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.
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Description
Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment.
ContributorsSawyer, Brandon J (Author) / Gaesser, Glenn A (Thesis advisor) / Shaibi, Gabriel (Committee member) / Lee, Chong (Committee member) / Swan, Pamela (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2013
Effect of a Wii Fit® intervention on balance, muscular fitness, and bone health in middle-aged women
Description
Sustaining a fall can be hazardous for those with low bone mass. Interventions exist to reduce fall-risk, but may not retain long-term interest. "Exergaming" has become popular in older adults as a therapy, but no research has been done on its preventative ability in non-clinical populations. The purpose was to determine the impact of 12-weeks of interactive play with the Wii Fit® on balance, muscular fitness, and bone health in peri- menopausal women. METHODS: 24 peri-menopausal-women were randomized into study groups. Balance was assessed using the Berg/FICSIT-4 and a force plate. Muscular strength was measured using the isokinetic dynamometer at 60°/180°/240°/sec and endurance was assessed using 50 repetitions at 240°/sec. Bone health was tracked using dual-energy x-ray absorptiometry (DXA) for the hip/lumbar spine and qualitative ultrasound (QUS) of the heel. Serum osteocalcin was assessed by enzyme immunoassay. Physical activity was quantified using the Women's Health Initiative Physical Activity Questionnaire and dietary patterns were measured using the Nurses' Health Food Frequency Questionnaire. All measures were repeated at weeks 6 and 12, except for the DXA, which was completed pre-post. RESULTS: There were no significant differences in diet and PA between groups. Wii Fit® training did not improve scores on the Berg/FICSIT-4, but improved center of pressure on the force plate for Tandem Step, Eyes Closed (p-values: 0.001-0.051). There were no significant improvements for muscular fitness at any of the angular velocities. DXA BMD of the left femoral neck improved in the intervention group (+1.15%) and decreased in the control (-1.13%), but no other sites had significant changes. Osteocalcin indicated no differences in bone turnover between groups at baseline, but the intervention group showed increased bone turnover between weeks 6 and 12. CONCLUSIONS: Findings indicate that WiiFit® training may improve balance by preserving center of pressure. QUS, DXA and osteocalcin data confirm that those in the intervention group were experiencing more bone turnover and bone formation than the control group. In summary, twelve weeks of strength /balance training with the Wii Fit® shows promise as a preventative intervention to reduce fall and fracture risk in non-clinical middle aged women who are at risk.
ContributorsWherry, Sarah Jo (Author) / Swan, Pamela D (Thesis advisor) / Adams, Marc (Committee member) / Der Ananian, Cheryl (Committee member) / Sweazea, Karen (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2014
Description
As a form of bodily modification, female circumcision has generated unprecedented debates across the medical community, social sciences disciplines, governmental
on-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In the last two decades, these debates have evolved from a local matter to a global health concern and human rights issue, coinciding with the largest influx of African refugees to the Western nations. Various forms of female circumcision are reported in 28 countries in the African Continent; Somalia has one of the highest prevalence of female circumcision and the most severe type. The practice is antithetical to Western values and poses an ideological challenge to the construction of the normal body, its bodily processes and its existential being-in-the-world. From the global health perspectives, female circumcision is deemed to be a health hazard--especially during childbirth--though the scientific evidence is inconclusive from studies conducted in post-migration. Yet, Somali refugee women have higher childbearing disparities in host nations, including the U.S. They are also perceived as difficult patients and resistant to obstetrics interventions. Although their FGC status and "cultural" differences are often cited, there is a lack of adequate explanations as to why and how these factors shape patient-provider interactions and affect outcomes. The objectives of this dissertation study are to quantitatively and qualitatively explore these questions within and between Somali refugee women and their healthcare providers in Arizona. Two theoretical frameworks and methods--culture consensus and embodiment-- are applied to identify variations in childbearing knowledge and to explore how the cultural phenomenon of circumcision is subjectively and intersubjectively embodied in the context of childbearing. Culture consensus questionnaire (N=174) and ethnographic interviews (N=40) using phenomenology approach were conducted. Analyses suggest cross-cultural disagreement hinged on: faith in science versus God, pregnancy/childbirth interventions, language challenges, and control-resistance issues; intra-cultural disagreement underscores that Somalis are not culturally homogenous group. Preconceptions of female circumcision body as a cultural phenomenon has different and conflicting meanings that may adversely impact patient-provider interactions and outcomes.
