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This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.
Created2016-05
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Description
Epigenetic mechanisms such as DNA methylation have been found to affect metabolic processes, which leads to conditions like type 2 diabetes and obesity. The aim of this project was to validate differentially methylated cytosines (DMCs) identified in skeletal muscle from seven obese, non-diabetic women pre- and 3 months post- Roux-en-Y

Epigenetic mechanisms such as DNA methylation have been found to affect metabolic processes, which leads to conditions like type 2 diabetes and obesity. The aim of this project was to validate differentially methylated cytosines (DMCs) identified in skeletal muscle from seven obese, non-diabetic women pre- and 3 months post- Roux-en-Y gastric bypass surgery. DNA samples extracted from skeletal muscle were sent to the Mayo Genotyping Core to undergo reduced representation bisulfite sequencing (RRBS). Differentially methylated cytosines at chr14.105353824 of the gene CEP170B, chr19.16437949 of the KLF2 gene, chr7.130126082 of MEST, and chr15.62457572 of C2CD4B were captured from the RRBS analysis using MethylSig. Bisulfite sequencing PCR (BSP) was performed on all DMCs listed above which resulted in no significant changes in methylation post-surgery. It was concluded that an alternate, more precise method should be used for validation of the RRBS, such as pyrosequencing.
ContributorsKelley, Conley Lane (Author) / Coletta, Dawn K. (Thesis director) / Roust, Lori R. (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description
Obesity has become a major area of research in many fields due to the increasing obesity rate not only in The United States, but also around the world. Research concerning obesity stigma has both physical and mental health implications. Weight bias and obesity stigma represent important research areas for health

Obesity has become a major area of research in many fields due to the increasing obesity rate not only in The United States, but also around the world. Research concerning obesity stigma has both physical and mental health implications. Weight bias and obesity stigma represent important research areas for health professionals as they confront these issues on a daily basis in interactions with their patients. To explore how gender, ethnicity, and a person's own BMI affect the stigma of certain weight related terms, a set of 264 participant's surveys on weight related situations on the campus of Arizona State University were analyzed. Using univariate analysis to determine frequency of words deemed most or least acceptable as well as independent t-test for gender and ANOVA for ethnicity and own BMI, we found that participant's view more clinical terms such as "unhealthy BMI" and "BMI" as acceptable words for use during a physician-patient interaction. Analysis across genders revealed the highest number of differences in terms, with females generally ranking terms across the board as less acceptable then men. Differences varied little between ethnicities; however, own BMI revealed more differences between terms; underweight participants did not rank any terms as positive. We analyzed average ATOP (Attitudes Toward Obese People) scores and found that there was no significant difference in average ATOP scores between gender and a participant's own BMI, but a statistical significance did exist between ethnic categories. This study showed that the term "obese/obesity", although normally considered to be a clinical term by many was not ranked as very positive across gender, ethnicity, or own BMI. Based on these findings, new material should be created to inform physicians on how to talk about weight related problems with certain populations of patients.
ContributorsBlasco, Drew Adair (Author) / Wutich, Amber (Thesis director) / Brewis Slade, Alexandra (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / Department of Psychology (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2014-12
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Description
This paper explains what factors influence mental health issues and what type of care is provided in various countries. The countries in this study will include the United States, Japan, Ethiopia and South Africa, all of which have varying degrees of ethnic diversity, economic status and understanding of mental health

This paper explains what factors influence mental health issues and what type of care is provided in various countries. The countries in this study will include the United States, Japan, Ethiopia and South Africa, all of which have varying degrees of ethnic diversity, economic status and understanding of mental health issues. It discusses the specific healthcare systems in each country, as well as the attitudes and problems associated with depression and schizophrenia, two prevalent mental health disorders. This paper examines the different ways that a diagnosis is reached for schizophrenia and major depression in these different countries, as well as what methods are used for treating individuals with these disorders. It will also examine the prominent notion that schizophrenia has better outcomes in developing countries than in places that have wider medical care available. It then discusses what treatments are available in each country, as well as social constructs that exist regarding those treatments in order to understand the ways that treatments can be expanded to improve outcomes. This paper will then examine the different outcomes of these mental health disorders that are common in each country, and conclude with ideas on how to make global mental health a reality.
ContributorsOlsen, Rachel Lindsay (Author) / Gaughan, Monica (Thesis director) / Wood, Reed (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor) / Department of Psychology (Contributor)
Created2015-05
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Description
This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed as a problem has a profound impact on the kinds

