UMD Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/1903/3

New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a given thesis/dissertation in DRUM.

More information is available at Theses and Dissertations at University of Maryland Libraries.

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Subject: search.filters.subject.Cancer Screening

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    Essays on Health Care Satisfaction, Health Insurance, and Cancer Screening Among Veterans
    (2021) Frost, Sydney; Chen, Jie; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Objective: to determine differences in satisfaction of health care services among veterans based on insurance type/coverage and the impact of service utilization of cancer screening services among female veterans who have received health care services within past 12 months. Methods: IPUMS National Health Interview Survey (NHIS) for the years 2013-2018 were used and logistic regressions applied. Results: veterans with VA-only coverage are significantly more dissatisfied with the services they receive compared to veterans who have any-private coverage. Conclusion: there are differences between satisfaction of care among veterans based on insurance type, but differences do not impact cancer screening utilization among female veterans who utilized health care services within the past 12 months. Future work: findings could be utilized to determine ways to increase satisfaction of care received among veterans within the VA, or drive policy creation to allow veterans to access health care services at non-VA facilities.
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    The relationship between health literacy and indicators of informed decision making for colorectal cancer screening among African Americans
    (2016) Tagai, Erin Kelly; Holt, Cheryl L; Garza, Mary A; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    African Americans are disproportionately affected by colorectal cancer (CRC) incidence and mortality. CRC early detection leads to better treatment outcomes and, depending on the screening test, can prevent the development of CRC. African Americans, however, are screened less often than Whites. Aspects of decision making (e.g., decisional conflict, decision self-efficacy) can impact decision making outcomes and may be influenced by social determinants of health, including health literacy. However the relationship between social determinants of health and indicators of decision making in this population is not fully understood. Additionally, individuals have a choice between different CRC screening tests and an individual’s desire to use a particular screening test may be associated with social determinants of health such as health literacy. This study aimed to examine the relationship between social determinants of health and indicators of decision making for CRC screening among African Americans. A total of 111 participants completed a baseline and 14-month follow-up survey assessing decisional conflict, decision self-efficacy, decisional preference (shared versus informed decision making), and CRC test preference. Health literacy was negatively associated with decisional conflict and positively associated with decision self-efficacy (ps < .05). Individuals who were unemployed or working part-time had significantly greater decisional conflict than individuals working full-time (ps < .05). Individuals with a first-degree family history of CRC had significantly lower decision self-efficacy than individuals without a family history (p < .05). Women were significantly more likely to prefer making a shared decision rather than an informed decision compared to men (p < .05). Lastly, previous CRC screening behavior was significantly associated with CRC test preference (e.g., individuals previously screened using colonoscopy were significantly more likely to prefer colonoscopy for their next screening test; ps < .05). These findings begin to identify social determinants of health (e.g., health literacy, employment) that are related to indicators of decision making for CRC among African Americans. Furthermore, these findings suggest further research is needed to better understand these relationships to help with the future development and improvement of interventions targeting decision making outcomes for CRC screening in this population.