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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Item Sleep throughout the alcoholism recovery process: a mixed methods examination of individuals' experiences transitioning from an inpatient research facility providing rehabilitation treatment to the community(2015) Brooks, Alyssa Todaro; Beck, Kenneth; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Despite research establishing the relationship between sleep disturbances and alcohol use, there is no clear understanding or model for what occurs once individuals who seek inpatient alcoholism treatment are discharged from rehabilitation facilities and attempt to integrate back into their homes and communities. This study used a mixed methods approach to assess individuals' perceptions of and experiences with sleep throughout the process of alcohol rehabilitation and to explore associations between sleep-related beliefs/behavior, sleep quality, and relapse. The Social Cognitive Theory (SCT), which posits that personal factors, the environment, and human behavior exert influence upon each other through reciprocal determinism, was used as the underlying theory for this study. Constructs from the SCT were measured directly in this study using both quantitative and qualitative approaches in a convergent parallel design to study the following aims: a) to assess perceptions of and experiences with sleep during alcohol rehabilitation, b) to describe sleep patterns, perceptions, and beliefs among individuals who are alcohol-dependent throughout the transition from a clinical research facility providing rehabilitation treatment back to the community, and c) to assess whether sleep-related beliefs and/or behavior are associated with sleep quality or alcohol relapse. Data were collected from a cohort of clinical research participants enrolled on an inpatient alcohol treatment protocol (n=32). Sleep was assessed quantitatively and qualitatively within one week of discharge from the inpatient facility and again four to six weeks post-discharge. Results indicated a prevalence of sleep disturbances throughout the process of rehabilitation. Self-efficacy for sleep was associated with better sleep quality at both time points. Thematic analyses of interview transcripts yielded overarching themes of sleep-related beliefs/behavior, sleep environments, stress related to transitions, and self-medication. This study demonstrates a prevalence of sleep disturbances among individuals undergoing alcohol treatment and relationships between SCT constructs and sleep quality. The period of transition from inpatient to outpatient represents a time of change, thus future behavioral sleep intervention efforts in this population may benefit from addressing underlying sleep-related beliefs and behaviors to improve sleep quality and encourage healthy and sober living.Item Scale Development and Dimensionality Analysis of a Protective Behavioral Strategies Multi-item Scale for Use with College Student Drinkers(2008-06-17) Griffin, Melinda; Boekeloo, Bradley O; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Protective behavioral strategies (PBS) have been defined as self-control behaviors individuals practice prior to, during, and/or after drinking to limit consumption and/or the negative consequences. Although a multi-item PBS measurement scale has been used in the research literature, the psychometrics, reliability, and validity of the PBS scale needed further examination. This study examined the 1) dimensionality of the PBS scale for self-identified college student drinkers as well as for gender and race/ethnicity subgroups, 2) internal consistency and test-retest reliability of the PBS sub-scales, and 3) construct validity of the PBS sub-scales. College students who self-reported as recent alcohol users (n=320) on a web-based survey administered during fall semester of the 2006 academic school year comprised the study sample. Factor analysis was utilized to determine the underlying factor structure of 22 item PBS scale. Additionally, congruence of the factor structure among gender and racial sub-groups was examined by rotating the sub-groups' matrices via the Procrustes orthogonal method. Reliability analysis was utilized to determine the internal consistency of the PBS sub-scales. Separate multiple linear regressions were performed to determine the construct validity based on relationships between the PBS sub-scales and potential motivations (refusal self-efficacy, protection self-efficacy, drunkenness avoidance self-efficacy, alcohol abstinence expectations) and potential alcohol-related outcomes (multiple alcohol use items, negative consequences) while controlling for gender and race. Examination of the output from repeated factor analyses, Procrustes rotation, and reliability analyses resulted in a 2-factor solution with 17 items. Both PBS sub-scales (Planning and Execution) had acceptable internal consistency across all samples and acceptable test-retest reliability. Construct validity of the Execution PBS was fully supported whereas the Planning PBS was partially supported. Specifically, the Planning PBS sub-scale was highly correlated with protection and drunkenness avoidance self-efficacy as projected but not alcohol-related outcomes. The Execution PBS sub-scale was highly correlated as projected with refusal, protection and drunkenness self-efficacy, alcohol use, and negative alcohol effects. Special attention was given in this study to PBS construct validity considering potential PBS motivations and PBS scale dimensionality across gender and race subgroups. This study contributes to parallel research attempting to identify a definitive, standardized measure of PBS.