Health Risk Behaviors in Peace Corps Volunteers Open Access

MacGurn, Amanda Kalyn (2013)

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Background With the expansion of the United States Peace Corps and other opportunities for Americans to reside overseas, there is a growing need to gain a clearer understanding of factors that affect the health of Americans living abroad. The circumstances surrounding Peace Corps service present a unique set of challenges to the health of Peace Corps Volunteers (PCVs), the various effects of which are largely undocumented at present. Methods Data on a range of behaviors practiced during and immediately prior to Peace Corps service were collected from 358 recently Returned Peace Corps Volunteers (RPCVs), using an original, web-based survey distributed through established RPCV networks. McNemar's tests and Chi-square tests were used to assess associations on dichotomous variables, while paired t-tests were used to compare changes in behaviors before and during Peace Corps. Findings Respondents' self-reports indicated statistically significant increases in tobacco use (p<0.001) and hitchhiking (p<0.001) during Peace Corps. Chi-square tests showed significant changes in pre-Peace Corps to during Peace Corps measures, and t-tests indicated the direction of change: during Peace Corps service, significant changes were reported in tobacco use frequency (p=0.0002), alcohol use frequency (p<0.001), average number of alcohol units consumed per occasion (p<0.001), marijuana use (p=0.052), and seatbelt use (p<0.001). When stratified by sex, male respondents reported having a higher number of sexual partners (p<0.001) and engaged more often in sexual intercourse during Peace Corps than females (p=0.0012). When asked whether overall risk behaviors increased, decreased or stayed the same during Peace Corps, 61.6% of respondents indicated an increase in their own risk-taking behaviors. Conclusions RPCVs reported having engaged more often in risk-taking behaviors during Peace Corps, compared with the period immediately before departure, with some variation by region, sex and age. This exploratory study has implications for targeted prevention and health promotion efforts for future Peace Corps Volunteers.

Table of Contents

Chapter 1: Introduction p.1 Introduction and Rationale p.1 Problem Statement p.3 Purpose Statement p.3 Research Questions p.3 Significance Statement p.4 Definition of Terms p.4 Chapter 2: Review of the Literature p.5 Alcohol Use p.5 Tobacco and Marijuana Use p.7 Sexual Risk Behaviors and Implications p.7 Drinking Water Risks p.9 Transportation Risks p.10 General Health p.11 Perceptions of Health Risks While Abroad p.11 Adjustment and Acculturation In Foreign Contexts p.12 The Health of Peace Corps Volunteers p.12 Chapter 3: Data and Methods p.13 Subjects p.13 Sample p.14 Measurements p.14 Analysis p.18 Results p.20 Chapter 4: Discussion, Recommendations and Limitations p.24 Discussion p.24 Limitations p.32 Recommendations p.33 References p.35 APPENDIX I: Tables p.38 APPENDIX II: Peace Corps Health Risk Survey p.44 APPENDIX III: IRB Approval Letter p.57

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