on-governmental agencies and activists and others. The various terminologies used to refer to it attest to differences in knowledge systems, perceptions, and lived experiences emerging from divergent cultures and ideologies. In the last two decades, these debates have evolved from a local matter to a global health concern and human rights issue, coinciding with the largest influx of African refugees to the Western nations. Various forms of female circumcision are reported in 28 countries in the African Continent; Somalia has one of the highest prevalence of female circumcision and the most severe type. The practice is antithetical to Western values and poses an ideological challenge to the construction of the normal body, its bodily processes and its existential being-in-the-world. From the global health perspectives, female circumcision is deemed to be a health hazard--especially during childbirth--though the scientific evidence is inconclusive from studies conducted in post-migration. Yet, Somali refugee women have higher childbearing disparities in host nations, including the U.S. They are also perceived as difficult patients and resistant to obstetrics interventions. Although their FGC status and "cultural" differences are often cited, there is a lack of adequate explanations as to why and how these factors shape patient-provider interactions and affect outcomes. The objectives of this dissertation study are to quantitatively and qualitatively explore these questions within and between Somali refugee women and their healthcare providers in Arizona. Two theoretical frameworks and methods--culture consensus and embodiment-- are applied to identify variations in childbearing knowledge and to explore how the cultural phenomenon of circumcision is subjectively and intersubjectively embodied in the context of childbearing. Culture consensus questionnaire (N=174) and ethnographic interviews (N=40) using phenomenology approach were conducted. Analyses suggest cross-cultural disagreement hinged on: faith in science versus God, pregnancy/childbirth interventions, language challenges, and control-resistance issues; intra-cultural disagreement underscores that Somalis are not culturally homogenous group. Preconceptions of female circumcision body as a cultural phenomenon has different and conflicting meanings that may adversely impact patient-provider interactions and outcomes.
ContributorsFawcett, Lubayna (Author) / Maupin,, Jonathan N. (Thesis advisor) / Brewis Slade, Alexandra (Committee member) / Johnson-Agbakwu, Crista E. (Committee member) / Arizona State University (Publisher)
Created2014
Description
The present study describes audiovisual sentence recognition in normal hearing listeners, bimodal cochlear implant (CI) listeners and bilateral CI listeners. This study explores a new set of sentences (the AzAV sentences) that were created to have equal auditory intelligibility and equal gain from visual information.
The aims of Experiment I were to (i) compare the lip reading difficulty of the AzAV sentences to that of other sentence materials, (ii) compare the speech-reading ability of CI listeners to that of normal-hearing listeners and (iii) assess the gain in speech understanding when listeners have both auditory and visual information from easy-to-lip-read and difficult-to-lip read sentences. In addition, the sentence lists were subjected to a multi-level text analysis to determine the factors that make sentences easy or difficult to speech read.
The results of Experiment I showed that (i) the AzAV sentences were relatively difficult to lip read, (ii) that CI listeners and normal-hearing listeners did not differ in lip reading ability and (iii) that sentences with low lip-reading intelligibility (10-15 % correct) provide about a 30 percentage point improvement in speech understanding when added to the acoustic stimulus, while sentences with high lip-reading intelligibility (30-60 % correct) provide about a 50 percentage point improvement in the same comparison. The multi-level text analyses showed that the familiarity of phrases in the sentences was the primary driving factor that affects the lip reading difficulty.
The aim of Experiment II was to investigate the value, when visual information is present, of bimodal hearing and bilateral cochlear implants. The results of Experiment II showed that when visual information is present, low-frequency acoustic hearing can be of value to speech understanding for patients fit with a single CI. However, when visual information was available no gain was seen from the provision of a second CI, i.e., bilateral CIs. As was the case in Experiment I, visual information provided about a 30 percentage point improvement in speech understanding.
The aims of Experiment I were to (i) compare the lip reading difficulty of the AzAV sentences to that of other sentence materials, (ii) compare the speech-reading ability of CI listeners to that of normal-hearing listeners and (iii) assess the gain in speech understanding when listeners have both auditory and visual information from easy-to-lip-read and difficult-to-lip read sentences. In addition, the sentence lists were subjected to a multi-level text analysis to determine the factors that make sentences easy or difficult to speech read.
