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- Member of: ASU Electronic Theses and Dissertations
Description
Public risk communication (i.e. public emergency warning) is an integral component of public emergency management. Its effectiveness is largely based on the extent to which it elicits appropriate public response to minimize losses from an emergency. While extensive studies have been conducted to investigate individual responsive process to emergency risk information, the literature in emergency management has been largely silent on whether and how emergency impacts can be mitigated through the effective use of information transmission channels for public risk communication. This dissertation attempts to answer this question, in a specific research context of 2009 H1N1 influenza outbreak in Arizona. Methodologically, a prototype agent-based model is developed to examine the research question. Along with the specific disease spread dynamics, the model incorporates individual decision-making and response to emergency risk information. This simulation framework synthesizes knowledge from complexity theory, public emergency management, epidemiology, social network and social influence theory, and both quantitative and qualitative data found in previous studies. It allows testing how emergency risk information needs to be issued to the public to bring desirable social outcomes such as mitigated pandemic impacts. Simulation results generate several insightful propositions. First, in the research context, emergency managers can reduce the pandemic impacts by increasing the percent of state population who use national TV to receive pandemic information to 50%. Further increasing this percent after it reaches 50% brings only marginal effect in impact mitigation. Second, particular attention is needed when emergency managers attempt to increase the percent of state population who believe the importance of information from local TV or national TV, and the frequency in which national TV is used to send pandemic information. Those measures may reduce the pandemic impact in one dimension, while increase the impact in another. Third, no changes need to be made on the percent of state population who use local TV or radio to receive pandemic information, and the frequency in which either channel is used for public risk communication. This dissertation sheds light on the understanding of underlying dynamics of human decision-making during an emergency. It also contributes to the discussion of developing a better understanding of information exchange and communication dynamics during a public emergency and of improving the effectiveness of public emergency management practices in a dynamic environment.
ContributorsZhong, Wei (Author) / Lan, Zhiyong (Thesis advisor) / Kim, Yushim (Committee member) / Corley, Elizabeth (Committee member) / Lant, Timothy (Committee member) / Jehn, Megan (Committee member) / Arizona State University (Publisher)
Created2012
Description
This study considered three main aims of (1) developing and validating a tool to measure parental perceived child mental health (MH) stigma, (2) determining whether perceived stigma levels corresponded in any way to parental identities, and (3) producing a decision-making process flow identifying where barriers such as perceived child MH stigma may affect families dealing with child MH issues. Recruitment of parents/guardians (18 years or older) with children (under the age of 18 years) was done through convenience and respondent-driven sampling in Phoenix, Arizona. A 44-prompt MH stigma tool was developed and validated (N=65, Cronbach's alpha 0.89) prior to utilizing (N=623) it to measure levels of perceived child MH stigma in the community. Analysis of variance showed potential significant (p<.005) interactions among education, income, and race/ethnicity (white, non-Hispanic/Latinx and Hispanic/Latinx) and levels of stigma. Specifically, higher education and lower income among the Hispanic/Latinx population in Phoenix showed a greater likelihood for higher levels of perceived child MH stigma. Factor analysis yielded three underlying factors of this stigma: interaction with MH, discrimination, and positive aspects. Content and thematic analysis of free response questions in the survey conveyed parents talk about MH diagnoses differently between general MH and child MH (e.g., child MH included ADD/ADHD while general MH included anxiety and schizophrenia). Fifteen, one hour-long, semi-structured interviews were completed, transcribed, and analyzed using narrative analysis to develop a parental decision-making process flow. The resulting flow showed parents went through informal methods of accessing MH care (e.g., research, awareness of MH issue) prior to formal methods such as seeking medical experts or school support. While the study was able to address these three aims, a significant shift in the landscape of MH occurred with the COVID-19 pandemic, increasing child MH risk and decreasing care access. This study developed a tool and set of methods that may be applied to identify changes in perceived child MH stigma and in how parents make decisions to access child MH care.
