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.
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Item Campus Oasis: A Sanctuary for Learning & Wellness(2024) Watson, Omari; Abrams, Michael C; Architecture; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The relationship between the built environment and its occupants can have a negative and positive effect on their wellbeing. Students across all college campuses experience stress, depression, and anxiety. The stress of academia can be impacted from the built environment, however, the spaces we decide to be in can relieve the stress if designed properly. Mental health support for students is a critical issue that can be addressed architecturally with biophilic design. The goal of this thesis is to explore the relationships between environmental psychology and the built environment to design spaces that improve the occupant’s well-being. The architecture embodies wellness shared with the natural and built environment with the focus on the user experience. Concepts such as phenomenology and biophilic design will be applied to design a welcoming and healing environment. The design of a spa and wellness center will function as a haven for the students and staff of an institution to decompress, relax, learn, feel motivated and feel relieved. The project will become a precedent for other colleges and universities to support their community against mental health issues.Item “SCREAMING DOWN THE HALLWAY”, BUT NO ONE IS LISTENING TO ME: EXPLORING THE LIVED EXPERIENCES OF BLACK RESIDENTIAL STUDENT AFFAIRS PROFESSIONALS REGARDING OCCUPATIONAL WELLNESS AT HISTORICALLY WHITE INSTITUTIONS(2023) Dissassa, Di-Tu; Moore, Candace M; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Amid ongoing occurrences of racism in the United States, consideration of the campus climate for Staff of Color remains under explored in literature. Specifically, Black student affairs employees who both live and work on campus are an understudied population regarding how race intersects with their residential life roles and how their wellness is impacted through these intersections. Through this study’s use of critical frameworks, the coresearchers and I sought to uncover their lived experiences through interviews, reflections, and focus groups. Four themes emerged from the findings of this research: (a) The Live-In Experience as Socialized and Conventional, (b) Belonging as Dualism, (c) Physical Safety as an Impediment to Occupational Wellness, and (d) Performativity as Racism. The coresearchers articulated that they were socialized into their experiences, yet (a) felt little belonging on campus due to their race and (b) felt a misfit when living in residence halls. Although the sense of belonging findings were consistent with existing campus climate research, articulated aspects of physical safety-related occupational health theories regarding occupational wellness suggested the coresearchers felt occupational distress surrounding their physical safety. The coresearchers also highlighted clearly that they experienced high levels of performative antiracism efforts from their departments and institutions, leading to feelings of isolation. Despite these challenges, the coresearchers described finding solace in community with other Black people and People of Color to provide aspects of wellness their institutions could not provide. Further research is needed to truly understand the implications of departmental and institutional leadership around performativity and lack of belonging for Staff of Color.Item ESSAYS IN THE ECONOMICS OF HEALTH EDUCATION IN DEVELOPING COUNTRIES: EVIDENCE FROM VIETNAM(2022) Noh, Haeyun; Leonard, Kenneth L; Agricultural and Resource Economics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Health education is widely implemented in school settings to prevent risky health behaviors of teenagers. The majority of the information-based programs target adolescents, when individuals’ health attitudes and behaviors are formed. In particular, schools are a vital place to implement a health education program to reach a large number of teenagers for years in a financially sustainable and logistically convenient way. However, a body of empirical studies finds limited effects on behavioral changes. My dissertation exploits randomized controlled trials in Vietnam to investigate a school-based health education intervention. In the first two chapters of my dissertation, I examine the effects of health education on adolescents’ health outcomes. The first chapter explores multidimensional health domains, including health behaviors and psychological health factors. In the second chapter, I focus on sexual and reproductive health education to assess to which extent health education affects teenagers by evaluating the effects on health knowledge, attitudes, and behaviors. In health education programs, classroom observation is often employed to improve the quality of teaching. However, its implications on students’ learning in sensitive health topics are understudied. Against this background, in my third chapter, I investigate whether and how the presence of an observer affects students’ learning in sexual and reproductive health education.Item “STARTED FROM THE BOTTOM, NOW WE’RE…WHERE?”” A QUALITATIVE ANALYSIS OF STRESS AND COPING AMONG HIGHLY EDUCATED BLACK WOMEN(2021) Ellick, Kecia Lurie; Lewin, Amy B; Roy, Kevin M; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Rationale: Black women suffer disproportionate rates of stress-related diseases including heart disease, diabetes, cancer, maternal mortality, and depression. Education is