The results of Experiment I showed that (i) the AzAV sentences were relatively difficult to lip read, (ii) that CI listeners and normal-hearing listeners did not differ in lip reading ability and (iii) that sentences with low lip-reading intelligibility (10-15 % correct) provide about a 30 percentage point improvement in speech understanding when added to the acoustic stimulus, while sentences with high lip-reading intelligibility (30-60 % correct) provide about a 50 percentage point improvement in the same comparison. The multi-level text analyses showed that the familiarity of phrases in the sentences was the primary driving factor that affects the lip reading difficulty.
The aim of Experiment II was to investigate the value, when visual information is present, of bimodal hearing and bilateral cochlear implants. The results of Experiment II showed that when visual information is present, low-frequency acoustic hearing can be of value to speech understanding for patients fit with a single CI. However, when visual information was available no gain was seen from the provision of a second CI, i.e., bilateral CIs. As was the case in Experiment I, visual information provided about a 30 percentage point improvement in speech understanding.
ContributorsWang, Shuai (Author) / Dorman, Michael (Thesis advisor) / Berisha, Visar (Committee member) / Liss, Julie (Committee member) / Arizona State University (Publisher)
Created2015
Description
Autism Spectrum Disorder (ASD) holds potential for significantly impacting the primary caregiver and family, as well as the child with ASD. In particular, sleep problems occur frequently among children with ASD, and their poor sleep may negatively affect that of their caregivers. Health-related quality of life (HRQoL) and Family Quality of Life (FQoL) are salient indices of caregiver and family well-being. This pilot study explored associations between family caregiver sleep problems and caregiver sense of coherence (SOC) or coping on HRQoL and FQoL. Additionally, this study examined relationships between child sleep and behavior problems on caregiver sleep and well-being.
Sixty-two family caregivers of children with ASD (M =7.61, range: 6-11 years old) participated in this survey study. Participants provided demographic information and completed measures of HRQoL, FQoL, caregiver sleep, SOC, parental stress, child sleep, and child behavior.
Caregivers with longer sleep duration reported better mental health and better FQol. Caregivers who reported insomnia symptoms, non-restorative sleep, and insufficient sleep were more likely to report poorer mental health than caregivers who did not report these sleep disorder symptoms. A stronger caregiver SOC was associated with lower caregiver stress, better mental health, and better FQoL. Significant relationships were found between shorter caregiver sleep duration or sleep disorder symptoms (i.e., difficulty staying asleep, early morning awakening, insufficient sleep) and greater child sleep problems. Moreover, short sleep duration or insufficient sleep among caregivers was significantly associated with greater parenting stress. Notably, biological parents with Restless Legs Syndrome (RLS) had children with more restless sleep and higher rates of some behavior problems.
There are a number of potential connections between sleep problems of children with ASD and sleep problems of their caregivers that are likely rooted in genetic, environmental, socio-economic, and behavioral factors. Interventions for sleep problems must address the context of the family and consider that sleep problems may be common to the caregiver and the child. The results of this study support findings from many prior studies and point to salient variables for future research and interventions to promote healthy caregiver sleep.
Sixty-two family caregivers of children with ASD (M =7.61, range: 6-11 years old) participated in this survey study. Participants provided demographic information and completed measures of HRQoL, FQoL, caregiver sleep, SOC, parental stress, child sleep, and child behavior.
Caregivers with longer sleep duration reported better mental health and better FQol. Caregivers who reported insomnia symptoms, non-restorative sleep, and insufficient sleep were more likely to report poorer mental health than caregivers who did not report these sleep disorder symptoms. A stronger caregiver SOC was associated with lower caregiver stress, better mental health, and better FQoL. Significant relationships were found between shorter caregiver sleep duration or sleep disorder symptoms (i.e., difficulty staying asleep, early morning awakening, insufficient sleep) and greater child sleep problems. Moreover, short sleep duration or insufficient sleep among caregivers was significantly associated with greater parenting stress. Notably, biological parents with Restless Legs Syndrome (RLS) had children with more restless sleep and higher rates of some behavior problems.
There are a number of potential connections between sleep problems of children with ASD and sleep problems of their caregivers that are likely rooted in genetic, environmental, socio-economic, and behavioral factors. Interventions for sleep problems must address the context of the family and consider that sleep problems may be common to the caregiver and the child. The results of this study support findings from many prior studies and point to salient variables for future research and interventions to promote healthy caregiver sleep.
