Abstract
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
About this Master's Thesis
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