Obesity and type 2 diabetes (T2DM) has increased greatly in incidence in the United States over the past decade. Diagnosis of T2DM is typically preceded by insulin resistance, which is typically indicated by increases in fasting blood sugar and called pre-diabetes. The Diabetes Prevention Program (DPP) is a group-based program focused on improving diet and maintaining consistent exercise towards a lower body weight. It has been found that minimum weight loss and 150 minutes of moderate exercise is more effective at preventing T2DM than medication-based treatment. Therefore, the DPP has potential in preventing T2DM however currently faces obstacles concerning recruitment and retention. Unfortunately, only 1-5% of individuals who would benefit from the program actually sign up. In order to address this, researchers obtained RDC funding and partnered with YMCA to determine barriers and motivators to the DPP. Individuals were invited to an on-campus, pilot DPP aimed towards employees in a single building. All employees received an invitation to give feedback in 1 of 3 focus groups: 1 with those who joined the program and 2 with employees who did not join. There were 4 individuals in the focus group for DPP participants and 18 total who attended the other focus groups (one group of 5, and one group of 13). The focus group for current participants was scheduled during the time of a normal weekly meeting, while the group for non-DPP participants was during lunchtime. Questions centered around individuals' perceptions on wellness programs, barriers to participation, and recommendations. Thematic analysis was done on notes taken at each focus group. Motivators found in the focus group with DPP participants included family history of diabetes, weight loss, desire to take control of lifestyle, hearing success stories, and support from others. A challenge faced by individuals going through the program included unsupportive family members or home environment. Themes found among the non-DPP participant focus groups gave greater insight in the negatives and barriers to wellness programs. Themes emphasized included importance of convenience, variability, coworker support, and appealing to individual interests. Overlapping themes included convenience, coworker support, and the importance of steering away from the 'diabetes' or 'prediabetic' labels. This study has significant impact especially in Tennessee where the DPP has become a covered benefit under insurance. In order to ensure strong recruitment and retention of these programs across the state and nation, researching further and addressing the motivators and barriers identified is key. With the DPP having such great potential in reducing risk of diabetes and obesity, a strong, intentional recruitment plan is necessary.

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study. A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape myths. The survey included basic demographics followed by 20 questions with dichotomous responses addressing male and female rape myths, empathy, belief in a just world and gender attitudes. Responses to each question were analyzed, followed by composite scoring for rape myths, empathy and gender attitude questions. Bivariate correlation analysis was performed to examine significant relationships. Ordinal and bivariate logistic regressions were completed to predict adherence to male rape myths. The exploratory nature of the survey provided a glimpse of veterans' views and indicated the majority, 317 (61.1%) of veterans did not adhere to any of the listed male rape myths, and 311 (59.6%) of veterans did not agree with the female rape myths. The ordinal logistic regression model predicted that empathy for male survivors and disagreement with some patriarchal gender attitudes were significantly associated with decreased acceptance of male rape myths in the sample of veterans. Significant predictors of male rape myths in the bivariate logistic regression model included increased empathy (Exp(B) = 6.373, CI [2.740, 14.822]), agreement with patriarchal gender attitudes (Exp(B) = 5.598, CI [2.059, 15.219]), and adherence to female rape myths (Exp(B) = 1.969, CI [.993, 3.904]). These results emphasized popular misinformation, and the need for education and awareness surrounding rape myths. Strategic suggestions for the military community were aimed at prevention, education, and policy changes. Despite the challenging environment, the topic of sexual violence perpetrated against males is a relevant issue affecting humanity.

The purpose of this study was to determine what sociocultural, sociodemographic, and sociopsychological factors the Sisters in four Wards in the Taipei Taiwan Stake of the Church of Jesus Christ of Latter-day Saints perceived as keeping them from using the health services during the period from June 1975 to May 1976.Forty-five Sisters, age twenty-one and older, were surveyed by a written questionnaire during Relief Society meetings during the last week in June and the first week in July 1966.A majority of the Sisters were found to have experienced times when they did not avail themselves of the existing health services. The way the Sisters viewed their illness, their unwillingness to take time to seek aid, and their limited finances were the reasons most often given as obstacles preventing use of the services. It was concluded that the Sisters tended most often to view the sociocultural factors as limiting their use of the health services.

