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The AIDS epidemic has tremendously impacted the population of Mozambique. The rate of newly infected young women continues to grow disproportionately which is why consideration of health interventions specific to this population to combat the spread of the disease is critical. The Health Belief Model emphasizes the importance of self

The AIDS epidemic has tremendously impacted the population of Mozambique. The rate of newly infected young women continues to grow disproportionately which is why consideration of health interventions specific to this population to combat the spread of the disease is critical. The Health Belief Model emphasizes the importance of self efficiency in the process of health related behavioral changes. Previous research has found that low levels of autonomy increase one's risk of contracting HIV/AIDS. This research uses data from a study conducted in 2006 in Mozambique to test whether higher levels of autonomy are associated with the practice of self protective behaviors related to the contraction of HIV/AIDS. Results suggest that some measures of autonomy such as education are positively associated with the practice of self protective behaviors. However, higher levels of decision making powers were negatively associated with the practice of self protective behaviors.
ContributorsWilliams, Kelli (Author) / Hayford, Sarah (Thesis advisor) / Agadjanian, Victor (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011
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Despite the extensive research on the consequences of migration, little is known about the effects of seasonal migration on fertility, contraception and sexually transmitted diseases in the countries of former Soviet Union, that have undergone vast demographic changes in the last two decades. Using cross-sectional data from two surveys conducted

Despite the extensive research on the consequences of migration, little is known about the effects of seasonal migration on fertility, contraception and sexually transmitted diseases in the countries of former Soviet Union, that have undergone vast demographic changes in the last two decades. Using cross-sectional data from two surveys conducted in Armenia in 2005 and 2007, this dissertation is exploring the effects of seasonal migration on reproductive behavior and outcomes, as well as sexual health among women left-behind. The dissertation is constructed of three independent studies that combined draw the broad picture of the consequences of seasonal migration in this part of the world. The first study, "Seasonal migration and fertility in low-fertility areas of origin" looks at the effect of seasonal migration on yearly pregnancy rates, lifetime fertility, and fertility preferences among women and their husbands. The models are fitted using discrete-time logistic regression, and random-intercept logistic regression for negative binomial and binary outcomes, correspondingly. The findings show that seasonal migration in low-fertility settings does not further disrupt fertility levels in a short-, or long-run, contradicting to the findings from high-fertility settings. However, the study provides some evidence that seasonal migration is associated with increased fertility preferences among migrant men. The second study, "Seasonal migration and contraception among women left-behind", examines the associations between migration and modern contraceptive use, by looking at current contraceptive use and the history of abortions. A series of random-intercept logistic regression models reveal that women with migrant partners are significantly less likely to use modern contraceptives, than women married to non-migrants. They also have higher rates of abortions; however this effect is moderated by the socioeconomic status of the household. The third study, "Seasonal migration and risks of sexually transmitted diseases (STDs) among women left-behind", looks at the effects of seasonal migration on the diagnosed STDs in the last three years, and self reported STD-like symptoms in the last twelve months. The results of random-intercept logistic regression for negative binomial and binary outcomes provide strong evidence of increased STD risks among migrants' wives; however, this effect is also moderated by the household income.
ContributorsSevoyan, Arusyak (Author) / Agadjanian, Victor (Thesis advisor) / Haas, Steven (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2011
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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

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
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ABSTRACT

The aim of the study is to examine the impact of international male labor migration on the sexual and reproductive health of women who stay back home in Tajikistan. The data for this study was gathered as a result of ethnographic field works conducted on several occasions from 2011 to

ABSTRACT

The aim of the study is to examine the impact of international male labor migration on the sexual and reproductive health of women who stay back home in Tajikistan. The data for this study was gathered as a result of ethnographic field works conducted on several occasions from 2011 to 2013.

The results of the study suggest that male migration does not have an impact on fertility levels of the left-behind women. Although similarly to previous studies this study shows that wives of migrants are less likely to use contraception, it nevertheless demonstrates changes in contraceptive behaviors of wives of migrants such as seasonal removal and insertion of an intrauterine device (IUD) and shift from long-term to short-term contraception use. However, despite the availability of numerous forms of contraception in the country, the pattern of contraceptive use such as the reliance on IUDs dominant during the Soviet period continues to exist among wives of non-migrants. One of the most important findings of this study is women’s ability to use condoms for a short term with husbands after their return and asking spouses to have an HIV test. This finding challenges the dominant discourses in HIV and migration literature focusing on the inability, impossibility and failure on the part of the wives to negotiate HIV prevention due to various factors impeding the promotion of HIV prevention skills and measures among women.

Moreover, the study demonstrates that, on the one hand, male migration worsens reproductive health of the left-behind women, but, on the other hand, it improves/increases their access to reproductive health institutions thanks to remittances. Although self-reported symptoms of women show a slight difference in reproductive morbidity, including STIs of wives of migrants and non-migrants, health care providers believe that this difference is significant and wives of migrants are more likely to have complications during pregnancy, delivery and post-delivery periods.

