Behavioral & Community Health Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2802
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Item PREDICTORS OF RESILIENCE AMONG COMMISSIONED OFFICERS IN THE UNITED STATES PUBLIC HEALTH SERVICE(2012) Peat, Raquel Antonia; Desmond, Sharon M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)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.Item Factors Influencing Childhood Swimming Instruction: Evaluation of the "Safe Water Initiative: Maryland" Program for Drowning Prevention(2010) Monteiro, Erinn Hurley; Green, Kerry M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Increasing swimming ability is a key preventive step in decreasing childhood drowning, a leading cause of unintentional mortality in the U.S. Yet, it remains unclear what factors influence parents to ensure that their children learn to swim. This study examined how attitudes, beliefs, perceptions, and barriers relate to parents' intentions and decisions to seek swimming instruction for their children. The evaluation also examined whether free introductory swimming lessons may be a useful model in changing any of these factors. Methods: The Safe Water Initiative: Maryland (SWI:M) community-based program provided free introductory lessons in summer 2010 to over 100 children who had previously never received swimming instruction. Parents/guardians completed pretest (N = 81) and posttest (N = 79) written surveys as well as a second follow-up online survey six weeks after the program ended (N = 71). The pre-and post-test surveys included questions about barriers as well as two scales on attitudes/beliefs about swimming importance and perceptions about drowning risk. These two scales were developed and their reliability (alpha=.70-.89) and validity evaluated as part of this study. Results: Participants were predominantly African-American mothers, the majority of whom had little to no swimming ability. Results revealed significant increases in attitudes/beliefs, perceptions, and intentions from the beginning to the end of the SWI:M program. While attitudes/beliefs and perceived susceptibility were significant predictors of intentions, strong intentions did not predict behavior, as only 14% of participants' children had received additional swimming lessons by the second post-test. Cost was reported as a significant barrier to pursuing additional instruction. Conclusions: This study provides preliminary findings for future research investigating factors influencing childhood swimming instruction. Reduced- or no-cost swimming lessons may be a key drowning prevention method, but additional research is warranted to find ways to address prevailing barriers. Evaluating the effectiveness of this and other programs is an important step in potentially decreasing morbidity and mortality due to drowning.Item Survey of Maryland Dentists' Knowledge, Opinions and Practices About Oral Cancer Prevention and Early Detection(2010) Maybury, Catherine A.; Green, Kerry; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)To reduce the morbidity and mortality associated with oral cancer, dentists must have oral cancer prevention and early detection knowledge and skills, and they must perform routine screening examinations. Maryland dentists were surveyed to assess their knowledge, opinions and screening practices relating to oral cancer prevention and early detection. Thirty-eight percent of dentists had a high level of knowledge of oral cancer risk factors, thirty-nine percent had a high level of knowledge of oral cancer diagnostic procedures, and thirty-eight percent received a high score for provision of oral cancer examinations. Dentists who strongly agreed or agreed that their oral cancer knowledge is current were more likely to receive a high score for knowledge of oral cancer diagnostic procedures and knowledge of risk factors and diagnostic procedures combined. Deficiencies exist in dentists' knowledge and practices relating to oral cancer. Actions are needed in education, policy and research to address these deficiencies.