promoted as a protective factor against these outcomes. An increasing number of Black women are leveraging advanced degrees to secure leadership positions in education, law, science, and technology. Yet, highly educated, middle-class Black women experience the same deleterious health outcomes, at the same rates, as Black women living in poverty. This suggests that neither education nor its correlates protect Black women from harmful outcomes. It further suggests that, for Black women, the cost of social mobility afforded by advanced education may result in diminishing returns by reproducing and reinforcing social inequalities that inform and exacerbate negative experiences.Purpose: The purpose of this study was to explore the experiences of highly educated Black women during their prime work, partnering, and reproductive years. This study examined the strategies that highly educated Black women employed to cope with stressors perceived while navigating, negotiating, and performing multiple roles, social identities, and responsibilities in their personal and professional lives. Methods: Data was collected from a sample of Black, middle-class women living in Georgia, ages 28 - 49, with doctorate degrees (n = 24, Mage = 40.2) via in-person, semi-structured interviews. Following a constructivist grounded theory approach, a triadic scheme of open, axial, and selective coding will be performed to uncover emergent themes from women’s narratives. Findings: Evaluation of the data revealed three central themes that serve as the main findings of this study and answer the study questions about how highly educated Black women experience and cope with stress: 1) redefining of the strong Black woman, 2) prioritization of self-care practices and, 3) unapologetic authenticity. Discussion: This study explored the heterogeneity of Black women and contributes to the body literature focused on the interactive effects of race, gender, and class. It provides empirical data on the ways in which Black women experience, perceive, and respond to stress and highlights the ways in which Black women take proactive approaches to protect their health and well-being.Item Understanding the Process of Sexual Health Communication Between African American Fathers and Their Daughters: A Multi Analytic Method Qualitative Study(2021) Kachingwe, Olivia; Aparicio, Elizabeth M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)African American youth and young adults living in the United States are disproportionately burdened by HIV/AIDS, and when compared to women of other races and ethnicities, African American women have the highest rate of chlamydia, gonorrhea, and syphilis. Although sexual health communication is a well-established protective factor against unprotected sexual intercourse, African American fathers and their daughters are a largely under-studied dyad in comparison to sexual health communication between intimate partners or mother-child dyads.The current dissertation study focused on sexual health communication between African American fathers aged 52-60 (M=56.7) years and daughters aged 19-21 (M=20.3) years recruited in Maryland and the District of Columbia. Of the 19 participants, 7 father-daughter dyads were interviewed, and each participant individually completed a semi-structured interview. This dissertation study encompasses three separate analyses, each presented as separate articles. Article One and Two used thematic analysis, and Article Three used constructivist grounded theory analysis. In Article One, thematic analysis revealed five themes among the topics fathers and daughters perceive to be the most challenging or easy to discuss with one another, and which topics, when discussed, have the greatest impact on daughters’ sexual behaviors. Each theme had two to six sub-themes. Although there were several topics fathers and daughters found easy or challenging to discuss with one another, there were also several topics that were neither definitively easy nor challenging but rather varied across dyads. In Article Two, thematic analysis produced five themes, with two to three sub-themes each, that characterize the family dynamics surrounding the perceived impact of father-daughter sexual health communication on daughters’ sexual health behavior. Family structure, communication skills, parenting style and relationship quality all proved important. In Article Three, Constructivist grounded theory was used to develop a theory describing the process of sexual health communication between African American fathers and their daughters. Analysis revealed the core category fathers and daughters communicating about sexual health was related to three supporting categories: navigating social, cultural and familial contexts, valuing open communication, and avoiding the topic. Taken together, study findings elucidate the unique contribution of African American fathers towards their daughters’ sexual development and the many factors preventing increased and effective father-daughter sexual health communication. Study findings can be used to inform future interventions as we strive to take steps towards mitigating racial sexual health disparities.Item COMMUNICATING THE RISKS AND BENEFITS OF PRESCRIPTION OPIOID USE: SELF-CATEGORIZATION AS AN INTRINSIC MESSAGE FEATURE THAT INFLUENCES CONSTRUAL LEVEL(2020) Stanley, Samantha Joan; Atwell Seate, Anita; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The opioid crisis presents a challenge for risk communicators because the judicious short-term use of prescription opioids for noncancer pain may benefit quality of life but also poses risks such as the development