Behavioral & Community Health Theses and Dissertations

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End date: 2009Subject: search.filters.subject.Health Sciences, Education

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    Sustainability of Healthy Tomorrows Partnership for Children Program
    (2005-04-21) Robertson, Latricia C.; Desmond, Sharon M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    ABSTRACT Title of dissertation: SUSTAINABILITY OF HEALTHY TOMORROWS PARTNERSHIP FOR CHILDREN PROGRAM Latricia C. Robertson Doctor of Philosophy, 2005 Dissertation directed by: Associate Professor Sharon M. Desmond Department of Public and Community Health The purpose of this study was to determine sustainability, the main reason(s) for sustainability, and the relationship between the amount of annual matching funds (as well as the extent of overmatch) and sustainability of the Healthy Tomorrows Partnership for Children Program (HTPCP) projects. In addition, the development of a predictive sustainability model was proposed. Ninety-four HTPCP projects received federal funding from 1989 through 1997. Five of these projects participated in the pilot-test for this study. The remaining 89 project directors (PDs) were mailed the Level of Institutionalization (LoIn) Instrument, developed by Goodman, et al. (1993), to measure institutionalization/sustainability in preventive health programs. Eighty-one PDs responded to the HTPCP survey questionnaire (91% response rate). Project directors were predominately female (80%) and had up to eight years of formal education after high school (59%). Thirty-five percent of the PDs were pediatricians, and their ages ranged from 32 - 80 years of age. Sustainability of the HTPCP projects was demonstrated in this study. Another major finding was that a HTPCP project with a pediatrician PD (as opposed to all other disciplines) was less likely to have written and operationalized program objectives.
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    AN EXAMINATION OF THE RE-INVENTION PROCESS OF A HEALTH PROMOTION PROGRAM: THE CHANGES AND EVOLUTION OF "FOCUS ON KIDS" HIV PREVENTION PROGRAM.
    (2004-04-27) Galbraith, Jennifer Scott; Boekeloo, Bradley; Public and Community Health
    Behavioral prevention programs remain one of our most powerful tools in slowing the human immunodeficiency virus (HIV) epidemic. However, questions persist on balancing fidelity of these programs and adapting them to a different target population or setting. The current study explored the extent to which "Focus on Kids," an HIV prevention program with efficacious results from a carefully conducted study, was re-invented when adopted by other agencies and implemented in new settings. This study investigated the quality of re-invention by using a proxy variable of adherence to the core components of the curriculum thought to be responsible for the positive behavior change. The use of a snowball sampling technique identified 34 service providers who had utilized the curriculum. After conducting a telephone survey with the participants, an ex post facto design was used to determine the relationship between reasons for re-invention and other variables thought to be associated with re-invention quality. Results indicated that considerable re-invention occurred. Organizations frequently changed and deleted activities and over half of respondents added new activities. The research allowed the construction of a model of re-invention with factors that were both positively and negatively associated with quality re-invention. Decreasing re-invention quality was associated with citing certain reasons for re-invention: time constraints or the host agency required change. Factors associated with quality implementation included an adopter organization being a national non-governmental organization, having a researcher on the team, or citing expanding to new topics as a reason for re-invention. The results of this study demonstrate the need for curriculum developers to understand the real world environment in which HIV prevention curricula are used. Developers must facilitate practitioners' understanding of the theory and core components of the curriculum thought to be responsible for behavior change.
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    THE EFFECT OF TWO DEATH EDUCATION PROGRAMS ON EMERGENCY MEDICAL TECHNICIANS
    (2004-03-29) Smith-Cumberland, Tracy Lynne; FELDMAN, ROBERT H.L.; Public and Community Health
    This study examined the changes in behavioral intent of EMTs in six EMS agencies in Wisconsin after exposure to 1 of 2 death education programs. The effectiveness of the programs was evaluated by a comparison of pretest and posttest scores on behavioral intent of on-scene death-related behaviors using non-equivalent control group design. One intervention group participated in a 2 day workshop using the Emergency Death Education and Crisis Trainingsm (EDECTsm) curriculum. A second intervention group participated in a 2 hour didactic Continuing Medical Education (CME) session on making death notifications. A third group served as a control group and participated in a 2 hour CME session not related to death. Prior to this research, no formal evaluations existed on the impact of these two programs. Ajzen's (1985) Theory of Planned Behavior was used to predict participant's death-related behavioral intentions, attitudes, subjective norms, and perceived behavioral control towards a behavior. Evaluation included comparisons on multiple measures, which stemmed from the goals of the programs. Study results indicated that the majority of EMTs intend to change their behaviors at the scene of a death after receiving either training program. Changes were greatest for the group exposed to the EDECTsm curriculum. In addition to testing the hypothesis, several questions explored EMTs' attitudes toward their role on-scene and their previous death-related training. Analysis of these questions show that most EMTs feel that death notifications and helping bereft families are part of their roles as an EMT. The need for death-related programs to help emergency responders manage bereaved families and the lack of methodologically rigorous evaluation studies of such programs were the principal factors that led to this study. Although there were limitations suggesting caution when interpreting the results, the evaluation showed these programs to be effective in changing the behavioral intent of EMTs. The effectiveness of these programs on EMTs and other emergency providers warrants further study.