a mixed method, cross sectional design (n = 487). Increased materialism was associated with greater physical activity and appears to influence the selection of activity location, experience, and norms. The findings of this study suggest that this line of inquiry is timely, culturally relevant, and worthy of further investigation.
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.
A theory-based investigation of leisure time physical activity among college students
(University of Alabama Libraries, 2010) Beville, Jill Marie; Umstattd, M. Renee; Turner, Lori W.; University of Alabama Tuscaloosa
This study examined the leisure time physical activity behavior of college students using the Theory of Planned Behavior (TPB) and two constructs, descriptive norm and self-efficacy, from the Integrated Behavioral Model (IBM). A sample of college students (n = 621) from a large, public university in the southeastern United States participated. Data were collected via a self-report class-room based assessment battery. The assessment battery contained questions related to leisure time physical activity, TPB constructs descriptive norm and self-efficacy and demographic information. In general, the results of this research indicate the utility of the TPB in examining leisure time physical activity among college students. In addition, this study supports the inclusion of the IBM constructs descriptive norm and self-efficacy in examining leisure time physical activity. The TPB constructs; attitude, subjective norm and perceived behavioral control were positively associated with intention to engage in leisure time physical activity among this sample of college students. The results of the final hierarchical regression model indicated that subjective norm was negatively associated with leisure time physical activity and intention was positively associated with leisure time physical activity behavior. In addition, the two IBM constructs descriptive norm and self-efficacy were positively associated with leisure time physical activity behavior. Finally, the results also found gender differences in the TPB and IBM constructs. For males, intention and subjective norm were significantly related to leisure time physical activity. For the females, intention, attitude and self-efficacy were significantly related to leisure time physical activity. This research has several implications for researchers and other college health professionals, with an interest in promoting leisure time physical activity. This research provides a better understanding of the leisure time physical activity behaviors of college students with regard to the TPB and IBM constructs (descriptive norm and self-efficacy). This examination of leisure time physical activity among college students should be of interest to those fostering programs, services and facilities to support this behavior, and particularly campus recreation professionals.
Knowledge, engagement, and perceptions of the American College of Sports Medicine guidelines for cardiovascular physical activity: a university undergraduate comparison
(University of Alabama Libraries, 2010) Brown, George Milton; Usdan, Stuart L.; Turner, Lori W.; University of Alabama Tuscaloosa
Background: The early onset of chronic disease is a major health concern facing the nation. Leading health indicators support physical activity to reduce the mortality and morbidity rates among individuals. The college years represent a time of transition and potential for improved adherence to positive health behaviors. As institutions of higher education seek to improve retention through positive health behavior, an increase in attention to physical activity is warranted. Purpose: The purpose of this study was to evaluate the knowledge, engagement and perceptions of the American College of Sports Medicine (ACSM) guidelines for cardiovascular physical activity among university freshmen and seniors. Methods: A cross-sectional study design was used to survey all University of Alabama undergraduate students (N=21,775). A 26-question electronic survey was used to collect data. Results: A total of 877 surveys were returned representing a four percent (4.0%) response rate. The mean knowledge scores were 4.26 (out of possible 8.0). Students engaged in moderate intensity physical activity on less (M=3.73) days per week than recommended by the ACSM. For vigorous intensity physical activity students reported engagement on more (M=4.06) days per week than recommended by the ACSM. Knowledge of physical activity guidelines was a significant predictor of engagement in vigorous intensity physical activity for both freshmen (n=216, p=.040) and seniors (n=211, p=.016). Significant differences (p=.047) by year in school were found with respect to walking activity where freshman walked more often than seniors. Age (p=.012), race (p<.001) and year in school (P=.047) were all significant with respect to moderate intensity physical activity. Males engaged in more vigorous intensity physical activity than females (p=.003). When examining physical among classes, freshman students reported significant differences in engagement to vigorous intensity physical activity based on the constructs of perceived self-efficacy (p<.001) and perceived barriers (p=.006). Seniors reported significant differences in engagement to vigorous intensity physical activity based on perceived benefits (p=.002) and perceived severity (p=.019). Discussion: University freshman and seniors vary in reasons for engagement in physical activity. While knowledge is not synonymous with engagement it does have an impact on a student's overall decision and understanding of the health benefits of physical activity.