ContributorsIvanova, Julia Ilkova (Author) / Maupin, Jonathan (Thesis advisor) / Jehn, Megan (Committee member) / Wadhera, Devina (Committee member) / Arizona State University (Publisher)
Created2022
Description
The current coronavirus disease 2019 (COVID-19) pandemic has highlighted the crucial role of mathematical models in predicting, assessing, and controlling potential outbreaks. Numerous modeling studies using statistics or differential equations have been proposed to analyze the COVID-19 dynamics, with network analysis and cluster analysis also being adapted to understand disease transmission from multiple perspectives. This dissertation explores the use of network science and mathematical models to improve the understanding of infectious diseases. Chapter 1 provides an introduction to infectious disease modeling, its history, importance, and challenges. It also introduces network science as a powerful tool for understanding the complex interactions between individuals that can facilitate disease spread. Chapter 2 develops a statistical model that describes HIV infection and disease progression in a men who have sex with men cohort in Japan receiving a Pre-Exposure Prophylaxis (PrEP) program. The cost-effectiveness of the PrEP programwas evaluated by comparing the incremental cost-effectiveness ratio over a 30-year period against the willingness to pay threshold. Chapter 3 presents an ordinary differential equations model to describe disease transmission and the effects of vaccination and mobility restrictions. Chapter 4 extends the ODE model to include spatial heterogeneity and presents partial differential equations models. These models describe the combined effects of local transmission, transboundary transmission, and human intervention on COVID-19 dynamics. Finally, Chapter 5 concludes the dissertation by emphasizing the importance of developing relevant disease models to understand and predict the spread of infectious diseases by combining network science and mathematical tools.
ContributorsYamamoto, Nao (Author) / Wang, Haiyan (Thesis advisor) / Lampert, Adam (Thesis advisor) / Jehn, Megan (Committee member) / Arizona State University (Publisher)
Created2023
Description
Contact tracing was deployed widely during the COVID-19 pandemic to attempt to stop the spread of SARS Co-V-2. This dissertation investigates the research on contact tracing from a scientometric perspective and looks qualitatively at how case investigators and contact tracers conducted public health practice during the pandemic. Through approaching the public health practice of contact tracing from both a broad, top-down angle, and an on the ground experiential approach, this dissertation provides insight into the issues facing contact tracing as a public health tool.
ContributorsWhite, Alexandra C. (Author) / Jehn, Megan (Thesis advisor) / Hruschka, Daniel (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2022
Description
Short-term medical missions (STMMs) are groups of volunteer medical providers who travel to provide health care, including basic services and surgeries, to global low-income populations. STMM organizations present their work as contrary to both public and private systems within Guatemala that do not adequately serve the patient population, though they operate within the same framework as other providers and mirror the same neoliberal ideology in their planning, organization and strategy, and execution. STMMs strive to offer free, high-quality access to surgeries and basic health care services via volunteer medical providers willing to dedicate their time and skill to low-income patients. The patient population of STMMs in Guatemala, who are often rural, indigenous, and low-income, already experience diminishing access to health care due to neoliberal health policies and discrimination within the existing health care landscape, going to great lengths to access quality health care services. This research investigates the planning, organization and strategy, and execution of STMMs through the lens of the enduring influence of neoliberal health ideologies on volunteer medical providers and existing health resources in Guatemala. Organizational strategies that prioritize the ease of travel for volunteer medical providers mirror the geographical lack of health care access, neglect of indigenous language services in the health care context, and urban focus already existing in the country’s public health care system. The patient population experiences heightened vulnerability exacerbated by STMMs when seeking care because of their low adherence to Guatemalan law surrounding registration requirements for foreign medical providers and poor institutional accountability, burdening patients, who lack legal literacy and financial resources, with denouncing malpractice or post-operative problems. Finally, STMM providers expect patients to both demonstrate passivity, humility, and material deficiency and show that they can be ‘good’ patients—able to understand and abide by the authority of the medical providers, know what information to provide, and communicate effectively—essentially, to be good health consumers. Ultimately, this research demonstrates how neoliberal health ideologies remain deeply engrained in the psyche of STMM organizations, despite their targeted approach to deliver health care to patients struggling to access services in Guatemala’s chaotic health care landscape.
ContributorsDriese, Mary Catherine (Author) / Maupin, Jonathan N (Thesis advisor) / Hall-Clifford, Rachel (Committee member) / Jehn, Megan (Committee member) / Arizona State University (Publisher)
Created2022
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
Description
Background. Street food stands (SFS) are common ways in which people in Mexico access food, having been a part of the environment and culture of Mexican food for generations. However, no studies have used a validated assessment tool to reliably measure food and beverage availability at a variety of SFS. Nor have the availability, density, variety, and distribution of SFS and street foods and beverages been assessed across neighborhood income levels.Objective: This dissertation’s goal was to decrease gaps in knowledge about the role SFS may play in food availability in the Mexican food environment.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT.
Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels.
Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population.
ContributorsRosales Chavez, Jose Benito (Author) / Jehn, Megan (Thesis advisor) / Bruening, Meg (Thesis advisor) / Lee, Rebecca E (Committee member) / Ohri-Vachaspati, Punam (Committee member) / Arizona State University (Publisher)
Created2020