School of Public Health

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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.

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    EXPANDING THE CONCEPTUAL FRAMEWORK OF HEALTH LITERACY TO IMPROVE LONG-TERM SERVICES AND SUPPORTS
    (2013) Ruben, Kathleen Ann; Simon-Rusinowitz, Lori; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Low health literacy is a significant and growing public health problem. It is estimated that 90 million individuals in the U.S. have low health literacy, which is associated with poor health outcomes. Individuals with low health literacy skills may not be able to obtain health information, communicate with health care providers, or make optimal health care decisions. People from all backgrounds can have low health literacy levels, however, the rates are higher in certain groups such as older adults, Medicaid beneficiaries, and minority populations. Due to our rapidly aging and increasingly diverse U.S. population, the problems associated with low health literacy may increase over the next few decades. Studies have examined the relationship between an individual's health literacy level and their own health outcomes. However, few have focused on how the health literacy level of others, such as caregivers and health care professionals, impacts the health outcomes of care recipients. It is important to understand this relationship in terms of elders who depend on others, such as caregivers and family members, for their care. This series of three studies addresses this critical gap in health literacy research. The first two studies examine the need for a health literacy component of a training program for care teams for individuals with dementia in participant-directed programs. The first is an ethnographic pilot study of caregivers in West Virginia's Personal Options Program, and the second is a mixed- methods study of "Decision-Making Partner" preparedness in Arkansas' IndependentChoices Program. The third study examines the effect of the emergency department referral process on repeated utilization of community health centers by low-income, uninsured adults and Medicaid Beneficiaries, as well as the role of Patient Navigators as mediators within the framework of health literacy. This research provides evidence that the health literacy level of others, including caregivers, decision-making partners, and health care providers significantly impacts the ability of older adults to access health services and supports, communicate with healthcare providers, navigate the healthcare system, and manage chronic diseases. Therefore, addressing health literacy is essential for increasing health-related knowledge, improving health outcomes, and decreasing health disparities in long-term care.
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    The Relationship Between Exercise and Cognitive Function: Is It Altered by APOE Genotype?
    (2006-12-11) Conery, Ryan; Hatfield, Brad D; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The risk of minor cognitive decline and dementia increases with advancing age. Thus, as the average lifespan of humans continues to rise the number of people that are affected by dementia will rapidly increase. Dementia is described as multiple cognitive deficits that adversely impact activities of daily living. Lifestyle behaviors may prove critical in delaying or preventing the onset of cognitive decline and dementia. Specifically, exercise has been shown to decrease reaction time, improve executive function, and maintain performance on gross measures of cognitive ability in an aging population. Further, physical activity becomes even more important when the genetic susceptibility for dementia rises. Apolipoprotein (APOE) e4 is one such risk factor and is associated with the development of Alzheimer's disease (AD). Severe memory loss is one defining symptom of AD and greatly reduces quality of life for afflicted individuals. The purpose of this investigation is to determine the specific behavioral impact of physical activity on those who are genetically at risk for AD compared to those who are not. Sixty cognitively normal individuals between 50 - 70 years old were assessed on medical history, gross cognitive function, physical activity, memory performance (Sternberg memory task), executive control function (Eriksen flanker task), and finally APOE genotype. Using hierarchical regression techniques, memory and executive function scores were regressed on age, education, genotype, physical activity, and the interaction between genotype and physical activity. Analysis revealed that on the more difficult conditions of the memory task as physical activity level increased, reaction time significantly decreased for APOE e4 carriers. No such relationship existed for noncarriers. These results imply, compared with other cognitive challenges, physical activity serves a protective role for maintaining memory, particularly in those who are at a genetic risk for developing dementia.