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.
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.
Nutrient intake and adequacy and consumption of food away from home of adults with children
(University of Alabama Libraries, 2011) Williams, Carolyn; Knol, Linda L.; Turner, Lori W.; University of Alabama Tuscaloosa
The dietary intake of Americans does not meet current recommendations. A greater desire for quick, convenient food options and food prepared outside the home (FAFH) may be two contributors to poor intake patterns. The Food Choice Process Model suggests that life changes such as becoming a parent may place additional time constraints on adults that in turn will impact on their food choices. Therefore, the purpose of this study was to examine differences in dietary intake of U.S. adults by (a) child presence in the household and (b) child presence plus frequency of FAFH. A sample of 4,904 adults, 18 to 50 years, was selected from the National Health and Nutrition Examination Survey (2005 to 2008). Using linear regression and logistic regression models, dietary intake was compared based on child presence in the household while controlling for variables that represented constructs of the Food Choice Process Model. When compared to females without children, females with children consumed significantly less fiber and were less likely to meet their fiber requirements. When examined by child presence and FAFH frequency, females with low FAFH frequency (1 or fewer FAFH meals per week) without children in the household had significantly lower total fat, saturated fat, and sodium intakes compared to high frequency users regardless of child presence. Females with children with high FAFH frequency (2 or more FAFH meals per week) were less likely to meet the recommendations for fiber intake and more likely to exceed the recommendations for sodium intake compared to females with children with low FAFH frequency. There were no clinically relevant findings for men. Dietary intake of women but not men changes based on whether a child is present in the household and meals are consumed away from home.
A survey examining the nonmedical use and diversion of prescription stimulant medications among college students using the theory of planned behavior
(University of Alabama Libraries, 2011) Gallucci, Andrew Robert; Usdan, Stuart L.; University of Alabama Tuscaloosa
The purpose of this study was two-fold. First, the proposed study aimed to create a reliable survey instrument designed to examine the nonmedical use of prescription stimulants (NMUPS) and diversion behaviors using the Theory of Planned Behavior (TPB) among undergraduate students aged 18-24. Second, this study examined the utility of the TPB in predicting NMUPS and diversion behaviors. The study utilized a cross-sectional design (n=1,026) to administer an 88-question survey assessing the nonmedical use and diversion of prescription stimulants. As part of this survey, students responded to theory-based questions for both behaviors. Results of a principal components analysis suggested strong reliability in the survey's ability to measure the theoretical constructs of diversion and NMUPS. Further statistical analyses found utility for TPB in predicting NMUPS. However, TPB had limited ability in predicting the diversion behavior.
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.
Association between stroke risk factors and access to care
(University of Alabama Libraries, 2011) Parton, Jason Michael; Higginbotham, John C.; University of Alabama Tuscaloosa
A number of medically diagnosed risk factors are associated with an increased risk of having a stroke. Individuals recognized with hypertension, diabetes, and dyslipidemia all show greater probability of experiencing a stroke. Rural inhabitants are often considered to have limited access to health care, thus frequently decreasing the likelihood of their being aware of, treated, or controlled for these and other stroke-risk factors. This investigation provides an avenue for exploration into the association nontraditional risk factors for stroke, rural/urban designation, and travel time to a usual source of health care have on awareness, treatment, and control of hypertension, diabetes, and dyslipidemia. The association between awareness, treatment, and control of stroke-risk factors and an individual's rural/urban status was investigated to identify geographic disparities. Furthermore, travel time to a participant's usual source of medical care was explored for its relationship to these stages of stroke-risk factors and to investigate how travel time might influence the association between these factors and rural/urban status. No associations were identified for the main effects between the likelihood of being aware of, treated, or controlled for stroke-risk factors, and living in rural and urban settings. Drive time showed no relationship with these stages of stroke-risk factors, nor did it modify the effect rural or urban status had on the dependent variables. Disparities were noted for demographic, socioeconomic, and health behavioral traits for all three risk factors. This project made use of REGARDS study data sources to provide an understanding of stroke disparities for a certain geographic dimension. However, these data alone are unable to specifically identify rural and urban differences in stroke-risk factors and assess what effects access to health care has on the management of stroke-risk factors. The results from this investigation specify limited variability for management of these conditions by this study's measures of access to care.