This project explores a variety of ways of framing the problem of obesity, beginning with a multidisciplinary assessment of genetic, environmental, cultural, nutritional, and socioeconomic factors involved in the structure and the consequences of each frame. How obesity is framed as a problem has a profound impact on the kinds of solutions that may be deemed scientifically appropriate. But frames are not entirely evidence-based, inasmuch as political and moral values infuse debates about the nature of obesity. Drawing on interdisciplinary resources from bioethics and the philosophy of science, I strive to offer strategic insight in to how to navigate the complexity of these issues.
ContributorsYanamandra, Meghana (Author) / Robert, Jason (Thesis director) / Wharton, Christopher (Committee member) / Drago, Mary (Committee member) / Barrett, The Honors College (Contributor) / School of Sustainability (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2014-05
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Description
Maternal health and mental health have recently become globally recognized as critical areas of focus. The continued research into the relationship between maternal health and mental health—in particular, how they are affected by public policy and infrastructure—is vital to the improvement of general health outcomes. An investigation of literature, current

Maternal health and mental health have recently become globally recognized as critical areas of focus. The continued research into the relationship between maternal health and mental health—in particular, how they are affected by public policy and infrastructure—is vital to the improvement of general health outcomes. An investigation of literature, current health landscape and indicators, gray literature, and the current policy landscape in an exemplar country (Australia), Bangladesh and Nepal was done. Bangladesh and Nepal were chosen due to the recent amounts of change seen in each country’s maternal health status. Both Bangladesh and Nepal are severely lacking in official mental health services, facilities, and personnel. The analysis revealed flaws and disparities in each country’s current policy landscape. Despite these disparities it should be recognized that policies and programs are being implemented – just in a very piecemeal manner, and not entirely by each country’s respective government. Integration of maternal health services and mental health services is recommended to improve functionality of already existing services. The addition of minimal but necessary components to health systems is recommended.
ContributorsCiampaglio, Kaitlyn Rae (Author) / Gaughan, Monica (Thesis director) / Hagaman, Ashley (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of Sustainability (Contributor)
Created2015-05
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Description
This paper describes a mixed methods investigation of undergraduate mental health support practices at Arizona State University (ASU), as well as an outside look at peer and other leading institutions. Methods employed in this study include: ASU undergraduate student survey to assess perception of resources provided by ASU and the

This paper describes a mixed methods investigation of undergraduate mental health support practices at Arizona State University (ASU), as well as an outside look at peer and other leading institutions. Methods employed in this study include: ASU undergraduate student survey to assess perception of resources provided by ASU and the likelihood to disclose physical and mental health conditions, key informant interviews to understand ASU mental health support from the perspective of those who implement support measures, participant observation of study abroad events that provide resources to prospective and pre-departure students, and a document review of the study abroad website from peer and other institutions. The target population of this study is undergraduate students who participate or plan to participate in study abroad programs across the United States. The sample population for the undergraduate student survey is undergraduate students at ASU, as well as sixteen institutions for the document review. Significant findings from the research include student concerns about financial and academic barriers to study abroad, as well as a greater likelihood to disclose physical health conditions rather than mental health conditions due to fear of stigma or of being a burden to program coordinators. Additionally, it was found that there is a separation between available resources and student awareness and use of these resources. ASU can work to remedy this disconnect by explicitly presenting easily accessible resource information on the website and in pre-departure materials, as well as addressing mental health awareness abroad in an inclusive manner towards all students in addition to those with pre-existing mental health conditions. Overall, more work should be done to fulfill the vision of comprehensive mental health support at ASU.
ContributorsThuraisingam, Aryanna Devi (Author) / Gaughan, Monica (Thesis director) / Henry, Adam (Committee member) / Hart, Dan (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Description
Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week

