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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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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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Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects

Chemotherapy refers to the use of chemical agents to inhibit or stop the growth of rapidly dividing cancer cells. There are many side effects of systemic chemotherapy, which are caused because the drug not only kills cancer cells but healthy cells as well (American Cancer Society, 2017). Common side effects include fatigue, hair loss, bruising/ bleeding, infection, anemia, nausea and vomiting, appetite changes, constipation, diarrhea, oral sores, nerve and muscle pain, dry skin and color change, kidney dysfunction, weight loss, cognitive difficulties, mood changes, sexual dysfunction, and fertility problems (American Cancer Society, 2017). Research shows that complementary and alternative medicine (CAM) may help relieve some of the side effects of chemotherapy. Examples of CAM include herbal medicine, dietary supplements, acupuncture, yoga, Tai Chi, massage, electromagnetic therapy, meditation, biofeedback, music, dance, and guided imagery (Johns Hopkins Medicine, 2017). The aim of this creative project was to design a third-party website to provide information to patients undergoing chemotherapy and their family members regarding the use of CAM for the treatment of chemotherapy-induced side effects. Rationale for this project stemmed from a preliminary research step. We analyzed and coded for presence or absence of CAM-specific information on the websites of 20 National Cancer Institute-designated comprehensive cancer centers across the United States. Fifty percent of websites were double-coded. Inter-rater reliabilities (kappa values) for coding of the presence or absence of specific CAM therapies ranged from 0.38 for acupuncture to 1.00 for exercise and yoga, expressive arts, and herbs (mean kappa = 0.75). Fourteen of the 20 websites mentioned meditation or mindfulness; 13 mentioned nutrition; 12 mentioned acupuncture; 11 mentioned exercise or yoga; 11 mentioned massage; 8 mentioned expressive arts; and 3 mentioned herbs. Frequencies for presence of either a description of the specific CAM therapy or an explanation of how the therapy works were lower. We then conducted a literature review using PUBMED to find peer-reviewed research on the efficacy of the previously described seven CAM therapies. The literature search focused on systematic reviews and meta-analyses published within the past 10 years. Based on the literature obtained, we created summaries of the scientific evidence for each CAM therapy. This information is now provided on our third-party website in tabular form with summative statements. The website describes in lay language: chemotherapy, chemotherapy side effects, CAM, seven specific CAM therapies, and evidence for the efficacy or lack thereof of each. Per the American Nurses Association (2015), it is our responsibility to advocate for our patients through education and holistic treatment. The role of the nurse is to educate the patient about treatment options; however, it is not within the nurse's scope of practice to prescribe a treatment. As such, this website should not be viewed as a prescription for CAM therapies, but instead as a user-friendly and easily accessible resource for informed decision-making regarding the adjunctive use of CAM therapies.
Created2017-12
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Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The

Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model. Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale. Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention. Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
Created2022-05-02
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Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer

Problem Statement & Purpose: Cervical cancer screening rates for a Federally Qualified Health Center (FQHC) in rural Northern Arizona is 78%, which is below the Healthy People 2030 goal of 84.3%. Identification of socioeconomic barriers unique to rural women through the use of an intake survey can improve cervical cancer screening rates. This project was guided by the Social Cognitive Theory (SCT). SCT proposes that behavioral change is determined by environmental, social, personal, and behavioral elements. Methods: At a one-day well-woman event called, “See, Test, and Treat” hosted by the FQHC, an anonymous intake survey was implemented that identified participant demographics, basic cervical cancer knowledge, and perceived socioeconomic barriers to routine cervical cancer screening. Participants were recruited through the FQHC. Participant inclusion criteria: Arizona resident, uninsured, underinsured, 21-65 years old, English or Spanish speaking. Results: Descriptive statistics were utilized to evaluate the survey responses, reliability, and validity of responses unknown due to self-reported responses. A total of 18 surveys were completed with a final yield of (n = 10). Surveys didn’t identify barriers to routine cervical cancer screening; however, an unawareness of cervical cancer risk factors including multiple sexual partners (n = 5, 50.00%), sex at an early age (n = 4, 40.00%), and misperception that cervical cancer is genetic (n = 7, 70.00%) was identified. Implications for Practice: A need for cervical cancer education exists within the surveyed community. Providing rural women with knowledge regarding cervical cancer can improve screening rates.
Created2022-04-29
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Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in

Objective: Attention Deficit Hyperactivity Disorder is a pervasive neurodevelopmental disorder among children. Research has shown that young girls are underserved in diagnosing and treating ADHD or never diagnosed compared males. Utilizing the Health Promotion Model, this project aims to determine if primary care providers are aware of sex differences in ADHD and if a brief education on sex differences in ADHD affects the primary care setting's screening rate. Design/Methods: With the Arizona institutional review Boards' approval, primary care providers (PCP) in a Southwest family practice in Arizona (n=35) are provided with virtual education on sex differences in ADHD. Pre- post-intervention surveys were electronically administered to five PCPS. Data were deidentified. A two-tailed paired t-test was conducted to examine the mean difference of responses. Results: Analysis of responses demonstrate that primary care providers are well aware of sex differences in ADHD but screened less for ADHD before the education intervention. Major themes emerged from provider comments on ADHD symptom recognition, time constraints, and increased screening to identify girls in the primary setting. A significant increase in ADHD screening is seen four weeks post-intervention t(4) = -6.32, p = .003. Conclusion: Future research is needed to identify other factors that could strengthen ADHD screening during well-child visits overall. Also, the use of a pediatric screener which can highlight inattentive symptoms would assist in the process of identifying girls with ADHD.
Created2021-04-27
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Skin cancer is the most prevalent form of cancer diagnosed in America. No formal educational program for skin cancer prevention and sun safety previously existed at a Southwest University. As a result, a sun safety educational intervention sought to address this gap. For this co-ed young adult population, an education

Skin cancer is the most prevalent form of cancer diagnosed in America. No formal educational program for skin cancer prevention and sun safety previously existed at a Southwest University. As a result, a sun safety educational intervention sought to address this gap. For this co-ed young adult population, an education video outlining sun safety measures was developed and delivered. An evidence-based review of the literature supported the intervention design inclusive of pre-and post- descriptive surveys, distributed via Survey Monkey. Data collected included sun safety behaviors, intent for behavioral change, and attitudes towards sun safety. Twenty-eight students completed both the pre-and post-survey. Based on the findings, it is clear that students are more likely to adhere to sun-safe behaviors following this video-based education, potentially decreasing their risk of skin cancer development.
Created2021-04-29
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Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available

Childhood cancer affects nearly eleven-thousand children under the age of fifteen years each year, which launches families into a treatment trajectory of unforeseen complexities in several domains. As pediatric oncology healthcare providers tailor family-centered care for these highly fragile children, it is vital to understand the family’s lifestyle and available community resources. Children residing in remote areas may experience more burdensome needs as they progress in the cancer treatment trajectory, which healthcare providers may not be aware of unless the information is specifically solicited or incidentally discovered. Use of an evidence-based needs assessment for families who reside in remote zip codes will aid in identification of unique needs and assist the multi-disciplinary care team to specifically tailor interventions to the family. Forty semi-structured interviews were conducted with parents of childhood cancer survivors using an expert-validated needs assessment tool. The purpose of this Doctor of Nursing Practice (DNP) project is to develop a needs assessment for children with cancer in order to identify which needs are amplified in a remote community in order to match and create resources to meet those needs.
Created2021-04-30
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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