Understanding prevalence and attitudes: dietary and exercise behaviors among African American collegiate athletes
(University of Alabama Libraries, 2012) Lewis, Dwight William; Leaver-Dunn, Deidre; University of Alabama Tuscaloosa
Context: Eating disorders, a serious public health issue, affect an estimated 8-11 million Americans (Hudson, Hiripi, Pope & Kessler, 2007; National Institutes of Mental Health [NIMH], 2010). The lack of inclusion of diverse minority populations from robustly-designed eating disorder research has produced limitations to the generalizability for theory-based prevention, diagnosis, and treatment programs, particularly among non-Caucasian populations. Objectives: The purpose of this study was to examine eating and exercise behaviors among student-athletes enrolled at historically black colleges and universities (HBCUs) through application of existing disordered eating, exercise dependence, and body image instruments. Participants: A battery of surveys was disseminated to 601 varsity level athletes enrolled at HBCUs, of which 71% (N = 427) were used in the analysis. Outcomes and Procedures: The main outcomes of interests were eating disorder (ED) risk, exercise dependence (ExD) risk, and orthorexia nervosa (ON) risk, and difference between perceived and ideal body stature. These outcomes were operationalized through application of the Eating Attitudes Test (EAT-26), Exercise Dependence Scale (EDS-21), ORTO 15 questionnaire (ORTO 15), and Pulvers and colleagues' (2004) Figural Stimuli. Regression (Logistical and Simple), chi-square, ANOVA/ANCOVA, and simple descriptive statistical analyses served as quantitative means of measurement. Results: Findings revealed that among HBCU student-athletes in this study, 10.8% were at risk for an ED, 10.3% were at risk for ExD, and 66.3% were at risk for ON. With respect to ED and ON risk, between group differences did not exist among most men's sports, while race and academic classification group differences were present among several women's sports. The Theory of Planned Behavior (TPB) construct, attitude, exhibited the largest influence on future intentions to engage in disordered eating among both male (p = .005) and female (p = .001) participants. Significant differences between ideal and perceived body stature exist among female subjects (p < .001). Conclusions: The ED risk findings among HBCU student-athletes failed to challenge current literature as to populations at increased risk for an ED. Also, individual treatment for EDs and ExD among HBCU student-athletes at risk should occur concurrently. ON risk findings among HBCU athletes exceed levels reported for European populations. Since ON is a novel phenomenon in the US, future research is warranted with respect to other American populations and the at-risk ORTO 15 threshold for athletes.
The examination of mixing alcohol and energy drinks among college undergraduates using the Theory of Planned Behavior
(University of Alabama Libraries, 2013) Reddy, Supriya Gillella; Usdan, Stuart L.; Nickelson, Joyce E.; University of Alabama Tuscaloosa
The purpose of this study was two fold. First, the study examined whether constructs from the Theory of Planned Behavior (TPB: Ajzen, 1985, 1991) play a role in predicting consumption of alcohol mixed with energy drinks (AmED) among college undergraduates. Second, the study also estimated the prevalence of AmED consumption and provided a better understanding of the theoretical and demographic variables associated with AmED consumption among a large sample of college undergraduates located at a public university in the Southeastern United States. The study used a cross-sectional study design (n=676) to administer a 39-item survey assessing alcohol use, energy drink (ED) use, and the consumption of mixing alcohol with energy drinks (AmED). As part of this assessment, students responded to theoretical questions about AmED consumption in the last 30 days. Analyses exploring the univariate significance of theoretical and demographic predictors revealed that all of the TPB constructs were significant univariately. Additionally, the demographic predictors of class year and Panhellenic affiliation were also univariately significant (p<.05). However, when incorporated into a logistic regression model, the TPB constructs of behavioral intention and attitude were the only significant predictors (p<.05) of AmED consumption among undergraduate college students. Subjective norms and perceived behavioral control were no longer significant. Furthermore, logistic regression analyses also showed that the demographic variables of age, sex, place of residence, and Panhellenic affiliation also did not predict AmED consumption, while class year remained a significant predictor (p<.05) of AmED consumption. Lastly, a mediation analyses was conducted using logistic regression techniques. Results showed that behavioral intention is a complete mediator for the effect of subjective norms on AmED consumption and is also a partial mediator for the effect of attitudes on AmED consumption in the last 30 days. Despite the cross-sectional nature of this study, its primary strength was its application of theory to better understand AmED use among college undergraduates. Findings from this study have implications for future intervention development aimed at targeting preventive efforts among college populations.
