Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
Displaying 1 - 9 of 9
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- All Subjects: Global Health
- Creators: School of Life Sciences
Description
This study investigated the potential efficacy of HEAL International's prevention education program in inducing health behavior change in HIV/AIDS, malaria, and communicable disease to children in grade levels ranging from primary school to secondary school. The health education program was aimed at changing health behavior by increasing knowledge. This increase in knowledge was analyzed as a modifying factor in the Health Belief Model suggesting that knowledge, along with five other modifying factors, are directly responsible for an individual's health perceptions. These health perceptions ultimately result in an individual's health behavior. As a result, it is argued that an increase in knowledge can lead to health behavior change so long as it is coupled with a strong theoretical framework. Administering pre-evaluations at the beginning of the program, post evaluations at the end of the program, and a second post evaluation again two months later completed the evaluation. It was hypothesized that if there was a significant difference between the percent of correct answers at the pre-evaluation compared the second post-evaluation then there is evidence that HEAL's health education program is, or at least has the potential to, create sustainable health behavior change. A paired samples t-test was completed on the data and showed a statistically significant difference between the percent of correct answers at pre-evaluation and the percent of correct answers at second post-evaluation. These results indicated that the number of students with a comprehensive knowledge of the subjects that HEAL taught during the program had increased. It was concluded that the results of the study indicate evidence that HEAL's program has the potential to deliver sustainable health behavior change but that it will be more quantifiable once HEAL is able to adopt a theoretical framework on which to base future programs.
ContributorsWright, Mia Christina (Author) / Jacobs, Bertram (Thesis director) / Salamone, Damien (Committee member) / Ayers, Stephanie (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (Contributor)
Created2014-05
Description
In 2015, the World Health Organization cited antibiotic resistance as one of the greatest current challenges to global public health. A major driver of the evolution of antibiotic resistance is the overuse and misuse of these drugs. While antibiotic stewardship, education campaigns, and health policy attempt to limit drug use globally, public understanding of antibiotic resistance and its consequences are lacking. The goal of this study is to analyze the social and cultural influences of antibiotic knowledge and usage behavior. Over a three-month period, I interviewed 211 laypersons in Guatemala, Spain, the Netherlands, India, South Africa, and New Zealand to understand their ideas, perceptions, and behaviors regarding antibiotics and compared results across countries. While an overall consensus across countries does exist, I found significant differences between low and high income countries as well as between low and high antibiotic consumption countries. Additionally, I found that having increased public health knowledge is related to lower antibiotic "risky" behavior. These results help contextualize national data on antibiotic consumption and resistance by illustrating relationships between access, beliefs, and consumption patterns within populations. The results also inform the development of community and culture specific educational campaigns regarding antibiotic resistance.
ContributorsHarris, Carlyn Larson (Author) / Maupin, Jonathan (Thesis director) / Gaughan, Monica (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This study examines associations between clean water, sanitation, mosquito net usage, and immune biomarkers among the Tsimane, a remote subsistence population of forager-horticulturalists with a high pathogen load. Interviews with heads of household (n=710, aged 18-92, median age 40 years) were conducted to ascertain household water sources, ownership and usage of mosquito nets, and latrine use. In this sample, 21% of households used latrines, 20% always boiled their water, and 85% used mosquito nets. Regression models estimate their associations biomarkers of pathogen exposure, including white blood cell count (WBC), hemoglobin (Hb), eosinophils, and sedimentation rate (ESR). Controlling for age, sex, and distance from the closest market town, latrine use (Std. β = -0.11, p= 0.017) and boiling water (Std. β = -0.08, p= 0.059) are associated with lower WBCs. Latrine use is marginally associated with higher hemoglobin (Std. β = 0.09, p= 0.048), but not boiling water (p= 0.447). ESR trends toward lower levels for households that always boil water (Std. β= -0.09, p= 0.131), but is not associated with latrine use (p=0.803). Latrine use was significantly associated with lower eosinophil counts (Std. β= -0.14, p=0.013), but not boiling water (p=0.240). Mosquito nets are not associated with any of these biomarkers. Both boiling water and latrine use are associated with better health outcomes in this sample. These results suggest that scarce public health resources in rural subsistence populations without malarial risk may wish to prioritize boiling water and latrine use to improve health outcomes.
