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.

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Now showing 1 - 7 of 7
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    Familial sources of encouragement and breast-feeding practices among women participating in the US Special Supplemental Nutrition Programme for Women, Infants and Children
    (Cambridge University Press, 2023-04-05) Channell Doig, Amara; Aparicio, Elizabeth M; Gallo, Sina
    Objective: To explore how sources of familial encouragement are associated with breast-feeding initiation and duration among a national sample participating in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: This study uses the 2013–2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breast-feeding initiation was measured at the first month, while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breast-feeding outcomes. Setting: A nationally representative sample of WIC participants in the USA. Participants: WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n 2807). Results: Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3·2 (95 % CI 2·8, 3·8) increase in odds of initiating breast-feeding in the unadjusted model and 3·0 (95 % CI 2·5, 3·6) increased odds, controlling for age, education, nativity, poverty status, race and ethnicity (<0·0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0·003 d (95 % CI 0·2, 0·3, <0·0001). When controls were added, it was associated with an increase of an average of 0·002 d (95 % CI 0·2, 0·3) per percent increase in encouragement source (<0·0001). Conclusions: Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work.
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    The emotional well-being of mothers of transgender and gender non-conforming children
    (2015) Allen, Samuel H.; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    In recent years, mental health professionals have reported an upsurge in the number of referrals relating to transgender identities among children. While controversies exist among clinicians over treatment for these children, a growing number of practitioners are encouraging parents to accept their children's gender expressions. This practice, however, may be challenging for parents to embrace for a number of reasons, resulting in a vulnerable mental state. Using a combined theoretical framework of decentering heteronormativity within Meyer's minority stress theory (2003), the present study seeks to determine the association between various factors--gender non conformity, gender role beliefs, and child misbehavior--and the anxiety and depression in mothers of transgender and gender non-conforming children. Data were taken from Wave 1 of a longitudinal study of transgender and gender non-conforming children and their parents. Results indicated that only child misbehavior was significantly associated with maternal anxiety, and social support did not moderate this relationship. Complete findings and their implications are discussed, for both future research and further deconstruction of gender in the social sciences.
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    IMPACT OF CHILDHOOD AND ADOLESCENT CHRONIC HEALTH CONDITIONS ON EDUCATIONAL ATTAINMENT
    (2013) Champaloux, Steven; Young, Deborah R; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    BACKGROUND: Youth with chronic health conditions face challenges that may prevent them from achieving their educational goals. PURPOSE: This dissertation examined whether children and adolescents with chronic health conditions were more likely to have poor educational attainment compared to youth without chronic health conditions. It examined the impact of type and onset of chronic health conditions as well as youth limited by chronic health conditions on educational attainment. The potential influences of mediating and moderating factors were also investigated. METHODS: Using data from the National Longitudinal Study of Youth - Cohort 1997, multivariate logistic regression models were fit to examine the associations between type, onset of chronic health conditions, as well as youth limited by chronic health conditions and their impact on educational attainment. The cohort's sample size was 8,984 and participants were followed up through 2009. Chronic health conditions were defined by the 1997 parent questionnaire and the 2002 youth questionnaire. Educational attainment was defined by completion of high school by 21 years of age. Academic, psychosocial, neighborhood and school factors were examined and potential mediators and effect modifiers were identified. RESULTS: The odds of poor educational attainment for youth who reported ever having a chronic health condition were significantly higher compared to youth who never reported a chronic health conditions, OR: 1.47 (95% CI: 1.22 - 1.76). Specifically youth with cancer, diabetes or epilepsy had the highest odds of poor educational attainment, OR: 1.96 (95% CI: 1.13 - 3.37). There were similar associations for youth limited by a chronic health condition, OR: 1.76 (95% CI: 1.33 - 2.34) and for youth with early onset of a condition, OR: 1.61 (95% CI: 1.29 - 1.99). Academic and psychosocial variables attenuated these associations and mediators were present. Interactions with school-level factors and chronic health conditions were also found. CONCLUSIONS: Youth with chronic health conditions, specifically those with cancer, diabetes or epilepsy, youth limited by or have early onset of a chronic health condition are at particular risk of poor educational attainment. There are strategies that may mitigate these associations such as depressive symptoms screenings and support services in school.
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    Military Fathers and Families: Experiences Across Contexts, Space, and Time
    (2013) Jones, Nicolle Buckmiller; Roy, Kevin M; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    There are approximately 1.8 million U.S. children with at least one parent in the military (Department of Defense, 2010). Maintaining an all-volunteer military force has led to an increase in older, career military members that are more likely to have children (RAND, 2010). Due to extended military commitments and recent deployments to Iraq and Afghanistan, the need to understand the impact of deployment and military work commitments on children and family relationships has come to the forefront. While a number of studies have explored the influence of deployment and a military lifestyle on children and families, few have explored the impact of military employment and deployment on father-child relationships from the perspective of fathers. This study explored the experiences of fathers as they negotiated the contexts of family and military life, created relationships with their children across physical spaces and over time, and strategized how to foster nurturant father-child relationships. Qualitative interviews with 23 Active Duty, National Guard, and Reserve Army fathers were used to address these exploratory areas. Among these fathers, 15 were from the enlisted ranks and 8 were officers. Fathers varied in terms of age, race, and socio-economic status but in order to better capture strategies, challenges, and fathering experiences, military fathers had at least one child during at least one deployment, had been deployed at least once, and were married or had been in a committed relationship. Approximately 90-minute interviews were used to capture and explore father's experiences, as well as field notes of observations detailing site visits and interactions with staff serving military fathers and families. The discussion of the resulting themes explores the relationship between work and family roles and identity and fathering, expands the view of how Army fathers manage mental health needs through compartmentalization and decompression and personal intervention as well as by being attentive to family needs, and emphasizes how Army fathers may be doing more than simply "making up for" implications related to their deployment but deliberately designing fathering to address the needs of their children in response to deployment and occupational demands. The theoretical lenses of situated fathering and symbolic interactionism are used to frame and interpret the recorded experiences of military fathers as they navigated the fields of fatherhood and military. The theoretical concepts of ambiguous loss, ambiguous presence, and ambiguous absence are also used to connect the theories of situated fathering and symbolic interactionism, and enhance the exploration of military men's fathering.
