School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
Browse
Search Results
Item The Challenge of Teen Nutrition: An Ecological View of Sociocognitive Influences on Urban, African-American Adolescent Diet Quality(2010) Wrobleski, Margaret Mary; Atkinson, Nancy L.; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The routine food choices that adolescents make impact their nutritional status, health, and their risk of developing chronic illnesses such as heart disease, cancer, and osteoporosis in the future. Nutrient requirements during adolescence are comparable to those in early infancy, emphasizing the importance of a high quality diet for healthy growth and development. A myriad of personal, social, and environmental factors influence adolescents in shaping their dietary intake and quality of diet. Low-income, African-American adolescents in Baltimore were identified as having sub-optimal nutritional intake compared to national dietary recommendations. This study explored the dynamic and relative contributions that factors within three environmental levels (personal, social, and community) made as predictors of diet quality in a sample of low-income, urban African-American adolescents using an integrated Social Cognitive Theory (SCT) / ecological theoretical framework. It was hypothesized that 1) the personal, social, and community environmental levels of dietary influences would all significantly contribute to diet quality, with community environment making the largest relative contribution; 2) self-efficacy for healthy eating moderated the relationship between parental beliefs about nutrition and diet quality; and 3) self-efficacy for healthy eating moderated the relationship between peer eating behaviors and diet quality. There have been very few studies using an integrated SCT/ecological model to explore the dietary influences on adolescent nutrition, especially on this demographic. The significant influence the SCT construct of observational learning has on adolescents was evidenced in this study by the positive relationship found between diet quality, parental beliefs about nutrition, and peer eating behavior. Younger participants in early adolescence and females were predominately guided by their parents' beliefs about nutrition, while males in this study appeared to identify more with their peers' nutrition-related behaviors. This study revealed that parents and peers play important roles in African-American adolescents' food choices and subsequent diet quality. Nutrition interventions should focus on parent-teen interactions and on improving the dietary habits of parents so they may be more effective role models for youth. Nutrition promotion research targeting young African-American men may consider using group interactive behavioral interventions with peers that build and reinforce peer modeling of positive nutrition behaviors.Item The Role of Provider-Role Ideology and Consistency in Couple Communication(2010) Brenneman, Jessica Lynn; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated how problem solving and conflict in couples' communication is affected by their beliefs about provider role ideology, and the consistency between their beliefs and their actions. It was predicted that couples who have the same provider-role ideology and couples who are consistent in their behavior and beliefs will use more problem solving and less hostile conflict behaviors than couples who are unmatched in their beliefs or inconsistent in beliefs and behavior. Contrary to predictions, no relationship between ideology, consistency, and communication was found. However, the results did show a significant relationship between women earning a large portion of the household income and greater amounts of hostile conflict in the couple communication. The implications for future research and clinical applications are discussed.Item Negotiation of Health Risks and Risk Management for Young Adult BRCA1/2-Positive Women: Implications for Partnering and Family Formation(2010) Hoskins, Lindsey Megan; Roy, Kevin M; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)In the mid-1990s, genetic testing was introduced for two breast and ovarian cancer predisposition genes: BRCA1 and BRCA2. For mutation carriers, lifetime risks of breast and ovarian cancer approach 90%, and 54%, respectively, versus general population risks of 12% and 2%. Women testing positive for mutations during young adulthood face numerous challenges related to navigating basic life course tasks, including establishing permanent couple relationships, family formation, and risk-management decision-making. These complex choices require young carriers to balance personal and family desires and provider recommendations for health maintenance and disease avoidance against their own desires/plans for personal, relationship, and family fulfillment. How they accomplish these tasks is significantly influenced by their experiences with cancer in close relatives, personal cancer risk assessment, and partner presence and support. Although the experience of older carriers and cancer survivors has been thoughtfully explored, little attention has been paid to the experiences of younger women. Using qualitative methods and grounded theory, I analyzed in-depth interviews with forty women aged 18-35 who knew themselves to be BRCA1/2-positive. Participants were recruited from: 1) an ongoing NCI Clinical Genetics Branch Breast Imaging Study; 2) the membership of FORCE, an online support network for mutation-positive individuals; and 3) snowball sampling, whereby participants referred others whom they knew to be mutation-positive. Using a semi-structured, open-ended interview format, participants were asked about family relationships and background; couple relationships; experiences and perceptions regarding family formation; and experiences and perceptions related to utilization of risk management strategies over time (i.e., surveillance, chemoprevention, risk-reducing surgery). Questions were developed using sensitizing concepts from the biopsychosocial perspective on health and illness and life course perspective, as well as attachment and feminist theories. Interviews were conducted by telephone, digitally recorded and transcribed, and analyzed using QSR N-Vivo software, version 8. The data-driven model indicates that risk perception and management decisions are closely tied to family and couple relationship experiences. Young mutation carriers aggressively and courageously utilize agency to alter their life trajectories while minimizing sacrifice to their family and relationship ideals, thereby freeing themselves from mutation-related emotional and physical constraints, and regaining control over their genetic destiny.