College of Public Health
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Browsing College of Public Health by Subject "Adolescents"
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Item Educational Interventions and Predictors of Health Related Quality of Life Among Adolescents with Type 1 DiabetesAbualula, Nada A; Abualula, Nada A; Milligan, Renee AThis dissertation had two objectives: A) determine the optimum diabetes selfmanagement educational (DSME) interventions in improving health-related quality of life (HRQoL) among adolescents with type 1 diabetes (T1D) and describe its characteristics, and B) assess the HRQoL of adolescents with T1D using one self-rated health (SRH) question and identify the most significant factors contributing to lower HRQoL. To address objective (A), a systematic review (SR) of 14 eligible studies was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results showed that the successful interventions provided a combination of direct and indirect behavioral skills or, at the very least, indirect behavioral skills such as stress reduction and coping strategies lasting at least two months. To address objective (B), a sample of adolescents with T1D (n=5,799) from the T1D Exchange Clinic Registry was analyzed. Descriptive statistics showed that those with lower HRQoL whose SRH was "fair" or "poor" (n`0), 62% were female, 59% were aged 16-18 years, 66% had public or no insurance, and 93% had high HbA1c. Logistic regression results showed that the most significant factor associated with lower HRQoL (SRH) among adolescents with T1D is stress. Both the systematic review and secondary data analysis identified stress as important factor in contributing to lowering HRQoL among T1D adolescents. Health care providers and researchers should design optimal DSME interventions that target stress as one of the most important factors associated with lower HRQoL among adolescents with T1D.Item Traditional Bullying and Cyberbullying among Adolescents: Patterns and Correlates of Victimization vs. PerpetrationZhang, Lijing; Zhang, Lijing; Griffin, KennethTraditional bullying and cyberbullying are serious global public health concerns. Based on a national sample of 2,439 students from 30 public middle schools between the ages of 10 and 14 (M = 11.7 years) in the United States, we investigated patterns and predictors of four types of bullying (physical, verbal, social, and cyber) including both bullying victimization and perpetration. We also examined how demographic variables and several psychosocial risk and protective factors would be related to bullying victimization and perpetration. Overall, findings indicated that bullying victimization and perpetration were widespread, with verbal bullying the most frequent type of bullying both in terms of victimization and perpetration, and cyberbullying the least frequently reported. Boys were more likely to engage in physical bullying perpetration, while girls were more likely to report being victimized by relational (verbal and social) bullying. Findings indicated that knowing how to respond to bullying and acting in appropriate ways to bullying, or bullying prevention skills, were associated with less bullying perpetration. However, we found that conflict resolution skills were not associated with many forms of bullying. While the study included a large sample and measured multiple forms of bullying, limitations were the cross-sectional design which limited the ability to examine direction of causality. Future research should examine samples containing students from diverse communities and countries, assessing in greater detail the contexts in which bullying occur. This can help us understand how factors that place students at relative disadvantage interact with the environments in which students are bullied.