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.Health Sciences, Education

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Now showing 1 - 5 of 5
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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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    CONTRIBUTING FACTORS TO RESILIENCE IN RELAPSING-REMITTING MULTIPLE SCLEROSIS
    (2004-11-18) DEARMAS-VALDES, CARMEN ALINA; Power, Paul W; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study examined the relationship between spirituality, medical access and support, social support and involvement, perceived severity of illness, illness status and resilience (i.e., self-reliance, equanimity and meaningfulness) in multiple sclerosis (MS). The sample consisted of 152 individuals diagnosed with relapsing-remitting MS who were either attending a neurology clinic, members of the National MS Society or members of a support group in the Northern Virginia, Washington DC area. Participants completed the Contributing Factors Questionnaire (CFQ), the Resilience Scale (RS), and the Spiritual Perspective Scale (SPS). The results indicated that individuals who had attributed higher rates of importance to medical access and support from doctors and nurses had an increased awareness that their lives had purpose and meaning. Furthermore, perceived severity of illness was significantly negatively related to self-reliance; those individuals who had a more severe perception of illness had a decreased belief in themselves and their capabilities. There was also a significant interaction effect between perceived severity of illness and spirituality on self-reliance and meaningfulness. That is, individuals with a more severe perception of illness who had higher levels of spirituality reported increased belief in themselves and their capabilities and an increased awareness that their lives had purpose and meaning. In addition, there was a significant interaction effect between illness status and spirituality on self-reliance and meaningfulness. That is, those individuals experiencing a relapse with higher levels of spirituality reported an increased belief in themselves and their capabilities and an increased awareness that their lives had purpose and meaning. There was neither a statistically significant relationship between spirituality, illness status and self-reliance, equanimity and meaningfulness nor between social support and involvement and self-reliance, equanimity and meaningfulness. There was not a significant relationship between medical access and support and self-reliance and equanimity. There was not a significant relationship between perceived severity of illness and equanimity and meaningfulness. There was not a significant relationship between spirituality and self-reliance, equanimity and meaningfulness after controlling for other contributing factors. There was not a significant interaction effect between perceived severity of illness and spirituality and between illness status and spirituality on equanimity.
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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 Development of Maternal Confidence for Labor Among Nulliparous Pregnant Women
    (2003-11-14) Kish, Julia Ann; Sawyer, Robin G.; Human Development
    Certain levels of fear and anxiety about childbirth are expected, especially among first-time mothers. However, problems arise when these feelings negatively impact a woman's decisions and perceptions about the birth process. Although millions of women give birth each year, there are limited data to document the development of maternal confidence for labor and fear of labor throughout the period of gestation. Applying Bandura's theory of self-efficacy, current research on maternal confidence for labor suggests women with increased childbirth self-efficacy experience decreased levels of perceived pain and increased levels of satisfaction with birth. The purpose of this quasi-experimental, multi-time series research study was to examine the development of maternal confidence for labor among nulliparous pregnant women throughout gestation. The following primary research question was addressed: Does maternal confidence for labor actually increase (i.e., fear decrease) as pregnancy progresses? Other research variables indicated in the literature to have an impact on maternal confidence were examined including prenatal care provider (physicians and midwives), attendance at a childbirth class, perceived childbirth knowledge, emotional support and importance of a medicine-free birth. A convenience sample of 46 nulliparous women completed three mail questionnaires (one at 8-12 weeks of gestation, 28 weeks, and 37 weeks) and a postpartum telephone interview. All three mail questionnaires were similar in content and contained two scales, the Maternal Confidence scale and the Fear of Childbirth scale. Data was collected from August, 2001 through June, 2003. A significant inverse relationship between maternal confidence for labor and fear of childbirth was found throughout gestation. Other major findings of this study included: 1) a significant positive relationship between perceived knowledge and maternal confidence, and 2) increased fear among women who initially seek midwifery-based prenatal care at 8-12 weeks of pregnancy. The type of prenatal care a woman obtains (midwifery-care or physician-based care) did not significantly impact her confidence for delivery or fear of childbirth. It is recommended future studies examine the role of self-efficacy with regard to childbirth in greater depth for nulliparous women throughout gestation or prior to pregnancy.
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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.