The COVID-19 pandemic provides an important opportunity to understand how parenting stress during social crisis may predict child feeding practices and perceptions of child mealtime behaviors. The objective of the present study was to explore whether parents’ perceived increases in and overall levels of parenting stress during the pandemic were associated with controlling feeding practices and perceptions of child eating behaviors. Parents (n = 284) of 4–6-year-old children completed a cross-sectional online survey between March and April 2020. The survey assessed parents’ perceived change in parenting stress during the onset of the pandemic and levels of parenting stress during the pandemic (via the Parenting Stress Scale), as well as child feeding practices (via the Comprehensive Feeding Practices Questionnaire), and children’s eating behaviors (via the Child Eating Behavior Questionnaire). Ordinal linear regressions were used examine whether changes in and levels of parenting stress predicted use of controlling or responsive feeding practices and parents’ perceptions of child eating behaviors. The majority (63.7%, n = 181) of parents indicated their family was moderately or extremely emotionally affected by the pandemic and 56.7% (n = 161) indicated pandemic-related precautions had been moderately or extremely challenging. Perceived increases in parenting stress during the onset of the pandemic were associated with more frequent use of food as a reward (OR = 1.15, 95% CI = 1.04 – 1.26) and for emotional regulation (OR = 1.13, 95% CI = 1.04 – 1.23), as well as low child food responsiveness (OR = 0.91, 95% CI = 0.84 – 0.99) and lower odds of slow eating (OR = 0.92, 95% CI = 0.84 – 1.00). Higher overall levels of parenting stress were associated with more frequent use of food as a reward (OR = 1.05, 95% CI = 1.02 – 1.08) and for emotional regulation (OR = 1.05, 95% CI = 1.03 – 1.08) but also with use of pressuring feeding practices (OR = 1.03, 95% CI = 1.01 – 1.06) and encouraging a balanced diet less frequently (OR = 1.03, 95% CI = 1.01 – 1.06). Higher overall levels of parenting stress were associated with greater child food fussiness (OR = 1.05, 95% CI = 1.02 – 1.08), low enjoyment of food (OR = 1.05, 95% CI = 1.02 – 1.07), and low satiety responsiveness (OR = 0.95, 95% CI = 0.93 – 0.98). During the COVID-19 pandemic, increases in and high levels of parenting stress predicted parents’ use of food for emotion and behavioral regulation, but also with various domains of children’s eating behaviors. Results highlight the need for targeted efforts to support families during social crisis.

This project takes a look at the impacts of our built environment on obesity in children living in racial and ethnic communities in relation to city planning. The results of this project results in a comprehensive report to provide an in-depth look into understanding the important relationships between children’s health and the built environment and understanding the best practices and recommendations for improving health in Guadalupe. Located in the Santa Barbara County, the City of Guadalupe is mainly an agricultural town with over 85 percent of its residents who are of Hispanic Origin. With almost half of its Latino population under 17 years of age, Guadalupe is an ideal location to examine the number of complex social, economic, and environmental matters that can contribute to higher overweight and obesity rates among Latino children. The food environments and physical environments were examined using Community Assessments and outreach efforts with school children and the residents of Guadalupe. Current professional and academic literature on childhood obesity, the built environments, food environments, and schools were reviewed for this project. Responses from a multitude of methods were analyzed and compared to create a list of recommendations for improving children’s health in Guadalupe. These methods included Community of Excellence (CX3) field surveys, walkability surveys, and a Photovoice project with school children.

Current cancer research is beginning to address the psychosocial implications of a prostate cancer (PCa) diagnosis from not just the perspective of quality of life of the patient, but of his partner as well. Such inquiries have created novel intervention programs aiming to alleviate the adverse side effects that a PCa diagnosis may inflict on the couple. Assessing efficacy of couple-based interventions, however, has been a difficult task due to the lack of homogeneity between studies regarding the operationalization process of primary outcome variables, as well as the instruments being used to measure them. This thesis, in response, aims to provide a detailed assessment of how previous interventions operationalized their targeted variables, the reported psychometric analysis of the instruments of measurement, and which instruments yielded statistically significant results. A narrative review was conducted using a database search strategy to collect articles regarding couple-based interventions that focused on outcomes related to PCa diagnosis, treatment, and survivorship. Out of the ten articles that passed the screening method, forty-two outcomes were identified, ranging from physical, social, and mental well-being of the couple, to the impact PCa had on their relationship quality. The outcomes were grouped into eight categories: quality of life, appraisal of PCa outcomes, sexual/physical well-being, relationship assessment, coping, mental health, knowledge, and distress. Various scales were used to measure similar outcomes with some articles failing to report on the psychometric properties of their chosen instruments. This assessment aims to provide future researchers with an indication as to what outcomes have been previously targeted and their corresponding methods of operationalization, categorization, and analysis. The multitude of assessed outcomes, the lack of uniformity on best practices in PCa couple intervention research, and the general failure to report on reliability and validity of measures may serve as significant barriers to producing high-quality evidence that can inform the development of future research and practice. This review provides the research community an aid in the development of behavioral interventions, and potentially, practice, via offering recommendations on certain outcomes that remain underreported within interventions. It is the ultimate aim of this project to assist in fostering a true public health for all.

