Theses and Dissertations from UMD
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Item FACTORS ASSOCIATED WITH COMPLETION OF THE HUMAN PAPILLOMAVIRUS VACCINE SERIES AMONG HISPANIC AND NON-HISPANIC WHITE ADOLESCENT GIRLS IN THE UNITED STATES(2011) Demarco, Maria Teresa; Carter-Pokras, Olivia; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Despite recommendations of three Human Papillomavirus (HPV) vaccine shots for all adolescent girls, only 29.1% of non-Hispanic Whites and 23.4% of Hispanics achieve completion. This study describes factors associated with completion of the HPV vaccine series among Hispanic and non-Hispanic White 13-17 year old girls who initiated the series. A secondary data analysis was performed of the cross-sectional 2009 National Immunization Survey-Teen survey. Despite similar initiation rates (one in five), Hispanic girls who had initiated the series (59.9%) were less likely to complete the series than non-Hispanic Whites (76.4%). After accounting for poverty status and home ownership, Hispanics were less likely to complete the HPV vaccine series. Factors associated with HPV vaccine series initiation were age at interview and age at HPV vaccine series initiation for Hispanics; and continuous health insurance since age of 11, mother's marital status, and number of children in the household for non-Hispanic Whites.Item How teen girls and parents make meaning of a cervical cancer vaccine campaign: Toward a feminist, multicultural critique of health communication(2008-12-17) Vardeman, Jennifer Eileen; Aldoory, Linda; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to understand how teen girls and parents of teen girls make meaning of an HPV/cervical cancer vaccine communication campaign. Factors that were considered in investigating meaning-making were personal, familial, educational, sociopolitical, and technological and media factors. Other cultural concepts explored were identity, difference, communication preferences, and medicalization. Using a cultural study approach and feminist, qualitative methods, 40 teens between the ages of 13- and 18-years old and 14 parents of teen girls were interviewed using focus groups, dyad interviews, and individual interviews. The study employed the grounded theory approach to data analysis. Overall, parents and teens hold resolute beliefs about the Gardasil vaccine and media about it, and participants are divided as to their favorability toward the vaccine and its promotion to them. More specifically, the data suggest that teen girls largely make meaning of the HPV/cervical cancer vaccine campaign through the sociopolitical and mediated relationships in their lives, and in particular, how the girls perceive and act around difference in their lives largely contribute to the ways they view communication about sexual health topics like HPV, cervical cancer, and the vaccine. Differently, parents largely make meaning of the campaign through the personal, familial, and educational aspects of their lives, for how they understand their roles as parents reflects a contradiction between their sexual lives growing up compared to their perceptions of how the media represent sexuality and health threats to their daughters. Overall, the data suggest that this campaign provides some empowering ideas and opportunities for teen girls and parents. However, the data also largely suggest that campaigns as such complicate not only decisions teen girls and parents must make about teen girls' health, but such campaigns also obscure how teen girls and parents know themselves individually, in relationship to one another, and in relationship with social and authoritative bodies outside their comfort zones. These data confirm previous studies findings in public relations, feminist media, and cervical cancer intervention research. The data also extend and combine extant research about culture, women's health topics, and communication campaigns in ways that suggest a feminist, cultural-centered health communication critique that encourages communicators to wholly reconsider traditional approaches to the origination, development, deployment, and involvement of communication campaigns involving women and teen girls and important health topics to them. Implications for health communication practice as well as feminist methodology are considered for similar future projects.Item The Medicalization of Menopause: Framing Media Messages in the Twentieth Century(2008-07-22) Cimons, Marlene Frances; Beasley, Maurine; Journalism; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)ABSTRACT Title of Document: THE MEDICALIZATION OF MENOPAUSE: FRAMING MEDIA MESSAGES IN THE TWENTIETH CENTURY Marlene Cimons Directed by: Dr. Maurine Beasley, Philip Merrill College of Journalism This dissertation analyzes print media language in three newspapers (the Washington Post, the New York Times and the Los Angeles Times) and five magazines (McCall's, Good Housekeeping, Ladies Home Journal, Reader's Digest and Time) during the twentieth century to determine how menopause was ``framed'' and to what extent these news media contributed to its medicalization. A critical reading showed that these media reflected and solidified society's negative notions about menopause and contributed to the approach by the medical profession of regarding menopause as a hormone deficiency disease. While the news media are not all-powerful, they do contribute ideas over time, contributing to the formation of societal attitudes and practices. Historically, the heavy print media concentration of negative ideas about menopause, followed by a flood of information about the wonders of hormones - first, on aging, then on health and longevity - both mirrored and amplified public perceptions about women, menopause, and aging, and contributed to its medicalization. The negative language often used imagery describing menopause as a time of wasting and non-productivity, and likened