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- All Subjects: public health
- Creators: Hruschka, Daniel
- Creators: Vega-Lopez, Sonia
Description
Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
ContributorsLondon, Douglas (Author) / Tsuda, Takeyuki (Thesis advisor) / Beezhold, Bonnie L (Committee member) / Hruschka, Daniel (Committee member) / Eder, James (Committee member) / Arizona State University (Publisher)
Created2012
Description
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
ContributorsVansteelandt, Amanda (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Stone, Anne (Thesis advisor) / Hruschka, Daniel (Committee member) / Rojas de Arias, Antonieta (Committee member) / Arizona State University (Publisher)
Created2014
Description
Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.
Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.
Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.
Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.
ContributorsChavez, Adrian (Author) / Vega-Lopez, Sonia (Thesis advisor) / Crespo, Noe (Committee member) / Hekler, Eric (Committee member) / Shaibi, Gabriel (Committee member) / Bruening, Meg (Committee member) / Arizona State University (Publisher)
Created2015
Description
By offering increased access to medical care, telemedicine offers significant opportunity for the process of development under Amartya Sen’s definition, that development is freedom, including freedom from illness, early death, and preventable disease. It advances development by freeing people from these burdens. However, like many emerging technologies, organizing information and understanding the field faces significant challenges. This paper applies Bashshur's three-dimensional model of telemedicine to the classification of telemedicine literature found in databases to assess the value of the model as a tool for classification. By standardizing language and creating a repository of research done to date in a centralized location, the field can better understand how it is progressing and where work still needs to be done. This paper aims to see if Bashshur's model serves well for this task.
ContributorsBlum, Alexander (Author) / Parmentier, Mary Jane (Thesis advisor) / Zachary, Gregg (Committee member) / Grossman, Gary (Committee member) / Arizona State University (Publisher)
Created2015
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
Suicide is one of the fastest-growing and least-understood causes of death, particularly in low and middle income countries (LMIC). In low-income settings, where the technical capacity for death surveillance is limited, suicides may constitute a significant portion of early deaths, but disappear as they are filtered through reporting systems shaped by social, cultural, and political institutions. These deaths become unknown and unaddressed. This dissertation illuminates how suicide is perceived, contested, experienced, and interpreted in institutions ranging from the local (i.e., family, community) to the professional (i.e., medical, law enforcement) in Nepal, a country purported to have one of the highest suicide rates in the world. Drawing on a critical medical anthropology approach, I bridge public health and anthropological perspectives to better situate the problem of suicide within a greater social-political context. I argue that these complex, contestable deaths, become falsely homogenized, or lost. During 18 months of fieldwork in Nepal, qualitative, data tracing, and psychological autopsy methodologies were conducted. Findings are shared through three lenses: (1) health policy and world systems; (2) epidemiology and (3) socio-cultural. The first investigates how actors representing familial, legal, and medical institutions perceive, contest, and negotiate suicide documentation, ultimately failing to accurately capture a leading cause of death. Using epidemiologic perspectives, surveillance data from medical and legal agencies are analyzed and pragmatic approaches to better detect and prevent suicidal death in the Nepali context are recommended. The third lens provides perceived explanatory models for suicide. These narratives offer important insights into the material, social, and cultural factors that shape suicidal acts in Nepal. Findings are triangulated to inform policy, prevention, and intervention approaches to reduce suicidal behavior and improve health system capabilities to monitor violent deaths. These approaches go beyond typical psychological investigations of suicide by situating self-inflicted death within broader familial, social, and political contexts. Findings contribute to cultural anthropological theories related to suicide and knowledge production, while informing public health solutions. Looking from the margins towards centers of power, this dissertation explicates how varying institutional numbers can obfuscate and invalidate suffering experienced at local levels.