The research is attempting to acknowledge and explain the impact, if any, on homeless individuals not wearing socks. The curiosity for this study started on December 25th, 2018 when my family and I were volunteering at a homeless shelter in South Florida. After having numerous conversations with homeless individuals, I was informed on how they do not have enough pairs of socks to keep their feet in a healthy condition. Thus, I decided to initiate a sock drive to improve the lives of those who are homeless. This study is looking at a series of articles that are reviewing the different foot issues amongst the homeless community but are looking to see if socks play a role in the feet developing any foot diseases. It was hypothesized that homeless individuals will be at greater risk for foot disease if they live outside and have improper footwear. The objective of the study sought to review the current literature on the lack of socks for those who are homeless. Between the United States and Canada, it is estimated that nearly 700,000 individuals are homeless in a 2016 report. Of the 700,000 there are roughly two-thirds of this population that have some type of disease with their foot (To and Brothers, 2017). Majority of people who perform a good deed, such as give away old clothes or shoes, very seldomly donate socks according to the company Bombas socks. Throughout the course of my time volunteering, I have witnessed several homeless individuals wear shoes but not socks. Due to uncomfortableness, the individuals remove their shoes and it is very eye opening to observe their feet. Homeless shall be defined as “having no home or permanent place of residence” as per the Merriam-Webster's dictionary. The study was reported based on guidelines recommended by the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) of 125 studies related to homelessness and foot diseases and disorders. Literature searches were carried out on PubMed, Google Scholar, and ScienceDirect. With an evidentiary table, the characteristics of the studies included in the meta-analysis (n = 100 studies) are presented. This analysis suggests that not wearing the appropriate foot protection (shoes and/or socks) leads to an increase in foot diseases and disorders among the homeless.

Adults with intellectual disability (ID) have a higher rate of falls than the general population, and changing health behaviors through exercise program could enhance health and reduce falls in this population. However, the feasibility study of fall prevention based on the theoretical framework for adults with ID has not been explored to date. This study examined the feasibility of a home-based exercise intervention for people with ID living in a residential setting. We provided an 8 week intervention consisting of a training workshop for support workers and sessions for adults with ID devoted to behavior reward, education about fall prevention and exercise, and exercise training. Adults with ID (n = 33) and support workers, including caregivers (n = 3), staff (n = 8), and one administrator, participated in this study. Adults with ID significantly improved physical performance, self-efficacy for activity, fall efficacy, and support from friends and support workers. There were no significant changes in free-living PA. There was no adverse event during the intervention, and the average adherence rate was sufficient. Adults with ID, support workers, and an administrator were satisfied with the program and had the intention to continue the program. The intervention was feasible and perhaps efficacious for adults with ID living in group-homes.

This study analyzed the research on older adults and resistance training exercise and assessed effects on health span and lowering disability rates. A targeted search of the literature was employed using the following key words: sarcopenia, resistance training, hypertrophy, quality of life, disability, activities of daily living, strength training, falls, and functional strength. These were used to find articles that were relevant to the research. Articles were excluded if they focused on young athletes as they did not meet my research age group. Articles that focused on nutrition were also excluded as they pulled the focus away from the impact of resistance training on sarcopenia. The final exclusion that was made was to avoid any articles that made the focus on aerobic exercise as opposed to the focus being on resistance training. The age range of the participants was 60 years old to 93 years old. The results of the study saw that out 20 studies/sources cited shows that resistance training has been shown to increase the overall health, both mental and physical, of the 65+ population. Resistance training has been shown to increase functional capacity and ability to do activities of daily living, most importantly it reduces fall risk in the 65+ population. Finally, by helping to reduce fall risk and increasing overall health, resistance training has been shown to reduce the risk of disability in elderly adults. In conclusion, the risk of falls and serious consequences were reduced as the functional capacity and muscular strength of the elderly population increased. Overall, strength training has a positive effect on the elderly population and contributes to them maintaining their health, independence, and quality of life as long as possible.

This Integrated Learning Experience (ILE) investigates service providers' perceptions of Johnson City, Tennessee's homelessness services, aiming to inform a city-wide strategic plan for reduction. Employing a mixed-methods approach, the study gathered qualitative data through in-depth interviews with service providers in 2022 and quantitative data via a 2024 survey. The research focused on those directly involved in serving or significantly influencing the lives of individuals experiencing homelessness (IEH). Three key aims guided the investigation: (1) To analyze provider perspectives to identify community assets, opportunities, barriers, and unmet needs, informing a comprehensive needs assessment; (2) To refine these findings through SWOT analysis and collaborative consensus-building with service providers and key partners; and (3) To develop and disseminate a city-wide strategic plan for coordinated, multi-level action to reduce homelessness. The survey specifically targeted providers most directly impacted by or capable of influencing the lives of IEH. The study's findings highlight a fragmented system characterized by limited resources, particularly affordable housing, and significant communication barriers between agencies. While strong community partnerships exist, inconsistent data collection and a lack of coordinated case management hinder effective service delivery. This necessitates a strategic plan, informed by a community-driven SWOT analysis, to address these challenges. The resulting plan emphasizes four foundational principles: data-driven decision-making, collaboration, sustainability, and equity and inclusion. Three key strategic areas are proposed: expanding access to stable and affordable housing through addressing systems gaps, implementing robust crisis intervention and response mechanisms, and developing proactive prevention strategies. This approach, aligned with USICH best practices, aims to improve the service system through policy advocacy, increased resource access, and strengthened stakeholder collaboration, ultimately striving for a substantial reduction in homelessness within Johnson City, Tennessee. The strategic plan, therefore, serves as a critical tool for local policymakers and service providers, guiding their efforts toward a more effective and coordinated response to homelessness in the community. The integrated approach of this ILE, encompassing both qualitative and quantitative research methods, ensures a comprehensive and nuanced understanding of the current landscape, paving the way for a more impactful and sustainable solution to homelessness in Johnson City.