this normal stage in a woman's life to a siege of bad weather, or a cruel accident of nature. Along with negative metaphors, print media messages also conveyed that menopause was a hormone deficiency disease whose ravages could be erased with drugs, and that hormones could turn back the clock. The print news and feature media frequently relied upon male physicians as sources to bolster this view, a practice that reinforced the power of medical authority and supported a patriarchal view of women as patients. Important studies raised questions about the risks of hormone replacement therapy during this period, and were reported by the news media; however, the coverage of these potential dangers was dwarfed by the sheer volume of articles that conveyed the message that hormones were a good thing for women to take. This study shows how the print media used language to communicate ideas about menopause and aging.Item Black women's meaning-making of HIV/AIDS campaigns: A Black feminist approach to the impact of race on the reception of targeted health communication(2007-05-09) Curry, Tiphane' Patrice; Aldoory, Linda; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this exploratory study was to understand how Black women make meaning of HIV/AIDS communication. This study combines Black feminist epistemology with the situational theory of publics in an examination of Black females' meaning making of HIV/AIDS communication. Twenty in-depth interviews were conducted with Black women under the age of 35. Findings suggest targeted publics may choose not to process messages because they feel the messages inaccurately represent their identity, or not to seek information because they do not want to face judgment from others who associate their identity with a health problem because of targeted messages. This study added to the situational theory of publics by proposing an emerging model describing the relationship between identity and the variables of the situational theory.Item The Relationship of Low Birth Weight and Current Obesity to Diabetes in African-American Women(2007-04-26) Harris, B. Michelle; Lei, David K. Y.; Nutrition; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Aims: (1) To test the fetal origins of chronic disease by examining birth weight, current obesity, and odds of developing type 2 diabetes (T2DM) in African-American women 38-57 years. (2) To assess birth weight and obesity in relation to fasting plasma glucose (FPG). Background: African-American women suffer disproportionately in prevalence and complications of T2DM. According to the fetal origins of chronic disease, T2DM is related to low birth weight with subsequent adult obesity. Several studies have substantiated this hypothesis; none have focused on African-American women. Outcome Measure: Self-reported physician diagnosis of T2DM. Exposure Measures: Birth weight, an indicator for fetal growth; waist-to-hip ratio, a marker for abdominal obesity. Other factors: physical activity, body mass index (BMI), history of gestational diabetes, blood pressure. Design: Retrospective, case-control observational study. Method: Convenience sample of urban African-American women. Cases (n=95) reported a physician diagnosis of T2DM. Controls (n=186), matched on race and age, reported no T2DM diagnosis. To verify control status, participants were screened for elevated FPG (cut-point, <126>mg/dL, as defined by the American Diabetes Association). Vital and family records were sources for birth weight. Current weight, height, and waist and hip circumferences were measured; BMI and waist-to-hip ratio were calculated. Confounding factors were collected on a 68-item questionnaire. Logistic regression analysis tested the proposed model for the odds of having T2DM. Multiple linear regression analysis was employed to assess FPG. Sample size was estimated. Results: The odds ratio for T2DM increased as waist-to-hip ratio increased (OR=1.13, 95% CI=1.08, 1.19, p<.0001). Birth weight did not contribute independently to the model's ability to examine T2DM (OR=0.92, 95% CI=0.74, 1.14, p=.4409). Birth weight and waist-to-hip ratio each contributed independently to assessing FPG. Conclusions: This study found an interaction between birth weight and abdominal obesity when examining T2DM in African-American women: those born small and who subsequently developed abdominal obesity had a greater odds for T2DM. Abdominal obesity, but not birth weight, was independently associated with T2DM. FPG significantly increased with increasing abdominal obesity and decreasing birth weight. African-American women are cautioned to maintain healthy body measures (waist-to-hip ratio <0.80 and BMI <25) to address T2DM.Item WOMEN'S MEANING MAKING OF CERVICAL CANCER CAMPAIGNS: USING A CULTURAL APPROACH TO REDEFINE WOMEN'S INVOLVEMENT WITH THEIR HEALTH(2005-12-16) Vardeman, Jennifer Eileen; Aldoory, Linda; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to understand how women from different racial and ethnic backgrounds make meaning of cervical cancer communication. In this exploratory cultural study, the situational theory of publics provided the theoretical framework to investigate to what extent women consider cervical cancer a problem, how they feel connected to it, and what factors constrain them from seeking information. The study used qualitative focus groups and one-on-one, in-depth interviews with African American, Hispanic, and White women. Findings suggest that women feel differentially involved to cervical cancer, and the distinctions are primarily based on age. Furthermore, women tend to group reproductive health issues together rather than separating them. This study expanded the situational theory of publics as well as a public relations theory for women's health. Practical implications include cues to action and suggested factors communicators can employ to improve culturally competent communication campaigns and messages.