of opioid use disorder, thus prompting calls for messaging to reduce the demand for prescription opioids. Communicating the possibility for benefits of short-term prescription opioid use and the risks is therefore ethically required, but message characteristics that simultaneously reduce the demand for opioids while offering complete information about its benefits would be most useful and ethical. Construal level theory posits that altering the level of abstraction of one’s mental representation of a choice meaningfully affects one’s cognitions and behaviors regarding said choice. However, in this theoretical framework changing the mental representation of a choice is usually achieved by methods unsuitable for public health messages that are communicated to a large audience (e.g., priming or changing the characteristics of a choice to be more psychologically distant) or interpersonally. Recognizing the limitations of these approaches, I suggest that self-categorization with its focus on self-construals at increasingly abstract levels may act as a potential intrinsic message feature that can affect construal level without altering the characteristics of the choice being evaluated. A thought-listing pilot study demonstrated that self-categorizing at the relational (i.e., significant other) versus subordinate level (i.e., individual) affects the type of salient behavioral beliefs. Study 1 experimentally demonstrated that altering self-categorization changes the extent to which participants focus on the pros of prescription opioid use (high construal level beliefs) but not their focus on the cons of use or psychological distance. However, psychological distance, pro focus, and con focus all predicted intent to use prescription opioids. Study 2 experimentally demonstrated that altering self-categorization in a message about pros and cons of using prescription opioids significantly indirectly predicted attitudes, subjective norm, and perceived behavioral control over prescription opioid use mediated by identity salience. Attitudes, subjective norm, and perceived behavioral control in turn predicted behavioral intent to use prescription opioids. This dissertation integrates construal level theory and self-categorization theory to provide an intrinsic message feature that alters behavioral intention to use prescription opioids.Item DESIGN, IMPLEMENTATION, AND EVALUATION OF A MINDFULNESS FOCUSED NUTRITION PROMOTION PROGRAM TO BALANCE USDA SCHOOL NUTRITION GOALS WITH FOOD WASTE REDUCTION IN ELEMENTARY SCHOOLS(2019) Schachtner-Appel, Amy Elizabeth; Song, Hee-Jung; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Healthy school meals offer numerous benefits for elementary school students, but low produce intake and high rates of waste prevent students from experiencing these benefits. This research aimed to create a mindful and sustainable eating intervention to encourage reduced waste and increased produce intake during lunch. The study was conducted using a mixed-methods triangulation approach for formative research, creation of a behavioral model to design a theory based intervention, and pilot test of the resulting program using a quasi-experimental controlled design. Formative findings, gathered from 50 3rd-5th grade focus group participants, 15 in-depth interviews with school staff, and 9 cafeteria observations supported the use of social cognitive theory (SCT) to explain eating behaviors and emphasized the importance of involving student leaders and creating environmental reinforcements. Pilot intervention approaches included delivery of an education curriculum, dissemination of messages by student leaders, cafeteria environment changes, and creation of a food recovery program. Measurements included observation of kindergarten – 5th grade lunches at baseline and follow-up (n = 162) to estimate foods selected, consumed, and wasted, survey of 3rd – 5th grade students at baseline and follow-up (n = 169) to measure psychosocial changes related to mindful and sustainable eating, and periodic food waste audits (n = 8) to monitor school-level plate waste. Baseline results showed students consumed only 36-42% of vegetables selected and 64-67% of fruit selected. At follow-up, intervention students selected more produce than controls (1.09 vs. 0.64 servings of vegetables; 1.32 vs. 1.06 servings of fruit). Similarly, they consumed more produce (0.51 vs. 0.33 servings of vegetables; 0.94 vs. 0.70 servings of fruit) than controls. Intervention students trended toward reduced vegetable waste while maintaining selection, whereas controls decreased selection substantially. Intervention students experienced significant increase in self-efficacy to base lunch choices on body cues. Higher produce consumption and lower waste were predicted by improved intentions to eat healthfully. Overall, the program successfully improved intake and trends indicate potential to reduce waste. Findings support expansion of the program, with potential to improve nutritional status of students and reduce the environmental impact of school meals.Item The Health Literacy Process Older Adult Long-Term Smokers Use to Make an Informed Decision about Lung Cancer Screening: A Grounded Theory Study(2019) Platter, Heather N; Feldman, Robert; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Lung cancer is the leading cause of cancer-related death in the United States with 160,000 annual deaths. Recent advances in screening technologies have proven effective in reducing mortality and increasing early stage detection of lung cancer, yet only 3.9% of the 6.8 million eligible Americans were screened in 2015. Potential barriers