The study also shows that the majority of HIV prevention and family planning programs target only wives of migrants and non-migrants, however it is crucial that migrant men should also be targets of these programs.
ContributorsMiskinzod, Dilofarid (Author) / Agadjanian, Victor (Thesis advisor) / Koblitz, Ann (Committee member) / Weitz, Rose (Committee member) / Arizona State University (Publisher)
Created2015
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The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public

The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public policy as well as the barriers and benefits. A 20- item survey was sent to all of the members of AzNA. There were 39 responses used in the analysis. The highest reported public policy activities in which the nurses had participated were: voted (90%), contacted a public official (51%), and gave money to a campaign or for a public policy concern (46%). Lack of time was the most frequently reported barrier to involvement and improving the health of the public was the most frequently reported benefit to involvement. The number of public policy education/information sources and the highest level of education positively correlate to the nurses' total number of public policy activities (r = .627 p <0.05; r = .504, p <0.05). Based on the results of stepwise linear regression analysis, the participants' age, number of education/information sources, and efficacy expectation predict 68.8% of involvement in public policy activities. The greater the number of education/information sources, the greater the number of public policy activities nurses report having participated in.
ContributorsHartman, Mykaila Corrine (Author) / Stevens, Carol (Thesis director) / Munoz, Aliria (Committee member) / Link, Denise (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
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Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention

Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.

The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.

ContributorsBabb, Maria (Author) / Link, Denise (Thesis advisor)
Created2020-04-18
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Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions

Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions to increase screening rates. Furthermore, the literature suggests provider education increases screening rates. However, before education could be completed an understanding of providers current knowledge, attitudes, and practice was needed. Using this information, a gap analysis that was completed in an Arizona county (“the County”) of syphilis screening during pregnancy by prenatal care clinicians will be presented guided by the Knowledge-Attitude-Practice (KAP) Model and the ACE Star Model of Knowledge Transformation.
ContributorsWard, Kinley (Author) / Link, Denise (Thesis advisor)
Created2020-04-24
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Pregnancy is a specific time in a woman’s life filled with complex changes in health, including the oral cavity. During this time, dental and perinatal care teams can be influential in helping women initiate and maintain essential habits to improve health and prevent adverse outcomes. There is research evidence that

Pregnancy is a specific time in a woman’s life filled with complex changes in health, including the oral cavity. During this time, dental and perinatal care teams can be influential in helping women initiate and maintain essential habits to improve health and prevent adverse outcomes. There is research evidence that dental providers are reluctant to treat dental problems during pregnancy. Barriers to practice identified by dentists include lack of education, time, financial constraints, and concern for the safety treating pregnant women. Factors that facilitate dental care for pregnant women include purposeful assessment, referrals from prenatal providers, and continuing education for dental team members.

Multiple organizations recommend the treatment of oral health conditions during pregnancy to promote health and prevent pregnancy complications. In order to promote community-based partnerships in a healthcare system, dentists are encouraged to develop an intentional plan to increase collaboration with other members of the women’s healthcare team. Prior to developing a system wide intervention to improve access to dental care during pregnancy, dental team members were surveyed to identify barriers and facilitators which promote or hinder care in their practice. The data acquired will be used to inform the design and implementation of an intervention to specifically meet the needs of patients and providers in that system.

ContributorsRideaux, Stephanie A. (Author) / Link, Denise (Thesis advisor)
Created2020-04-15
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Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects. While emphasis on preconception and prenatal care has increased nationwide, attendance at this important visit is on the decline. The

Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects. While emphasis on preconception and prenatal care has increased nationwide, attendance at this important visit is on the decline. The purpose of this project was to investigate how enhanced prenatal education and concurrent scheduling of a well-baby visit at four weeks, instead of the traditional six weeks, could increase adherence to recommended follow-up care at a federally qualified health clinic in the Southwestern United States.

The Theory of Reasoned Action guided the intervention while Rosswurum and Larrabee’s evidence-based practice model was used to develop the project. The pre-existing weekly prenatal education program was enhanced with information regarding the importance of a four-week postpartum follow-up visit. Front desk schedulers were educated to offer same day appointments for the postpartum care visit and one-month well-baby appointment. Data collection took place for three months after implementation of the project and was compared to adherence rates during the three months prior to the intervention. Providers and scheduling staff members participated in a short post-intervention interview. Prenatal education and convenience of concurrent scheduling increased the percentage of adherence to follow-up visits over a three-month period. Providers and clinic staff recommend continuing with the process changes to increase patient’s access to family centered care.

ContributorsRusso, Leah (Contributor) / Link, Denise (Contributor)
Created2017-05-01
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Maintaining good oral health during pregnancy is a significant contributor to healthy pregnancy outcomes. The physiological changes that happen during pregnancy can adversely affect women’s oral health and place her at risk for pregnancy outcomes such as miscarriage and preeclampsia. The unborn child’s health can also be affected by premature

Maintaining good oral health during pregnancy is a significant contributor to healthy pregnancy outcomes. The physiological changes that happen during pregnancy can adversely affect women’s oral health and place her at risk for pregnancy outcomes such as miscarriage and preeclampsia. The unborn child’s health can also be affected by premature birth and low birth weight. Although professional organizations have evidence-based practice guidelines for both prenatal and dental providers, the evidence shows a gap between recommendations and practice. An oral health promotion project for pregnant women was implemented in a federally qualified community health center where there was a lack of adherence to the guidelines.

The purpose of this project was to implement established oral health screening guidelines for pregnant women and to increase dental visits among pregnant women. For this project, a two-item maternal oral health-screening tool (MOS) for the prenatal providers was added into the electronic health record to standardize and document oral health screening for pregnant women at their first prenatal visit. After three months of implementation, there was a significant increase in maternal oral health screening and referral. This project may be replicated at any prenatal setting to improve oral health during pregnancy.

ContributorsPhilsy, Jaison (Author) / Link, Denise (Thesis advisor)
Created2018-04-24