Theses and Dissertations - Department of Health Science

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Browsing Theses and Dissertations - Department of Health Science by Subject "Health Sciences, Public Health"

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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.
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    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.