Theses and Dissertations from UMD
Permanent URI for this communityhttp://hdl.handle.net/1903/2
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 give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item A Qualitative Examination of the Barriers and Facilitators of Pre-Exposure Prophylaxis (PrEP) Uptake Among Heterosexual HIV Serodiscordant Couples(2022) Mathews, Ronneal; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)It is estimated that there are 140,000 heterosexual serodiscordant couples in the United States. Given the considerable number of these couples and the high risk of HIV acquisition among non-infected partners, it is important to focus prevention methods on programs and interventions that target transmission of HIV infection among serodiscordant heterosexual couples. Currently, we understand little about factors that influence these couples to use pre-exposure prophylaxis (PrEP). According to the CDC, this population is one of the highest risk groups, therefore, understanding the factors that influence them to use PrEP as a strategy in their HIV prevention regimen is an important step in preventing new HIV cases among this population. This study was a qualitative analysis that explored potential motivators and inhibitors for PrEP among heterosexual HIV serodiscordant couples. Secondary data from 26 qualitative interviews of HIV serodiscordant couples (N = 52 individuals) was examined to determine the factors that influenced the decision to use PrEP. Overall, there were five overarching themes from the Health Belief Model that manifested in all participant interviews. Perceived threat, perceived barriers (concerns about side effects, fear/anxiety about taking medication, indifference about HIV transmission), perceived benefits, cues to action (partner protection, PrEP use as condom replacement, PrEP use due to concerns about condom efficacy), and relational efficacy emerged as the most salient themes that determined whether couples chose to use PrEP as an HIV prevention method. Two constructs from the Theory of Gender and Power, sexual division of power and cathexis also emerged as relevant factors that influenced the decision to use PrEP in these couples. Findings from this study indicate that practitioners need to consider the motivators and barriers to PrEP uptake, and critically examine how power dynamics impact the decision to use PrEP. There is a need for the development of couples-based interventions to encourage PrEP uptake and adherence in mixed status couples.Item FACTORS INFLUENCING MARYLAND FARMERS' ON-FARM PROCESSING LICENSE APPLICATION BEHAVIOR(2010) Lubran, Meryl; Kantor, Mark; Food Science; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)A 2005 regulation adopted by Maryland's state health department allowed farmers to sell foods processed in their home kitchen provided they complete an 8-hour food safety education course and apply for an on-farm processing license. Although more than 100 farmers completed the course, only 25 farmers applied for and received a license. The number of licenses granted has not met expectations and the health department is continually looking for ways to improve the program. The objective of this study was to identify factors that may influence Maryland farmers' intentions to apply for a license as well as their actual license application behavior using a model which combines two dominant theoretical paradigms - the Health Belief Model and the Theory of Planned Behavior. To test the proposed model, a mail survey was administered to farmers who completed the training, farmers who have an on-farm license, and to a systematic random sample of other Maryland farmers (n = 745). To explore reasons why the courses may not have encouraged more farmers to apply, a content analysis of the training presentations was conducted by two trained coders. The usable survey response rate was 15% (n = 110). Using structural equation modeling, the proposed model, predicting farmers' intentions to apply for a license, was found to have marginal fit. Significant direct relationships were found between farmers' attitudes, subjective norms, and their intentions. Significant indirect relationships were found between farmers' beliefs of perceived benefits and barriers and their attitudes. Using rare events logistic regression to predict license obtainment, and a multiple regression and two correlation analyses to test the proposed indirect relationships, the same relationships were found to predict actual behavior as behavioral intentions. An additional significant relationship was found between perceived behavioral control and behavior. Few differences were found between mean responses of farmers who did and did not attend the training. The content analysis of training materials revealed few persuasive strategies were utilized during training. These findings provide insight into factors affecting farmers' decisions to apply for an on-farm license, and suggest relevant factors, concerns, and issues to address in future educational outreach efforts.