ContributorsDinkel, Katelyn Aubree (Author) / Trumble, Benjamin (Thesis director) / Costa, Megan (Committee member) / Jehn, Megan (Committee member) / School of Mathematical and Statistical Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
In an increasingly interconnected world, the 17 Sustainable Development Goals are the United Nations’ framework for ensuring we continue to transform our world for the better, leaving no population behind. This study examines how the terminology of Sustainable Development Goal 17 for global partnership affects its implementation, focusing on “building capacity”—a widely referenced target in the development arena—and the involvement of the private sector. Key informant interviews with experts in the fields of conflict of interest, ethics, and development revealed a wide variety of (often conflicting) notions about partnership, frameworks for capacity development, and the interactions between public and private actors. A literature review of key policy documents examined the terminology and implementation of multistakeholder partnerships, and analysis offered considerations for risks and suggestions in policy terminology. Results indicate a need for increased attention to the use of partnership terminology as a catch-all term to encompass development work, and makes several recommendations for changes to combat misuse of the partnership label. Finally, this study acknowledges that there is a continued need for research-based evidence for effectiveness of the partnership-based development approach.
ContributorsThomson, Azalea Mae (Author) / Gaughan, Monica (Thesis director) / Hruschka, Daniel (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Antibiotic resistance in the modern era has reached near-epidemic levels, resulting in much more difficult treatment of previously well-managed pathogens. Previous understandings of how antibiotic resistance emerges failed to account for the function of the environment. Over the past 15 years, new research has provided a link between the environmental and clinical spheres of antibiotic use. This data suggests that environmental bacteria, particularly those found in livestock farming ecosystems, may significantly contribute to the overall flow of antibiotic resistance genes into human populations. The main force behind this is the utilization of antibiotics as growth promoters in animal feed supplements, seeding individual animals and their surroundings with low doses of antibiotics. Notable increases in resistance have been observed within areas that utilize these supplements, as well as in connected but unrelated systems. Waste management strategies are poorly implemented, leading to the dispersal of contaminated runoff into groundwater and riverine environments. Furthermore, existing waste processing is limited in efficacy, often releasing large amounts of unprocessed antibiotics as well as a concentrated population of resistant bacteria. Within these resistant populations, horizontal gene transfer has emerged as a vehicle for the distribution of resistance genes into other populations of bacteria. Due to the prevalence of these transfer events, a new role for the environment as a reservoir and incubator of resistance genes is proposed. Current strategies for managing the spread of antibiotic resistance are woefully inadequate, and the continued emergence of new resistance mechanisms due to negligence highlights the need for global, multidisciplinary solutions. To corral the spread of antibiotic resistance, a system is proposed that utilizes metagenomic monitoring and the enforcement of core global policies to slow the advance of resistance while waiting for novel treatment strategies to bear fruit.
ContributorsHrkal, Jacob (Author) / Gile, Gillian (Thesis director) / Shi, Yixin (Committee member) / Sarno, Analissa (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
For African countries during the 1960s and 70s, decolonization marked the first step in a slow crawl toward complete independence. For Western powers and the Soviet Union, however, decolonization presented an opportunity to exert new influence over countries in desperate need of aid, investment, experts, and trade. Amidst the backdrop of increasing Cold War tensions, the US and USSR used foreign aid to pressure development according to either capitalist or Marxist agendas. Thus, sub-Saharan Africa became a battleground of proxy wars and neocolonialism. The Cold War superpowers would back opposing regimes in Angola and prop up, oust, or assassinate leaders in Ghana, Democratic Republic of the Congo, and Tanzania. This disrupted natural political development and created instability and violence, which was compounded by the arrival of the AIDS epidemic in the mid-1980s. AIDS ravaged African societies and destroyed the remaining fibers of leadership. The disease illuminated harsh historical realities as it spread among the conflict-stricken countries of sub-Saharan Africa. The goal of this thesis is to analyze the motivations behind US and USSR foreign aid during the Cold War, understand how their involvement halted the natural progression of pan-Africanism and leadership in newly-independent African countries, and link the resulting violence to the devastation of the AIDS crisis twenty years later. It begins with a look at European colonization in sub-Saharan Africa and traces the legacy of western influence in the region. The paper will then analyze specific examples of the consequences of historical interference, such as in the Angolan Civil War, the Congo Crisis, and the Rwandan genocide. It will introduce the AIDS crisis—coincident with major civil conflict and the end of the Cold War—and reveal the foreign aid response of the international community in the late 1990s and early 2000s, once Cold War-era pressures were gone. Through realizing the continued impact and spread of HIV/AIDS, the objective of this paper is to present a comprehensive view of the modern-day consequences of historical interference.