ContributorsRussell, Maureen (Author) / Baldwin, Carol (Thesis advisor) / Quan, Stuart F (Committee member) / McClain, Darya (Committee member) / Smith, Christopher (Committee member) / Matthews, Nicole (Committee member) / Arizona State University (Publisher)
Created2014
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Health-related quality of life (HR-QOL) is a significant treatment outcome for persons with end-stage renal disease (ESRD); however, little is known about the HR-QOL of Mexican patients with ESRD. This pilot study describes relationships between demographics, sleep disorders, spirituality, mood, folk practices and dialysis modality on the HR-QOL of patients with ESRD residing in Guanajuato, Mexico. Mexican patients receiving continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and hemodialysis (HD) provided information on demographics, clinical health data including body mass index (BMI), and folk health practices. Measures included the Short Form (SF)-36 HR-QOL survey, Sleep Habits Questionnaire, Latin Spirituality Perspective Scale and Hospital Anxiety and Depression Scale. Data were analyzed using SAS software (V9.1). Signifi¬cance level for this pilot study was set at p<0.10. The Quality-Adjusted Life Year method was utilized to examine cost effectiveness for each dialysis modality. Demographics and clinical data showed participants (N=121) to be 59 (SD=13) years, predominantly men (55.4%), married (66.9%), Catholic (92.6%), and not currently working (78.3%). The majority were diabetic (72%) and slightly overweight (BMI M=26.1; SD=5.1). The CAPD group (n=39) demonstrated significantly lower HR-QOL scores compared to the APD (n=42) and HD (n=40) groups. Patients on HD reported higher rates and greater numbers of sleep disorders, including insomnia symptoms, non-restorative and insufficient sleep, and daytime somnolence compared to patients on CAPD and APD. Patients on CAPD reported more anxiety and depression compared to patients on HD and APD. Overall linear regression for HR-QOL found dialysis type, sleep disorders and income to be significant predictors and the model accounted for 31% of the variance. Cost analysis indicated APD as the preferred treatment because it is less costly and results in the best HR-QOL compared to the other treatment modalities. Findings provide the first SF-36 norms for Mexicans with ESRD. Sleep disorders and dialysis type greatly impinge on the HR-QOL of these patients, particularly their mental health. APD was identified as the preferred treatment based on low cost and improved HR-QOL. Results can inform clinical care and health policy for Mexican patients with ESRD.
ContributorsReynaga-Ornelas, Luxana (Author) / Baldwin, Carol M. (Thesis advisor) / Quan, Stuart F (Committee member) / Arcoleo, Kimberly (Committee member) / Arizona State University (Publisher)
Created2011
Description
The effects of a long-term combat deployment on a soldier's physical fitness are not well understood. In active duty soldiers, combat deployment reduced physical fitness compared to pre-deployment status, but no similar research has been performed on Army National Guard soldiers. This study is the first to identify physical fitness changes in Arizona National Guard (AZNG) soldiers following deployment to a combat zone and to assess the relationships between physical fitness and non-combat injuries and illness (NCII). Sixty soldiers from the Arizona National Guard (AZNG) completed a battery of physical fitness tests prior to deployment and within 1-7 days of returning from a 12-month deployment to Iraq. Pre and post-deployment measures assessed body composition (Bod Pod), muscular strength (1RM bench press, back-squat), muscular endurance (push-up, sit-up), power (Wingate cycle test), cardiorespiratory fitness (treadmill run to VO2 peak), and flexibility (sit-and-reach, trunk extension, shoulder elevation). Post deployment, medical records were reviewed by a blinded researcher and inventoried for NCII that occurred during deployment. Data were analyzed for changes between pre and post-deployment physical fitness. Relationships between fitness and utilization of medical resources for NCII were then determined. Significant declines were noted in mean cardiorespiratory fitness (-10.8%) and trunk flexibility (-6.7%). Significant improvements were seen in mean level of fat mass (-11.1%), relative strength (bench press, 10.2%, back-squat 14.2%) and muscular endurance (push-up 16.4%, sit-up 11.0%). Significant (p < 0.05) negative correlations were detected between percentage change in fat mass and gastrointestinal visits (r = -0.37); sit-and-reach and lower extremity visits (r= -0.33); shoulder elevation and upper extremity visits (r= -0.36); and cardiorespiratory fitness and back visits (r= -0.31); as well as behavioral health visits (r= -0.28). Cardiorespiratory fitness changes were grouped into tertiles. Those who lost the greatest fitness had significantly greater number of NCII visits (8.0 v 3.1 v 2.6, p = .03). These data indicate a relationship between the decline in cardiorespiratory fitness and an overall increase in utilization of medical resources. The results may provide incentive to military leaders to ensure that soldiers maintain their cardiorespiratory fitness throughout the extent of their deployment.