Correlates for metabolic syndrome among employees at a Southeastern university
(University of Alabama Libraries, 2013) Johnson, Paige Turner; Turner, Lori W.; University of Alabama Tuscaloosa
Presently, it is estimated that thirty-four percent of Americans, over the age of twenty years, have a combination of risk factors known as metabolic syndrome. OBJECTIVES: This study examined the relationship of the risk factors for metabolic syndrome and multiple lifestyle variables. METHODS: Data was collected on 1358 employees from a southeastern university that participated in a wellness program. After controlling for missing variables, 1156 employee records were used to identify the relationship between risk factors for metabolic syndrome and lifestyle variables. Metabolic syndrome risk factors were analyzed along with covariates of demographics and self -reported overall physical health status. RESULTS: Significant relationships were identified to explain lifestyle variables and the cluster of risk factors in metabolic syndrome. CONCLUSIONS: These findings suggest that metabolic syndrome is associated with the modifiable risk factors of sleep and physical activity. Metabolic syndrome is also predictive of poor self-reported overall physical health status. Some findings from this study support previous research efforts, while some are unique to this southeastern population. The findings from this research will translate into health promotion activities aimed at decreasing risks of metabolic syndrome in individuals that are most susceptible.
Influence of a content course and early field experience on preservice teachers' acquisition of content and pedagogical content knowledge
(University of Alabama Libraries, 2013) Shipp, Kate Hall; Curtner-Smith, Matthew; University of Alabama Tuscaloosa
The purpose of this study was to examine the influence of one content course and its follow-up early field experience (EFE) on preservice teachers' (PTs) acquisition of content knowledge (CK) and development of pedagogical content knowledge (PCK). The three specific sub-questions which guided data collection and analysis were (a) With what level of CK did PTs enter a PETE program?, (b) How did PTs acquire CK and develop PCK during the content course?, and (c) How did PTs acquire CK and develop PCK during the follow-up EFE connected with the content course? Participants were 16 PTs enrolled in the content course and EFE. Six qualitative techniques were employed to gather data. Data were analyzed using analytic induction and constant comparison. Findings indicated that the majority of the PTs who began the course with very little CK and no PCK acquired impressive levels of both forms of knowledge and were fairly successful in terms of teaching third grade children swimming and basic aquatic skills. Factors that enhanced the acquisition of CK and PCK were the course structure, pedagogical strategies used by the instructor, nature of the content, and the children who took part in the EFE. Factors that negated the effectiveness of the hybrid course were the level of PTs' CK at entry and the length of the EFE. PTs' acculturation either facilitated or negated the acquisition of both forms of knowledge depending on whether they began the course with coaching or teaching orientations.
An evaluation of the intention of college students to utilize calorie labeling in fast food and full-service restaurants: application of the Theory of Planned Behavior
(University of Alabama Libraries, 2013) Stran, Kimberly; Knol, Linda L.; Turner, Lori W.; University of Alabama Tuscaloosa
The Restaurant Nutrition Menu Labeling Requirement of the Affordable Care Act will require chain restaurants to provide calorie information on menus. The Theory of Planned Behavior (TPB) includes attitudes, subjective norms, and perceived behavioral control constructs, and explains attributes that lead to behavior intention and use of menu labeling in meal selection. Studies on characteristics of college students who use menu labeling in restaurants are limited. The purposes of this study were to determine predictors of intention to use calorie information, whether students changed meal choices after viewing calorie information, and describe groups of students most likely to change meal selections in fast food and full-service restaurants. Two hundred undergraduate students, 19 years or older, participated in this quasi-experimental study. Students participated in the full-service (n=100) or fast food (n=100) portion of the study. Participants selected a meal from a menu without calories, selected a meal from the same menu with calorie information, and completed a survey that addressed TPB constructs, intention, and potential barriers. Backward elimination was used to determine significant predictors of intention to use labels and changes in calories of meals ordered. Students ordered significantly fewer calories with posted calorie information on both fast food (909 versus 838 calories, p=0.02) and full-service (1370 versus 1203 calories, p<0.01) menus. Subjective norms (p<0.01) and perceived behavioral control (p=0.03) were predictive of greater intention to use calorie information on fast food menus but not of a change in caloric intake. Barriers such as cost (p=0.07) and perceived ease of label use (p=0.01) were associated with fewer calories ordered while lack of time (p=0.05) and hunger (p=0.02) were associated with an increase in calories ordered with posted information on fast food menus. Attitudes (p=0.04), subjective norms (p<0.01), and perceived behavioral control (p<0.01) predicted greater intention to use calorie information on full-service menus. Lack of time (p=0.08), frequent Nutrition Facts panel use (p=0.05), and positive attitudes (p<0.01) towards menu labeling predicted decreases in calories ordered with posted information on full-service menus. Menu labeling could provide information that college students need to select lower calorie items at both fast food and full-service restaurants.
