UT Southwestern School of Health Professions
Permanent URI for this collectionhttps://hdl.handle.net/2152.5/6691
Welcome to the UT Southwestern School of Health Profession’s electronic theses and dissertations (ETD) collection. (Note: The school was previously named the UT Southwestern School of Allied Health Sciences.)
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Print theses and dissertations from 1943 to 2004 are located in the Library's Special Collections and Archives (Room E3.314) and are available by appointment. (Note: Former students may request a digitized copy of their work by email, but other users may submit an Interlibrary Loan request.) For more information, contact archives@utsouthwestern.edu.
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Browsing UT Southwestern School of Health Professions by Subject "African Americans"
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Item The Prevalence of Temporomandibular Disorder in African Americans(2011-12-09) Doyle, Nicole J.; Gatchel, Robert J.; Chiu, Chung-Yi; Haggard, RobbieThis pilot study collected a convenience sample of adult residents of the Dallas, Texas metropolitan area to estimate the prevalence of temporomandibular disorder (TMD) in African Americans. Additionally, the study also collected the same data on Caucasians for comparisons against the African American numbers on all measures. At the conception of this study, there existed no prior studies focusing primarily on prevalence of TMD in African Americans. The study administered a survey of acute jaw pain symptoms to a convenience sample of 274 participants 18 years and older, 129 African Americans, 116 Caucasians and 29 of other races. The survey assessed TMD symptoms using 19 questions derived from the Research Diagnostic Criteria for TMD. The overall prevalence of TMD for total sample of 274 was 22.3%, with a higher prevalence of TMD in women (25.3%) than in men (16%). The prevalence of TMD among African Americans was 22% with a higher prevalence among females (24.4%) than males (15.6%). Among Caucasians, the prevalence of TMD was 22.5%, with a higher prevalence among females (23.7%) than males (20%). Caucasians reported greater rates of tinnitus, low back pain (p<.05), clenching and grinding (p<.1), while African Americans reported greater rates of teeth problems (p<.1). For all-participants, African American and Caucasian samples, discriminant analysis showed the ability of the symptoms listed on the survey to classify correctly the participants as having TMD or as not having TMD approached 100%. Among the top predictors of TMD for African Americans were earache and sounds around ears, while among top predictors for Caucasians were a diagnosis of TMD and joint locking. Distinct symptom clusters found within the overall sample as well as a 2-symptom cluster within both African American and Caucasian samples, yielded highly significant differences. In treatment seeking for TMD symptoms, both African Americans and Caucasians with private insurance types sought treatment at the same rates (60%). TMD rates for this sample were notably higher than found in other national studies (about 4-8%). However, where definitions of and measurement instruments for TMD differ among prevalence studies, it appears that prevalence rates tend to differ.Item Self-Management of Physical Activity in African Americans and Hispanics with Multiple Sclerosis: Mixed Methods(2013-05-17) Griffith, Desiree Nicole; Chiu, Chung-Yi; Rose, Lindsey; Frierson, GeoritaBACKGROUND: People with multiple sclerosis (MS) are prone to inactivity due to mobility impairments, which too often leads to obesity and other secondary conditions (e.g. depression, diabetes). Minorities with MS have health disparities when compared to Caucasians with MS, but the current health behavior theories were developed and validated mainly among the Caucasian population. There is a paucity of research considering multicultural perspectives for minorities with MS. The present study used the Health Action Process Approach (HAPA) as a theoretically driven framework to study how people with MS, specifically African Americans (AF) and Hispanics, self-manage their physical activity (PA). SUBJECTS: Eighteen AF (4 males, 14 females) with MS were recruited, ages 27-61 years old (M = 44.72, SD = 8.89). Three Hispanics (3 females) with MS were recruited, ages 27-54 years old (M = 38.33, SD = 14.01). They were all diagnosed with MS on average about 8 years prior (M = 7.83, SD = 5.58) and the majority of the participants (n = 18, 86%) lived in the Dallas-Forth Worth area. METHODS: Recruiting flyers were posted in the Multiple Sclerosis Clinic at UT Southwestern Medical Center, neurology clinics, churches in the community, and the National Multiple Sclerosis Society website. This study used a mixed methods research design. Qualitative data, used to gather minorities’ perspectives of their self-promotion of PA, was collected via focus groups and phone interviews; this data was transcribed verbatim and coded. For quantitative data, each participant filled out several HAPA surveys to assess severity of symptoms, self-efficacy, coping and planning, and PA engagement. RESULTS: An independent samples t-test was conducted to examine whether there was a significant difference between AF and Caucasians in self-evaluation of HAPA constructs, using an archived data of 170 Caucasians with MS as a norm for following comparisons. All measured HAPA constructs for PA were not significantly different between AF and Caucasians with MS. Interestingly, AF with MS had stronger intention to eat healthily (when comparing 18 Caucasians and 18 AF, t = -3.29, df = 34, p = 0.002; when comparing a norm database of 170 Caucasians and 18 AF, t = -2.31, df = 186, p = 0.02). However, Caucasians with MS had higher recovery self-efficacy for nutrition than the counterpart (comparing 170 Caucasians and 18 AF, t = 2.63, df = 186, p = 0.009). Qualitative analyses of transcriptions from six focus groups produced significant themes of self-motivated regulation of health promotion for minorities with MS. Significantly, modified item content on some HAPA-based measures is required to make the model more conducive to AF. For example, the study found that PA has been redefined for minorities with MS, self-efficacy is based on successful daily functional PA, it is not necessary to make a PA schedule because the course of MS is unpredictable, and self-defined PA goals vary according to daily MS course. DISCUSSION: Although many HAPA constructs were shared amongst AF, Hispanics, and Caucasians, this study discovered many new themes that were related to how minorities with MS approach PA. AF with MS redefined exercise as being any body movement costing physical energy. For AF, the fear of losing life roles and daily functioning was motivation to persevere and do any PA given the opportunity. In contrast to many studies on AF, this study showed AF with MS do not need social support from family or friends to do PA because they view it as self-responsibility and they have learned to be independent. For Hispanics, it appeared as though collective family thoughts regarding exercise were more influential on the intention to engage in PA. AF and Hispanics with MS agreed healthy eating habits had equal importance to PA for people with relatively severe MS status. Being AF commonly led to late treatment of MS among the focus group participants.