ContributorsWarr, Bradley (Author) / Swan, Pamela (Thesis advisor) / Lee, Chong (Committee member) / Campbell, Kathryn (Committee member) / Erickson, Steven (Committee member) / Alvar, Brent (Committee member) / Arizona State University (Publisher)
Created2011
Description
Introduction: Several faith-based or faith-placed programs have focused on the physical dimension of wellness in efforts to improve health by increasing physical activity and improving diet behaviors. However, these programs were not designed to intervene on the mental dimension of wellness which is critical for stress reduction and health behavior change. Purpose: To evaluate the feasibility of a spirituality-based stress reduction and health behavior change intervention using the Spiritual Framework of Coping (SFC) model. Methods: This study was a quasi-experimental one group pretest posttest design. The study was a total of eight weeks conducted at a non-denominational Christian church. Participants were recruited from the church through announcements and flyers. The Optimal Health program met once a week for 1.5 hours with weekly phone calls during an additional four week follow-up period. Feasibility was assessed by the acceptability, demand, implementation, practicality, integration, and limited efficacy of the program. Analysis: Frequencies for demographics were assessed. Statistical analyses of feasibility objectives were assessed by frequencies and distribution of responses to feasibility evaluations. Limited efficacy of pretest and posttest measures were conducted using paired t-test (p <.05). Results: The Optimal Health Program was positively accepted by participants. The demand for the program was shown with average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was both practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy changes within the program were mostly non-significant. Conclusion: This study tested the feasibility of implementing the Optimal Health program that specifically targeted the structural components of the Spiritual Framework of Coping Model identified to create meaning making and enhance well-being. This program may ultimately be used to help individuals improve and balance the spiritual, mental, and physical dimensions of wellness. However, length of study and limited efficacy measures will need to be reevaluated for program success.
ContributorsWalker, Jenelle R (Author) / Swan, Pamela (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Fleury, Julie (Committee member) / Hooker, Steven (Committee member) / Arizona State University (Publisher)
Created2012
Description
This dissertation examines associations between religious affiliation, religious community context and health of women and their children in Mozambique focusing on the following issues: (1) attending prenatal consultations and delivering children in a health facility; (2) women's symptoms of STDs; and (3) under-five mortality. Estimation of random intercept Poisson regression for the outcome about attending prenatal consultations demonstrated a favorable effect of affiliation to Catholic or Mainline Protestant and Apostolic religious groups. The concentration of Zionist churches in the community had a negative influence. Random intercept logistic regression was used to estimate the relationship between religion and institutional child delivery. Affiliation to Catholic or Mainline Protestant denominations as well as concentration of Catholic or Mainline Protestant churches in the community had some beneficial effect on giving birth in health clinics. The presence of Zionist churches in the community had some negative effect and that of other groups no significant influence. Random intercept logistic regression was also employed for investigating the influence of religion on women's symptoms of STDs. Belonging to the Catholic or Mainline Protestant church had some protective effect on reporting symptoms of STDs. There was no effect of religious context, except that the concentration of Other Pentecostal churches had a positive effect on reporting symptoms of SDTs. Event-history analysis was conducted for examining relationships between maternal religious affiliation with under-five mortality. Affiliation to Catholic or Mainline Protestant churches and to Apostolic denominations increased the odds of child survival, although, the influence of having a mother belonging to Catholic or Mainline Protestant churches lost statistical significance after accounting particularly for the average level of education in the community, for the period of 5 years preceding the survey date. Taken together, the results in this dissertation show some protective effect of religion that varies primarily by denominational group to which women are affiliated. They also indicate that religious community context may have some negative effect on health of women and children. The nature of the effect of religious community context varies with the type of outcome considered and the type of religious mixture in the community.
ContributorsCau, Boaventura Manuel (Author) / Agadjanian, Victor (Thesis advisor) / Hayford, Sarah (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011