Matching Items (339)
Description
Native American communities face an ongoing challenge of effectively addressing cancer health disparities, as well as environmental racism issues that may compound these inequities. This dissertation identified the shared cultural knowledge and beliefs about cancer in a southwest American Indian community utilizing a cultural consensus method, an approach that combines qualitative and quantitative data. A community-based participatory research (CBPR) approach was applied at all stages of the study. The three phases of research that were undertaken included: 1) ethnographic interviews - to identifying the themes or the content of the participants' cultural model, 2A) ranking of themes - to provide an understanding of the relative importance of the content of the cultural model, 2B) pile sorts - identify the organization of items within specific domains, and 3) a community survey - access whether the model is shared in the greater community. The cultural consensus method has not been utilized to date in identifying the collective cultural beliefs about cancer prevention, treatment or survivorship in a Native American community. Its use represents a methodological step forward in two areas: 1) the traditional ethnographic inferences used in identifying and defining cultural meaning as it relates to health can be tested more rigorously than in the past, and 2) it addresses the challenge of providing reliable results based on a small number of community informants. This is especially significant when working with smaller tribal/cultural groups where the small sample size has led to questions concerning the reliability and validity of health-related research. Results showed that the key consultants shared strong agreement or consensus on a cultural model regarding the importance of environmental and lifestyle causes of cancer. However, there was no consensus found among the key consultants on the prevention and treatment of cancer. The results of the community survey indicated agreement or consensus in the sub-domains of descriptions of cancer, risk/cause, prevention, treatment, remission/cure and living with cancer. Identifying cultural beliefs and models regarding cancer could contribute to the effective development of culturally responsive cancer prevention education and treatment programs.
ContributorsClaus, Cynthia (Author) / Koss, Joan (Thesis advisor) / Brandt, Elizabeth, (Thesis advisor) / Joe, Jennie (Committee member) / Maupin, Jonathan (Committee member) / Arizona State University (Publisher)
Created2011
Description
Culture informs ideas about healthy and acceptable body types. Through globalization the U.S.-European body model has become increasingly significant in local contexts, influencing local body models. While Puerto Ricans have historically valued plump bodies - a biocultural legacy of a historically food scarce environment - this dissertation investigated shifts in these ideals across generations to a stronger preference for thinness. A sample of 23 intergenerational family triads of women, and one close male relative or friend per woman, were administered quantitative questionnaires. Ethnographic interviews were conducted with a sub-sample of women from 16 triads and 1 quintet. Questions about weight history and body sizes were used to address cultural changes in body models. Findings indicate the general trend for all generations has been a reduction in the spectrum of acceptable bodies to an almost singular idealized thin body. Female weight gain during puberty and influence of media produced varied responses across age groups. Overall, Puerto Ricans find it acceptable to gain weight with ageing, during a divorce, and postpartum. Thin bodies are associated with beauty and health, but healthy women that do not resemble the thin ideal, submit themselves to dangerous weight loss practices to achieve self and social acceptance. Further research and direct interventions need to be conducted to alter perceptions that conflate beauty with health in order to address the `normative discontent' women of all ages experience. Weight discrimination and concern with being overweight were evident in Puerto Rican everyday life, indicated by the role of media and acculturation in this study. Anti-fat attitudes were stronger for individuals that identified closely with United States culture. Exposure to drama and personal transformation television programs are associated with increased body image dissatisfaction, and increased exposure to variety shows and celebrity news shows is associated with increased anti-fat attitudes and body dissatisfaction. In sum, the positive valuation of fat in the Puerto Rican cultural body size model in the 1970s has shifted toward a negative valuation of fat and a preference for thin body size.