Relationships between high school students' health behaviors and perceptions of their 9th grade health education experience
(University of Alabama Libraries, 2014) Mitchell, Qshequilla Parham; Birch, David A.; University of Alabama Tuscaloosa
In the majority of U.S. schools, health education has been delivered in a fragmented and disorganized way resulting in poor quality. While studies have assessed the perceptions of health education from lead health education teachers and school administrators, a review of the literature revealed no studies of high school students' perceptions of school health education. The perceived experiences and perceptions of school health education among high school students have not been fully explored. The purpose of this study was to a) assess the perceptions of a 9th grade health education course from 10th and 11th graders attending a rural high school in West Central Alabama, b) identify students' self-reported current health behaviors and c) explore the relationship between the perceptions of their 9th grade health education course and reported health behaviors. Results showed that for each of the National Health Education Standards at least 60% of the students indicated that the course helped them to perform the standard. Results also showed that for each of the six CDC risk behaviors at least 50% of students indicated that the course helped them to make decisions about the risk behaviors. Additionally, at least 55% of high school students in grades 10-11 perceived their 9th grade health education course to be effective in helping them to make decisions about their general health and decisions related to the six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, a) behaviors that contribute to unintentional injuries and violence, b) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection, c) alcohol and other drug use, d) tobacco use, e) unhealthy dietary behaviors, and f) inadequate physical activity. Over 60% of 10th grade students and 55.4% of 11th grade students perceived their 9th grade health education course to be effective in preparing them to use decision-making skills to enhance health. Similarly, 10th grade students (70.8%) and 11th grade students (59.5%) perceived their 9th grade health education course to be effective in preparing them to comprehend concepts related to health promotion and disease prevention.
Predictors of depression diagnoses and symptoms in veterans: results from a national survey
(University of Alabama Libraries, 2014) Thomas, Katherine Hendricks; Turner, Lori W.; University of Alabama Tuscaloosa
The suicide numbers among active duty military personnel eclipsed the number of combat deaths in 2011. Before the wars in Iraq and Afghanistan, the incidence of suicide in active duty US service members was consistently 25% lower than in the civilian population. Currently military and veteran suicide rates exceed those found in the general population, with 22 per day being the most conservative estimates by the Veteran's Administration. The reasons for this are multi-faceted, with the question looming as to whether repeated ground combat tours have a deleterious effect on resilience and overall mental health. Operational tempo in the last ten years has exceeded all previous expectations and metrics; frequent trips to Iraq and Afghanistan are commonplace for this community. The purpose of this study was to examine the relationship between ten key variables and rates of diagnosed depression and symptoms of undiagnosed depression in a national sample of veterans to generate predictive models for the condition in military veterans. This study utilized secondary data analysis of veteran respondents using the 2012 Behavioral Risk Factors Surveillance Survey conducted by the Centers for Disease Control and Prevention. Logistic regression analysis explored associations between diagnosed and undiagnosed depression in veteran respondents and independent variables including: veteran era, sex, ethnicity, race, relationship status, physical activity, binge drinking, smoking, physical disability and pain, and beliefs about mental health care's usefulness. This timely and culturally-relevant line of inquiry offers insight that may guide targeted resilience programming for the veteran community.

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