ContributorsStaker, Gabrielle (Author) / Niebuhr, Robert (Thesis director) / Hruschka, Daniel (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor)
Created2023-05
Description
There is an enormous unmet need for services, education, and outreach to improve women’s breast health. Healthcare systems and insurance systems vary widely around the world, and this may play an important role in understanding variability in women’s breast health knowledge and behavior globally. The goal of this study is to determine how varying healthcare systems in three countries (Japan, Paraguay, US) affect a woman’s likelihood of seeing a physician in regard to their breasts. For example, Japan is a clear example of a region that provides universal health insurance to its citizens. The government takes responsibility in giving accessible and equitable healthcare to its entire population (Zhang & Oyama, 2016). On the other hand, a country such as Paraguay is composed of both public and private sectors. In order for citizens to gain insurance, one would have to either be formally employed or choose to pay out-of-pocket for hospital visits (“Paraguay”, 2017). A country such as the United States does not have universal health insurance. However, it does have a mix of public and private sectors, meaning there is little to no coverage for its citizens. To accommodate for this, the United States came up with the Affordable Care Act, which extends coverage to the uninsured. Although the United States might be a country that spends more on healthcare than any other nation, there are residents that still lack healthcare (De Lew, Greenberg & Kinchen, 1992). This study, then, compares women’s breast health knowledge and behavior in Japan, Paraguay, and the US. Other variables, which are also considered in this study, that might affect this include wealth level, education, having general awareness of breast cancer, having regular health checks, and having some breast education. Using statistical analysis of breast check rates of women in Japan, Paraguay, and the United States, this research found that women sampled in Asunción, Paraguay check their breasts more often than either women sampled from Scottsdale, U.S. or Osaka, Japan. It was also found that women sampled from Paraguay were more confident in detecting changes in their breast compared to women sampled from the Japan or the US. Finally, it was noted that women sampled from Japan were least likely to partake in seeing a doctor in concern of changes in their breasts compared to women sampled from the other two research locations. These findings have relevance for the implementation of advocacy and public education about breast health.
ContributorsKumar, Navneet Surjit (Co-author) / Kumar, Navneet (Co-author) / Wutich, Amber (Thesis director) / Brewis, Alexandra (Committee member) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
The purpose of this study is to analyze what barriers of care exist within the Senor de los Milagros community in Trujillo, Peru and how these barriers to care can identify shortcomings in the public healthcare system. This study is a collaboration of field research and outside literature. The research conducted was done via structured interviews with 15 participants, all promotoras (mothers of the community) and their husbands in the Senor de los Milagros community of Trujillo, Peru. Summaries and quotes from these interviews were uploaded and quantified to identify common barriers to care derived from socioeconomic and cultural determinants . Although this was on the main focus of the study, observations and conversations with healthcare staff and patients showed that the two most specific barriers found when data was analyzed were the wait times of public sector facilities and quality of care within these facilities. These barriers to care did not stop the promotoras from seeking care at MINSA facilities, but it does pose the questions as to how it affects healthcare-seeking behaviors and if this affects long-term healthcare outcomes.
ContributorsDragon, Jordan Elizabeth (Author) / Maupin, Jonathan (Thesis director) / Marsteller, Sara (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Hepatitis C virus (HCV) is endemic in Pakistan, with 5% of the population suffering from the disease. A unique aspect about HCV in Pakistan is the major role that healthcare workers play in its transmission, by reusing needles and giving therapeutic injections when they are not needed. This issue is furthered by patients’ misconceptions that invasive treatments, like injections, are more effective than oral medicines. The purpose of this project was to create a short video that addressed this inaccurate and dangerous perception, by educating Pakistanis about HCV and how to prevent infection and reinfection. In addition to disease transmission, accessibility to treatment options in Pakistan were also discussed. The video featured Pakistani physicians and some young adults. There were several limitations that delimited the project, including time, budget, the sudden death of a project participant, and the current COVID-19 epidemic as well as cultural, language, and physical barriers that come from filming a video about Pakistan as Americans. In the future, this video can serve as a framework for future efforts.
ContributorsKisana, Soofia (Co-author) / Ahmed, Kinza (Co-author) / Compton, Carolyn (Thesis director) / Buetow, Kenneth (Committee member) / Nadir, Abdul (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05