to lung cancer screening have been examined; however, there is limited research available on the impact of health literacy and the process of informed decision-making about lung cancer screening. To fill this gap, this study explored how health literacy relates to intentions and behaviors to screening for lung cancer among long-term smokers between 55 to 80 years old who have a 30-pack year smoking history, health insurance, and a provider seen in the past two years. The study was guided by the following research question: “How does health literacy relate to intentions and behaviors to screen for lung cancer?” Twelve participants (N=12) were enrolled in the study. Participants were 58.3% female, 83.3% black, 83.3% had screened for any cancer besides lung cancer, and 75% were current smokers with a 41.8 mean pack-year history. The majority of the sample (91.7%) had adequate health literacy based on the Short Test of Functional Health Literacy in Adults. Data were transcribed verbatim and analyzed using constructivist grounded theory methods, proceeding through four stages of coding (open, focused, axial, and theoretical). Analysis produced a Health Literacy Theoretical Model of Informed Decision-Making about Lung Cancer Screening. The theoretical model is underpinned by a core category: Making an Informed Decision about Lung Cancer Screening. This core category is supported by eight categories characterizing how health literacy relates to lung cancer screening among older adult long-term smokers, including Health Information Seeking Behaviors, Trusted Sources, Knowledge, Trusted Provider, Advocacy, Perceived Risk, Patient-Provider Communication, and Shared Decision-Making. This is one of the only known studies that describes the health literacy process of informed decision-making about lung cancer screening. The results of this grounded theory study have several implications for public health practice, research, and policy and have the ability to increase lung cancer early detection and survival.Item PARENT PERSPECTIVES ON DIAGNOSIS OF AND SERVICES FOR CHILDREN WITH CORTICAL VISUAL IMPAIRMENT(2019) Kempler, Sara Kathleen; Beckman, Paula J; Special Education; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Medical advances in recent years have increased survival rates of infants born prematurely and/or infants and children that present with life-threatening conditions (Good et al., 1994; Khetpal & Donahue, 2007; Murphy & Carbone, 2011). These increased survival rates are associated with an increase in the number of children who have severe and/or multiple disabilities, including those conditions that are associated with cortical visual impairment. Children with typical or nearly typical eye exams, but having observable visual impairment are those generally diagnosed with cortical visual impairment, or CVI (Jan, Groenveld, Sykanda, & Hoyt, 1987). Delayed or lack of diagnosis of CVI can lead to missed opportunities for learning, and especially missed sensitive periods during which recovery can occur faster (Hubel & Wiesel, 1970; Roman-Lantzy, 2018). Without diagnosis, children may not be eligible for funding assistance for educational materials (American Printing House for the Blind, n.d.b). The purpose of this study was to explore parents’ experiences in getting a diagnosis of CVI for their children. For example, whether there were lapses in time between suspected vision difficulties and diagnosis, and what information was provided when diagnosis was obtained. The research questions guiding this investigation included: What are parents’ experiences in seeking a diagnosis for their child’s suspected vision challenges? What needs do parents recall related to information and supports while seeking a diagnosis for their child’s suspected vision challenges? What kind of information is offered or readily available to parents upon diagnosis of CVI? The primary data source for this study was interviews with parents of children having diagnosed CVI. Secondary data sources included interviews with ophthalmologists, teachers of the visually impaired, and records review.Item CREATIVE PERSUASION: ENHANCING WELL-BEING AND SELF-EFFICACY THROUGH THEATRICAL PERFORMANCE(2018) Ganzermiller, Josie Deanna; Khamis, Sahar; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This manuscript is intended as a first step in exploratory research to examine the efficacy of creative performance in entertainment-based health interventions, as well as the cognitive mechanisms for that efficacy. Creative performance for the purposes of this study is defined as engaging in an activity that requires the participant to use his or her body to creatively portray a character and/or enact a message. While much is known about the efficacy of entertainment-based health interventions, less empirical work has focused on how merely participating in creative performance promotes well-being. Well-being is psychological and mental health, which is more than the absence of mental disorder or disease, but rather the state of "optimal psychological functioning and experience" (Ryan & Deci, 2001). This document outlines a panel study that evaluates the degree to which active involvement in an immersive theatre camp leads to increases in well-being and self-efficacy for adolescents, as well as the theoretical basis for expecting such a result. A front matter table (p. vii) provides a reference for the key concepts and variables included in the study. The following chapters expand on the rationale for this work, including entertainment-education, benefits of creative performance, and the importance of well-being in adolescence.