http://hdl.handle.net/1903/2802 2013-05-26T01:24:33Z http://hdl.handle.net/1903/13698 Title: DEMOGRAPHIC AND PSYCHOSOIAL CORRELATES OF WATERPIPE USE AMONG COLLEGE STUDENTS Authors: Sharma Acharya, Eva Abstract: The primary goal of this study was to characterize the role of demographic and psychosocial factors that influence waterpipe use among college students. Data were gathered in two stages that incorporated mixed methods. A series of 59 in-depth interviews were conducted with college students who were established waterpipe smokers. Participants identified socializing as the main reason to smoke waterpipe. Other reasons included social acceptance of waterpipes compared to cigarettes, peer influence, relaxation, perception of looking "cool" and physiological effects commonly referred to as "buzz." Perceptions that smoking waterpipe was safer and less addictive than smoking cigarettes were fairly common. The second stage involved a cross sectional survey (n=378), conducted among college students. The goal of the survey was to examine the association between demographic factors, background variables (involvement in Greek organizations, participation in athletics, and living arrangements), and psychosocial factors (perceived risks, resistance self efficacy, peer influence) in relation to waterpipe use among college students. Ever use of waterpipe smoking was reported by 59%. Students who had ever smoked cigarettes or cigars and had a best friend who smoked waterpipes were more likely to ever smoke waterpipe. Also, college students with high levels of resistance self-efficacy were less likely to ever smoke waterpipe. The secondary aim of the study was to develop an instrument that measured the social contexts of smoking waterpipe among college students. A pool of 50 items was administered to a purposive sample of college students (n=274), who were regular waterpipe users. Three factors emerged that accounted for a cumulative variance of 47% and possessed adequate reliability. These factors were labeled "social facilitation", "family/cultural influence", and "alternatives to cigarettes." The summed scores for the three social context subscales were examined across frequencies of waterpipe use. Those who reported smoking waterpipe at least on weekly basis reported significantly higher scores on social facilitation than the other two groups. Similar effects were observed for family/cultural influence; weekly smokers used waterpipe more frequently in a context of family/cultural influence than occasional smokers. Understanding patterns of correlates of waterpipe use among college students is critical in developing interventions. 2012-01-01T00:00:00Z http://hdl.handle.net/1903/13089 Title: CONDOM USE IN OLDER AFRICAN AMERICANS: AN EXPLORATORY STUDY Authors: Ramos, Ina Ananda Abstract: The purpose of this mixed methods exploratory study was to examine perceptions regarding condom use and sexual intercourse among African Americans 50 to 65 years of age, specifically attitudes, norms, self-efficacy and barriers regarding condom use behavior. There were three study phases: 1) a pilot study of the survey instrument (N=31), 2) an on-line survey (N=175), and 3) post survey explanatory interviews (N=10). The online survey contained items from the Sexual Risk Behavior Beliefs and Self-Efficacy Scales (SRBBS) (Basen-Enquist et al., 1999). Pilot study data indicated the online survey was understandable, acceptable, readable and appropriate for use by this sample of African Americans. Factor analyses of the survey items yielded similar constructs to the original SRBBS with seven of eight scales demonstrating internal consistency; Cronbach's alpha reliabilities ranged from .49 to 1.0. Logistic regression models found two independent variables increased the likelihood of condom use (condoms should be used even if people know each other well and friends feel condoms should be used even if pregnancy isn't possible) and two decreased the likelihood of condom use (friends feel you should use condoms even if people know each other well, and using condoms would be a hassle). A logistic regression model of significant independent variables found that provider speaking to patients about safer sex and male gender increased condom use, while being married and lower educational level decreased condom use behavior. Post-survey interviews, where participants (N = 10) were asked to elaborate on study findings, yielded six themes (the importance of trust and relationships, lack of knowledge, attitudes about condom use, sexual activity, health care providers, and friends opinions) that further explained statistical findings. Findings from this study have the potential to reduce the spread of HIV/STDs in this population through the use of educational programs that include empowerment and risk reduction components. Additionally, health care providers can potentially play a key role in these efforts and should be trained on how to communicate effectively with older adults around sexual health. 2012-01-01T00:00:00Z http://hdl.handle.net/1903/13065 Title: PREDICTORS OF RESILIENCE AMONG COMMISSIONED OFFICERS IN THE UNITED STATES PUBLIC HEALTH SERVICE Authors: Peat, Raquel Antonia Abstract: The purpose of this cross-sectional study was to examine the predictors of resilience and mental health among United States Public Health Service (USPHS) commissioned officers who have deployed. The study employed the Transactional Model of Stress and Coping (Antonovsky and Kats, 1967; Cohen, 1984; Lazarus and Cohen, 1977) to aid in evaluation of the above factors. Relatively few research studies have examined the concept of resilience, and to date, no study has systematically examined risk, social support, mental health and resilience in USPHS commissioned officers. A pilot study (N = 11) was conducted to determine acceptability of the survey items and assess time needed to complete the questionnaire. The final 94-item on-line survey was completed over a two month time period by a convenience sample of 534 USPHS commissioned officers. Univariate analyses demonstrated that when entered individually, team support, post-deployment social support and mental health (protective factors) and the covariates, gender and relationship status were significantly (p<0.05) associated with resilience, while predeployment affectivity (risk factor) was not. When all risk and protective factors were entered into the multivariate logistic regression model, team support, post-deployment social support, mental health, gender and being divorced as compared to being separated, widowed or living with a partner were found to be significantly associated with resilience (p<0.05). Also, both team support and resilience were negatively associated with mental illness measured using depression, anxiety and post-traumatic stress disorder subscales (p<0.05). Those USPHS commissioned officers who reported mental illness were less likely to be resilient. This study provides new data that may help improve our understanding of the resilience and mental health of USPHS commissioned officers, before and after deployment. Findings can be used to inform education and training programs for USPHS commissioned officers (e.g. coping skills training techniques) to help increase their ability to thrive despite adversity before and after deployment. 2012-01-01T00:00:00Z http://hdl.handle.net/1903/12989 Title: Self-Efficacy and Stigma in Seeking Mental Health Services in the U.S. Army Authors: Koeppl, Patrick Thomas Abstract: Among the highest personal costs, and perhaps the most pervasive and potentially disabling consequences of engaging the U.S. military in combat operations, is the threat to the psychological health of the servicemen and women and the associated impacts on their families. Negative stigma associated with seeking mental health services undermines servicemen and women's access to such services and to seeking the care they require, either for themselves or their families. While negative stigma is well documented in servicemen and women and their families, little has been done to understand the role self-efficacy plays in relation to servicemen and women seeking such services. This study assessed and evaluated aspects of stigma associated with seeking mental health services among members of the U.S. Army, and explored the role self-efficacy plays in predicting the seeking of those services. It also sought to explore and understand the factors which predict servicemen and women's willingness to seek mental health services for themselves and their children in an environment where stigmatization of those who seek such services is high. This study included an analysis of data from a 53-item email survey administered to active-duty Army servicemen and women in 2007. Stigma was found to be the primary barrier to servicemen and women's willingness to seek care for themselves or for a child, and self-efficacy was found to moderate the relationship between stigma and willingness to seek mental health services. The results of this study will provide information pertinent to developing strategies and interventions for the U.S. Army to assist their servicemen and women (and their families) in overcoming negative stigma associated with seeking mental health services and for improving the access to and use of mental health services offered by the Army. 2012-01-01T00:00:00Z