ContributorsRodriguez-Soto, Isa (Author) / Maupin, Jonathan (Thesis advisor) / Wutich, Amber (Committee member) / Walters-Pacheco, Kattia (Committee member) / Arizona State University (Publisher)
Created2013
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
This dissertation is intended to tie together a body of work which utilizes a variety of methods to study applied mathematical models involving heterogeneity often omitted with classical modeling techniques. I posit three cogent classifications of heterogeneity: physiological, behavioral, and local (specifically connectivity in this work). I consider physiological heterogeneity using the method of transport equations to study heterogeneous susceptibility to diseases in open populations (those with births and deaths). I then present three separate models of behavioral heterogeneity. An SIS/SAS model of gonorrhea transmission in a population of highly active men-who-have-sex-with-men (MSM) is presented to study the impact of safe behavior (prevention and self-awareness) on the prevalence of this endemic disease. Behavior is modeled in this examples via static parameters describing consistent condom use and frequency of STD testing. In an example of behavioral heterogeneity, in the absence of underlying dynamics, I present a generalization to ``test theory without an answer key" (also known as cultural consensus modeling or CCM). CCM is commonly used to study the distribution of cultural knowledge within a population. The generalized framework presented allows for selecting the best model among various extensions of CCM: multiple subcultures, estimating the degree to which individuals guess yes, and making competence homogenous in the population. This permits model selection based on the principle of information criteria. The third behaviorally heterogeneous model studies adaptive behavioral response based on epidemiological-economic theory within an $SIR$ epidemic setting. Theorems used to analyze the stability of such models with a generalized, non-linear incidence structure are adapted and applied to the case of standard incidence and adaptive incidence. As an example of study in spatial heterogeneity I provide an explicit solution to a generalization of the continuous time approximation of the Albert-Barabasi scale-free network algorithm. The solution is found by recursively solving the differential equations via integrating factors, identifying a pattern for the coefficients and then proving this observed pattern is consistent using induction. An application to disease dynamics on such evolving structures is then studied.
ContributorsMorin, Benjamin (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Hiebeler, David (Thesis advisor) / Hruschka, Daniel (Committee member) / Suslov, Sergei (Committee member) / Arizona State University (Publisher)
Created2012
Description
Due to persistent undernutrition in India and the increased demands placed on a woman’s body during childbearing and lactation, the Indian government has implemented a program to provide supplemental nutrition packets to women in rural India. This study examines the factors influencing uptake of nutritional packets by lactating mothers in southern, rural Rajasthan. Women were recruited from 65 villages in Rajasthan, India (n=149, minimum of 2 per village) to evaluate the relationship of nutrition packet uptake and two factors--education levels and distance to the health center.
Level of education had little impact on whether or not women received the nutrition packet. Of those women with no education, 63.1% received the packet. Of those with any education, 63.9% got the packet.
In contrast, distance was strongly correlated with whether or not women received the packet. For example, of the women living within 200 meters of the health center, 93.2% received a nutrition packet. Of the women living between 250 meters and one kilometer of the health center, 68.4% received a nutrition packet. Of the women living over one kilometer from the health center, only 25% received a nutrition packet. The relationship between uptake of packets and women’s perception of distance to the health center was also explored. Out of 50 women who did not receive the packet, all of the women who said there was no health center in their village did live more than one kilometer from a health center. Of the women who lived between 250 meters and one kilometer from the health center, 40% felt it was too far. Of the women who lived more than a kilometer from the health center, 66.7% felt it was too far and 29.6% said there was no health center in their village. Again, it does not appear that ‘too far’ is just a default reason for women, but that actual distance, more so than education, is a major contributing factor in their ability to take the nutrition packet. These findings suggest that improving access to supplemental nutrition packets at the village level may increase uptake by the women.
Level of education had little impact on whether or not women received the nutrition packet. Of those women with no education, 63.1% received the packet. Of those with any education, 63.9% got the packet.
In contrast, distance was strongly correlated with whether or not women received the packet. For example, of the women living within 200 meters of the health center, 93.2% received a nutrition packet. Of the women living between 250 meters and one kilometer of the health center, 68.4% received a nutrition packet. Of the women living over one kilometer from the health center, only 25% received a nutrition packet. The relationship between uptake of packets and women’s perception of distance to the health center was also explored. Out of 50 women who did not receive the packet, all of the women who said there was no health center in their village did live more than one kilometer from a health center. Of the women who lived between 250 meters and one kilometer from the health center, 40% felt it was too far. Of the women who lived more than a kilometer from the health center, 66.7% felt it was too far and 29.6% said there was no health center in their village. Again, it does not appear that ‘too far’ is just a default reason for women, but that actual distance, more so than education, is a major contributing factor in their ability to take the nutrition packet. These findings suggest that improving access to supplemental nutrition packets at the village level may increase uptake by the women.