ContributorsHagaman, Ashley (Author) / Wutich, Amber (Thesis advisor) / Hruschka, Daniel (Committee member) / Kohrt, Brandon (Committee member) / Arizona State University (Publisher)
Created2017
Description
It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project one identified validity evidence for the new MyWellness Key accelerometer in sixteen adults. The MyWellness Key demonstrated acceptable validity evidence when compared to a criterion accelerometer during graded treadmill walking and in free-living settings. This supports the use of the MyWellness Key accelerometer to measure physical activity. Project two evaluated validity (study 1) and test-retest reliability evidence (study 2) of the Global Physical Activity Questionnaire (GPAQ) in a two part study. The GPAQ was compared to direct and indirect criterion measures including object and subjective physical activity instruments. These data provided preliminary validity and reliability evidence for the GPAQ that support its use to assess physical activity. Project three investigated the optimal h.d-1 of accelerometer wear time needed to assess daily physical activity. Using a semi-simulation approach, data from 124 participants were used to compare 10-13 h.d-1 to the criterion 14 h.d-1. This study suggested that a minimum accelerometer wear time of 13 h.d-1 is needed to provide a valid measure of daily physical activity. Project four evaluated validity and reliability evidence of a novel method (Movement and Activity in Physical Space [MAPS] score) that combines accelerometer and GPS data to assess person-environment interactions. Seventy-five healthy adults wore an accelerometer and GPS receiver for three days to provide MAPS scores. This study provided evidence for use of a MAPS score for future research and clinical use. Project five used accelerometer data from 1,000 participants from the 2005-2006 National Health and Nutrition Examination Study. A semi-simulation approach was used to assess the effect of accelerometer wear time (10-14 h.d-1) on physical activity data. These data showed wearing for 12 h.d-1 or less may underestimate time spent in various intensities of physical activity.
ContributorsHerrmann, Stephen (Author) / Ainsworth, Barbara (Thesis advisor) / Gaesser, Glenn (Committee member) / Der Ananian, Cheryl (Committee member) / Kang, Minsoo (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2011
Description
In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation experiments ranging from 1944 to 1974. The goal of this thesis is to analyze the ways in which that committee formed moral evaluations and the extent to which its strategies related to a broader historical and philosophical discourse. Here I attempt to describe two specific techniques of simplification the committee deploys in order to make a retrospective moral analysis possible. Although the techniques comprise specific problems, frameworks, subjective perspectives, and conceptual links, their unifying principle is the field of choices the techniques produce. In the first technique I outline, I argue that by focusing on the problem of historical relativism, the committee gains a platform through which it would be granted flexibility in making a distinction between moral wrongdoing and blameworthiness. In the second technique of simplification I outline, I argue that the committee's incorporation of a principle to reduce uncertainty as an ethical aim allow it to establish new ways to reconcile scientific aims with moral responsibility. In addition to describing the structure of these techniques, I also demonstrate how they relate to the specific experiments the analysts aim to evaluate, using both the ACHRE experiments as well as the Nuremberg Trial experiments as my examples. My hope is not to show why a given committee made a particular moral evaluation, or to say whether a decision was right or wrong, but rather to illustrate how certain techniques open up a field of choices that allow moral analysts to form retrospective moral judgments.
ContributorsCirjan, Cristian (Author) / Hurlbut, Ben (Thesis director) / Humphrey, Ted (Committee member) / Zachary, Gregg (Committee member) / Barrett, The Honors College (Contributor)
Created2015-05
Description
Objectives. To determine how health-related conversations between parents and their adolescent children are associated with mealtime media device use by adolescents. Methods. A sample of Hispanic parents (n=344; 40.4 ± 6.6 years; 89.2% female) of 6th, 7th, or 8th-grade adolescents enrolled in a parenting intervention promoting healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health- or weight-related conversations with their adolescent child, and the frequency with which the adolescent used media devices during mealtimes (television/movie watching, cellphone use/texting, hand-held gaming devices, listening to music with headphones). Associations between health-related conversations and mealtime media devices were assessed with Spearman’s rank correlations. Chi-square tests and crosstabs were used to identify differences in parents setting limits on media use during mealtime depending on adolescent gender. Independent sample t-tests were used to compare the frequency of health- and weight-related conversations and media device use during mealtime based on adolescent gender. Results. Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r=0.213; p<0.001), talking on a cellphone (r=0.119; p=0.034), using hand-held gaming devices (r=0.131; p=0.022), and listening to music with headphones (r=0.129; p=0.022). Having conversations about exercising to lose weight was also significantly correlated with television/movie watching during mealtimes (r=0.134; p=0.017). Parents reported having more frequent conversations about weighing too much with males when compared to adolescent females (2.45 ± 1.43 vs. 1.93 ± 1.28; t-stat= 3.58; p=0.005). Parents also reported more frequent weight-related conversations overall (weight-related scale) with males when compared to female adolescents (2.73 ± 1.39 vs 2.52 ± 1.26; t-stat=1.51; p=0.024). Conclusion. Findings suggest that higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Whether parenting practices, parental concerns about their children’s weight, and the home mealtime environment play a role on adolescent weight status in Hispanic households warrants further investigation.
ContributorsMartinez, Gabriela (Author) / Vega-Lopez, Sonia (Thesis advisor) / Bruening, Meg (Committee member) / Ayers, Stephanie (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