Background:
Pediatric obesity is associated with lower quality of life (QOL) and populations with high obesity rates, such as Latinos, are especially vulnerable. We examined the effects of a 12-week diabetes prevention program on changes in weight-specific QOL in Latino youth.
Method:
Fifteen obese Latino adolescents (BMI%=96.3±1.1;age=15.0±1.0) completed a 12-week intervention. Youth completed weight-specific QOL measures at baseline, post intervention, and 1-year follow-up. For comparison purposes, intervention youth were matched for age and gender with lean controls.
Results:
At baseline, obese youth exhibited significantly lower weight-specific QOL compared with lean youth (70.8±5.4 to 91.2±2.2, p<0.005). The intervention did not significantly impact weight (90.6±6.8 to 89.9±7.2kg, p=0.44). However, significant increases in weight-specific QOL were observed (70.8±20.9 to 86.2±16.9, p<0.001). Post-intervention QOL scores were no longer significantly different than lean controls (P=0.692). Data from nine youth who returned for follow-up indicated that increases in weight-specific QOL were maintained over time (90.5±4.5 to 85.8±5.9, p=0.74).
Conclusion:
These results indicate that a community-based diabetes prevention program can result in sustained improvements in weight-specific QOL among obese Latino youth. Lifestyle interventions that focus on social interaction and physical activity, rather than weight-loss per se, may help improve the psychosocial health of obese Latino youth.
ContributorsBrito, Elizabeth (Author) / Shaibi, Gabriel (Thesis director) / Barroso, Cristina (Committee member) / Patrick, Donald (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-05
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Description
Through a standpoint feminist perspective (Harding 2009) I conducted a situational analysis (Clarke, 2015) that examined academic literature and cancer support discussion boards (DBs) to identify how Western biomedicine, specifically oncology, can integrate complementary and alternative medicine (CAM) to improve cancer treatment in children. The aims of this project were:

Through a standpoint feminist perspective (Harding 2009) I conducted a situational analysis (Clarke, 2015) that examined academic literature and cancer support discussion boards (DBs) to identify how Western biomedicine, specifically oncology, can integrate complementary and alternative medicine (CAM) to improve cancer treatment in children. The aims of this project were: 1) to identify the CAM treatments that are being used to alleviate the side effects from oncological treatments and/or treat pediatric cancers; 2) to compare the subjective experience of CAM to Western biomedicine of cancer patients who leave comments on Group Loop, Cancer Compass and Cancer Forums, which are online support groups (N=20). I used grounded theory and situational mapping to analyze discussion threads. The participants identified using the following CAM treatments: herbs, imagery, prayer, stinging nettle, meditation, mind-body therapies and supplements. The participants turned to CAM treatments when their cancer was late-stage or terminal, often as an integrative and not exclusively to treat their cancer. CAM was more "effective" than biomedical oncology treatment at improving their overall quality of life and functionality. We found that youth on discussion boards did not discuss CAM treatments like the adult participants, but all participants visited these sites for support and verification of their cancer treatments. My main integration recommendation is to combine mind-body CAM therapies with biomedical treatment. This project fills the gap in literature that ignores the ideas of vulnerable populations by providing the experiences of adult and pediatric cancer patients, and that of their families. It is applicable to areas of the social studies of medicine, patient care, and families suffering from cancer. KEYWORDS: Cancer; Complementary and Alternative Medicine; Situational Analysis; Standpoint Feminism
ContributorsEsposito, Sydney Maria (Author) / Martinez, Airín (Thesis director) / Hruschka, Daniel (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
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Description
Climate change presents a significant threat to human health, both mental and physical; as a result, it has become one of the most commonly discussed phenomena of the 21st century. As many people are aware, a wide range of social and physical factors affects mental health. However, many people fail

Climate change presents a significant threat to human health, both mental and physical; as a result, it has become one of the most commonly discussed phenomena of the 21st century. As many people are aware, a wide range of social and physical factors affects mental health. However, many people fail to realize that these increases global temperatures also have a significant impact on mental health as a result of increased vulnerability that is often manifested through one's emotions. By analyzing perceptions of people across the globe, in the United Kingdom, New Zealand, and Fiji, we were able to pinpoint these emotions and trace them individual's feelings of worry, distress, and hope that resulted from their perceived impacts on climate change. Overall, we found that people tend to have overall more negative emotional reaction when it comes to the perceived effects of climate change. Of the respondents, more men than women expressed concern regarding the various negative implications. Finally, those in the United Kingdom exhibited a stronger emotional response, followed by those in New Zealand and Fiji, respectively.
ContributorsSmith, Austin Lee (Author) / Wutich, Amber (Thesis director) / du Bray, Margaret (Committee member) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05