ContributorsJeffers, Eva Marie (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / Cook, Jeffrey (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2015-05
Description
Over the past three decades, medical anthropology research, published within both public health and anthropological journals, demonstrates both the prevalence of traditional folk medicine in Latino populations in the United States and the potential difficulty of negotiating these beliefs and practices with clinical, western biomedicine. I bring attention to what might be a narrative of divergent values that occurs in Latino communities in the United States. A well-documented source (Pachter, 1994) of this clash is the culturally pervasive use of folk medicine in Latino layperson populations seeking biomedical care in the Unites States (U.S.). Numerous studies (Padilla, 2001; Koss 1972) suggest that a significant portion of Latinos in the continental United States call upon folk knowledge to diagnose, reinterpret, and treat illness. The Puerto Rican population seems to be no exception, though few studies are specific to native-born Puerto Ricans living in Puerto Rico, where the issue of access to quality public health care becomes increasingly problematic. In this honors undergraduate thesis project, I conduct a review of the literature that bridges anthropology and public health research and proceed to describe a study I conducted on Culebra Island, Puerto Rico in May of 2015. The study aims to determine whether patient satisfaction can be linked to being treated by a physician hailing from a similar cultural background, or if an irredeemable disparity between patient and provider present a roadblock to health outcomes. I found that the Puerto Rican physicians are receptive to folk illness (symptoms) and consider folk therapy as part of the treatment regimen. The physicians make patients feel understood, which might improve treatment adherence and thus health outcomes. Still, respondents demonstrated that there is high patient trust in the biomedical model by emphasizing the use of conventional medications in tandem with the folk therapy. Nevertheless, the health care provider's disposition in regards to folk knowledge and modalities are important but does not present a roadblock to optimal care and health outcomes as much as access, available services or clinic resources.
ContributorsVanasse-Torres, Elena Georgina (Author) / Maupin, Jonathan (Thesis director) / Maienschein, Jane (Thesis director) / MartÃÂnez, AirÃÂn (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
2015 marks the deadline for the UN Millennium Development Goal 5 to reduce global maternal mortality rate (MMR) by 75% since 1990. As of 2015, MMR has only been reduced by 45%. Many international organizations claim that more medically trained midwives can meet global maternal health care needs. This study investigates two major questions. What is the role of midwives in diverse international maternal healthcare contexts? How do midwives in these different contexts define their roles and the barriers to providing the best care for women? From May to August 2015, I conducted over 70 interviews with midwives in Netherlands, Sweden, Rwanda, Bangladesh, Australia and Guatemala, interviewing between 6 and 13 midwives from each country. The majority of midwives defined their roles as supporting women's individual capacities and power through normal birth, and knowing when to refer when high-risk complications arise. Although thematic barriers vary by country, midwives in all countries believed that maternal healthcare can be improved by increased collaboration between midwives and other health care professionals, better access to culturally appropriate services, and greater public awareness of the role of midwives.
ContributorsCarson, Anna Elizabeth (Author) / Hruschka, Daniel (Thesis director) / Maupin, Jonathan (Committee member) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
How are perceptions of morality and disgust regarding meat consumption related to each other? Which factor is more salient in determining one's willingness to eat the meat of a specific animal? How do these answers vary across religious groups? This study investigates the ways that concepts like morality and disgust are related to food preferences and hopes to shed light on the mechanisms that enforce culturally sanctioned food taboos. The study compares 4 groups of people in the U.S.: Christians (n = 39), Hindus (n = 29), Jews (n = 23), and non-religious people (n = 63). A total of 154 participants were given surveys in which they rated their feelings about eating various animals. Data from Christian and non-religious groups exhibited similar patterns such as a high likelihood of eating a given animal when starving, while results from Jews and Hindus were consistent with their religion's respective food taboos. Despite these differences, morality and disgust are strongly correlated with one another in almost all instances. Moreover, morality and disgust are almost equally important considerations when determining willingness to eat when starving.