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    Evaluating an Evidence-Based Intervention for Families and Survivors after Traumatic Brain Injury: The Brain Injury Family Intervention
    (2008-10-28) Stejskal, Taryn M; Epstein, Norman; Kreutzer, Jeffrey; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The long-term detrimental impact of traumatic brain injury (TBI) on individuals and their family members is well known. However, there have been few standardized family interventions or findings from treatment efficacy studies to guide clinical practice. The Brain Injury Family Intervention (BIFI) is an evidence-based, five-session, manualized clinical intervention, provided for both family members and the injured person. Guided by cognitive behavioral theory, the program provides education, skill building, and psychological support for both persons with brain injury and their family members. The objective of the present study was to test the efficacy of the BIFI as it was designed to improve the emotional well-being and life quality of persons with brain injury and their family members. Evaluation occurred in an outpatient neuropsychology department attached to a major academic medical center, with a sample of 53 family member caregivers of 53 TBI survivors. It was hypothesized that the BIFI would increase the proportion of caregivers' met needs, decrease their psychological distress, increase their perception that survivors' neurological functioning had improved, and reduce perceived obstacles to obtaining services. It also was hypothesized that the BIFI would result in improved neurological functioning for survivors. A secondary analysis of existing data using repeated measures mixed models was used to analyze four self-report measures for family members: (1) the Family Needs Questionnaire (FNQ); (2) the Service Obstacles Scale (SOS); (3) the Brief Symptom Inventory-18 (BSI-18); and (4) the Neurological Functioning Inventory (NFI). Survivors' neurological functioning was examined based on their own self-report data, also measured by the NFI. Data were collected at pre-treatment, immediate post-treatment and at a three-month follow-up after treatment. Statistical analyses revealed that, after participating in the BIFI program, caregivers reported significantly more met family needs, perceived fewer obstacles to receiving services, and rated the survivor as having reduced depression and somatic symptoms. No significant effects were observed for caregiver psychological distress or survivors' reports of their neurological functioning. Methodological limitations, implications for clinical intervention with families after TBI, and suggestions for future research are discussed.
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    The Relations Among Maternal Depression, Parenting Behaviors, and Adolescents' Perceptions of Family Functioning: The Moderating Effect of Mothers' Couple Relationship Status
    (2008-05-05) Drescher, Amanda; Epstein, Norman; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study examined relations among maternal depression, parenting behaviors, and adolescents' perceptions of family functioning. It also investigated whether parenting behavior mediated the relation between maternal depression and adolescents' perceptions of family functioning, as well as whether mother's couple relationship status moderated the relation between depression and parenting behavior. Maternal depression was not associated with adolescents' perceptions of family functioning. Maternal depression was associated with authoritarian and permissive parenting but not with authoritative parenting. Authoritarian and permissive parenting was associated with adolescents' perceptions of less positive family functioning, whereas authoritative parenting was associated with perceptions of more positive family functioning. Parenting behavior did not mediate between maternal depression and adolescents' perceptions of family functioning. Overall, mother's couple relationship status did not moderate the relation between maternal depression and parenting behavior; but there was a trend for the relation between depression and permissive parenting to be stronger when mothers were unpartnered.
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    Female Doctoral Students' Family and Academic Department Experiences and their Relationships to Career Choices
    (2006-12-19) McClintock-Comeaux, Marta Suzanne; Anderson, Elaine A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The purpose of this study was to determine factors that may influence women's choices of whether or not to enter the pool of tenure track faculty, and for those who do pursue these positions, factors that influence their choices of the type of institution in which they will seek employment: research I universities, liberal arts universities, or community colleges. Feminist and role theories guided the conceptual model and research questions. It was hypothesized that career salience, family structure, social support at the familial and department levels, the presence of a faculty role model successfully balancing work and family, and perceived work to family and family to work conflict would influence intended career tracks of female doctoral students. The sample (n=273) included female doctoral students who were United States citizens at The University of Maryland, College Park who were married, partnered, separated, divorced, widowed, or single with children. A letter explaining the study with a link to an online survey was emailed to all students in this population and completed surveys were compiled on an internet website. This study revealed that career salience was a significant positive predictor of students' intent to pursue research I and liberal arts university tenure track positions, and for women's increased interest throughout their doctoral program in pursuing such faculty positions. Marriage was a significant negative predictor for intent to pursue research I and liberal arts positions, while age and number of children were not significant predictors. Family support was a significant positive predictor for intent to pursue liberal arts positions, and a significant negative predictor for no intent to pursue faculty positions. Department faculty support was a significant negative predictor for career choice change scores for no intent to pursue faculty positions. Advisor support was a significant positive predictor of intent to pursue liberal arts faculty positions, whereas having a faculty role model was a significant negative predictor of no intent to pursue faculty positions. Work to family and family to work conflict were not significant mediating variables in the path between predictor and dependent variables. Implications for program and policy development are discussed.