Behavioral & Community Health

Permanent URI for this communityhttp://hdl.handle.net/1903/2271

Prior to January 24, 2011, this unit was named the Department of Public & Community Health.

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    STATE-LEVEL STRUCTURAL RACISM AND ALCOHOL AND TOBACCO USE BEHAVIORS IN A NATIONAL PROBABILITY SAMPLE OF AFRICAN AMERICANS
    (2023) Woodard, Nathaniel; Knott, Cheryl L; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Structural racism is how society maintains and promotes racial discrimination through established and interconnected systems. Structural racism is a historical driver of health disparities, including those in the area of cancer. One pathway posited for this effect is through the promotion of maladaptive coping behaviors, such as alcohol and tobacco use. This dissertation empirically assessed the association between state-level structural racism and alcohol and tobacco use behaviors among African Americans, including within various subgroups of African Americans based on age, gender, and household income. This project analyzed secondary self-report data collected from a national probability sample of 1,946 African Americans in the Religion and Health in African Americans (RHIAA) Study. Existing measures of state level structural racism were merged into the RHIAA dataset including a composite index of structural racism assessed using five dimensions (i.e., residential segregation, and economic, employment, education, and incarceration disparities). Analyses were performed in SPSS Version 28 using hierarchical linear and logistic regression models. In the first study, two models (Model A and Model B) were constructed for each of four outcomes, frequency of alcohol consumption (measured in days per month), frequency of binge drinking (measured in the number of occurrences per month), smoking status (current smoker or not a current smoker), and smoking frequency (never smoked, former smoker, currently smoke on some days, and currently smoke every day). Model A used the composite structural racism index measure to model the four alcohol and tobacco use measures and Model B analyzed the disaggregated dimensions of structural racism rather than the composite measure. All hierarchical analyses controlled for confounding variables (i.e., participant gender, age, education, income, and employment status). In the second study, analyses using the dimension-level approach in Model B from study one were repeated in subgroups stratified by participant age, gender, and income for the frequency of binge drinking and smoking status behaviors. Statistical comparisons of the slope estimates between corresponding subgroups (e.g., younger and older age) were used to test the moderation effects of age, gender, and income on the association between structural racism and alcohol and tobacco use behaviors. Results from these studies generally indicated a positive association between state level structural racism, especially in the incarceration dimension, and binge drinking and tobacco use behaviors. Stratified analyses generally did not support age, gender, or income as moderating variables of the association between structural racism and binge drinking and tobacco use behaviors. Current findings demonstrate a need for further research on structural racism and health and progress in structural racism measurement, including further emphasis of dimension-level measurement and analysis. Findings from the current dissertation highlight the importance of addressing structural racism, especially in incarceration, to reduce alcohol and tobacco use behaviors among African Americans and help address existing health disparities.
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    "Promoting Responsible Action in Medical Emergencies": Determining the Impact of a New University of Maryland Alcohol Protocol
    (2010) Hammamy, Ranwa Diaa; Clark, Pamela; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The purpose of this investigation was to determine the impact of the University of Maryland's "Responsible Action Protocol." Judicial records were evaluated to determine if calls for medical assistance increased after the protocol. Descriptive summaries indicated that the number of calls in the semester following the RAP was double the average of the previous six semesters. While there was no variation in calls prior to the RAP (χ2 = 4.346, p = .501, df = 5), the post-RAP Fall 2009 semester added significant variation (χ22 = 25.069, p < .001, df = 6). Student focus groups were used to evaluate student reaction to the protocol. Students seemed unaware of the RAP's provisions, and stated its language prevented them from trusting the protocol. Students further indicated the university alcohol education was not relevant and did not provide information regarding alcohol poisoning. The findings suggest that the RAP and the university's alcohol education programming will need revisions to increase their impact.
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    The influence of parental communication about the negative effects of alcohol on college students' alcohol use
    (2004-12-08) Boyle, Jennifer Rebecca; Boekeloo, Bradley O; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Many college students experience negative effects of excessive and underage drinking. Parental influences have been found capable of delaying adolescent drinking and reducing riskier adolescent drinking behaviors. However, there has been little investigation regarding the influence of parents on the drinking behaviors of college students while students are at school. A web-based survey was conducted with 265 University of Maryland first-year students who were18-19 years old and living in residence halls. Focus groups (n=12), observed pre-tests and in-depth interviews (n=5), pilot tests (n=4), an alpha test, and expert review (n=5) were conducted to assist in the development of the web-based survey. It was hypothesized that: 1) students who report greater parental communication regarding the negative effects of alcohol are less likely to report problem drinking than students who report less communication, 2) the association between communication and problem drinking is mediated by constructs borrowed from the Theory of Reasoned Action (TRA), 3) the association between communication and problem drinking is mediated by constructs borrowed from the Health Belief Model (HBM), 4) the association between communication and problem drinking is mediated by constructs borrowed from both the TRA and HBM, 5) the association between communication and problem drinking is best explained by the model incorporating constructs from both the TRA and the HBM. Logistic regression was conducted to test the first hypothesis. Path analysis and structural equation modeling were used to test hypotheses two through four. Models were qualitatively compared to test hypothesis five. Results of logistic regression indicated that there was no significant direct relationship between parent-child alcohol communication and problem drinking. Structural equation modeling revealed that the relationship between communication and problem drinking was mediated by attitude toward alcohol. Students whose parents talked with them more about the negative effects of alcohol held more favorable attitudes toward alcohol (p = -0.13, p < 0.05). In turn, students holding more favorable attitudes toward alcohol experienced more drinking problems (p = 0.19, p < 0.05). The TRA model was determined to be the model that best explained the relationship between communication and problem drinking. Possible explanations for unexpected findings are discussed.