ContributorsParekh, Shaili Rajul (Author) / Hruschka, Daniel (Thesis director) / Jacobs, Mark (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor) / School of Human Evolution and Social Change (Contributor) / Hugh Downs School of Human Communication (Contributor)
Created2014-12
Description
Because children do not have the same decision-making powers as adults in matters affecting their health, their opinions have often been underrepresented in research (Bradding & Horstman, 1999). However, there is growing interest in the way that children view health because this knowledge elicits the development of more child-centered and effective approaches to health education and intervention (Bradding & Horstman, 1999). Professionals have often utilized the write-and-draw technique in school settings to gain a better understanding of how to best implement health education programs. The "bottom-up" approach of the write-and-draw method encourages participation and has been shown to elicit thoughtful responses about how children conceptualize health (Pridmore & Bendelow, 1995). This study uses the write-and-draw method to perform a cross- cultural comparison of child perspectives of health in the United States and Guatemala, countries that represent contrasting paradigms for child health. The results of this study are consistent with previous research, especially the emergent health themes. Children from the United States and Guatemala predominantly depicted health in terms of food. Guatemalan students were more likely to refer to hygienic practices and environmental conditions, while US children mentioned vegetables, water, and exercise as being healthy. For the unhealthy category, themes of poor hygiene, chips, fat/grease, fruit, carbohydrates, and environment were mentioned more often in Guatemala, while U.S. students listed sweets and fast food more frequently. Results support claims made in other literature that children's concepts of health are shaped by life experience and social context. Potential applications of the research include exposing areas (themes) where children are less likely to understand health implications and developing educational curriculum to increase a more comprehensive understanding of health.
ContributorsRenslow, Jillian Marie (Author) / Maupin, Jonathan (Thesis director) / BurnSilver, Shauna (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution and Social Change (Contributor) / School of International Letters and Cultures (Contributor)
Created2015-05
Description
The United States is experiencing an increase in the prevalence and influence of complementary and alternative medicine (CAM) in patient healthcare, reflecting the increasingly positive public and professional attitudes on the use of CAM therapies. Despite the growing presence of CAM in U.S. healthcare, there are still many barriers to integration. This study aims to reveal the attitudes of conventional, integrative and CAM practitioners concerning the major challenges of CAM's integration, explore their proposed solutions, and reveal any discrepancies in these attitudes among different types of practitioners. Twenty-eight practitioners were interviewed on the challenges in the five facets of CAM's integration: integration into hospitals, integration into medical schools, insurance coverage for CAM, licensing & regulation of CAM practitioners, and clinical research in CAM. The overall positive attitudes on the benefits of CAM's integration support previous research on the subject; however, the conventional practitioners were unable to extend these benefits to real-world application, and they were unaware of many of the challenges facing CAM's integration. The CAM practitioners attributed many of the problems facing integration to the inability of CAM's philosophy to comply with the current ideology of medical academia, health insurance model, and laws that govern the licensing and regulation of medical practitioners. The CAM and integrative practitioners perceived there to be a large resistance from conventional practitioners, specifically concerning the integration of CAM into education, providing insurance coverage for CAM, and the licensing and regulation of CAM practitioners. They attributed this to a perceived lack of research on safe and effective treatments in CAM. The conventional practitioner responses reflected this weariness of treatment effectiveness in their responses. However, the CAM and integrative practitioners believed these claims to be largely inaccurate, and constructed by the influence and manipulation of large-scale medical corporations and organizations. The participants believed that more evidence-based research in CAM, and increased public awareness in CAM therapies will force conventional practitioners to increase their knowledge in CAM, helping to alleviate their fears and skepticism of CAM therapies. By easing these concerns, dialogue can occur among practitioners of different modalities that will help to ensure a smooth integration of CAM and will raise the quality of patient healthcare by providing safe and effective resources for alternate forms of treatment.
ContributorsJohnston, Shantele Hanna Lee (Author) / Hruschka, Daniel (Thesis director) / Hurlbut, Ben (Committee member) / Barrett, The Honors College (Contributor) / School of International Letters and Cultures (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2014-05