Sudden Infant Death Syndrome (SIDS) is a serious public health issue in this country and a major contributor to infant mortality in African American populations. African Americans have one of the highest rates of SIDS, some of which is due to increased risk factors for SIDS, such as prone sleeping and bed-sharing, as well as a lack of adherence to the SIDS risk reducing recommendations. Little is understood about this lack of adherence in the African American population or how to effectively address it but some research suggests a link between parental health beliefs of SIDS and the risk reducing recommendations and the implementation of these recommendations. This study used quantitative methods to gather data about the health beliefs and perceptions of SIDS among African American women living in Service Planning Area (SPA) Six of Los Angeles County to better understand the link between beliefs about SIDS and how this relates to implementation of the safe infant sleeping recommendations, specifically bed-sharing and prone sleeping. A self-administered questionnaire was developed to collect data using the Health Belief Model and several of its concepts as a guiding framework to assist with the construction of the questionnaire. The questionnaire was distributed electronically through the survey software program, Survey Monkey and analyzed using statistical software, SPSS. Exploratory factor analysis found the questionnaire reliable and valid upon the removal of four items, including the construct of cues to action. The new 19-item questionnaire suggested that the women felt that SIDS was a big problem but didn't feel as susceptible. There was also a clear confusion about prone sleeping position. Overall, the data suggests a need for tailored educational campaigns in African American communities to increase awareness of and susceptibility to SIDS and stressing the benefits of supine sleeping position.

Introduction and Rationale: Sudden infant death syndrome (SIDS) continues to be the leading cause of death in infants 28 days to 12 months old and the third leading cause of infant mortality (CDC, 2014; Task Force on SIDS, 2011a). SIDS has no identifiable cause although many hypotheses have existed and there are many known risk factors. Nicotine use is the second most modifiable risk factor for SIDS and to date there is no national public education campaign. Formal education is needed. Written education materials, such as brochures, are an effective way to increase knowledge and awareness of a health topic. Purpose and Objective: The purpose of this DNP Project was to create an educational brochure about SIDS and nicotine as a significant modifiable risk factor. The brochure is directed towards pregnant women and women with infants less than 12 months of age. The objective was to educate and inform mothers about SIDS, nicotine and its relation to SIDS, and the importance of abstaining from nicotine during and after pregnancy. Methods: The brochure was created using the Health Belief Model (HBM) as a framework. The HBM was used to explain health behavior modifications and was used as a foundation for education interventions. The model has successfully been applied to explain other preventative health behaviors and provide health education in various contexts. Results: The brochure was evaluated by two subject matter experts who have published peer reviewed articles using the HBM. Both subject matter experts found the HBM applied to the brochure appropriately. In their opinion, the content of the brochure should have positive impact for health modification in women who use nicotine and are pregnant or have a child less than 12 months of age. Conclusions: This DNP Project demonstrated SIDS as a current significant health problem and identified maternal nicotine use as the second most modifiable risk factor. Due to lack of current public education, a brochure was created using the HBM as a framework. Subject matter experts stated the brochure was created based on the HBM and will likely a have positive health influence on the intended population.

Vaccination, one of public health’s greatest disease prevention tools, is broadening to focus on adolescents. Now that there are more vaccines targeted specifically for adolescents, it is time to give more focus to vaccine delivery in this population. This research will increase the knowledge base to support informed changes in adolescent vaccine delivery by identifying knowledge and attitudes of adolescents toward vaccination within the context of barriers and solutions. Perceived susceptibility to disease, benefits and barriers to vaccination and other constructs were collected through a survey to 1368 high school students. In this population, a scheduled adolescent healthcare visit is feasible, vaccine education can diminishes health misconceptions, and vaccination mandates are ways to reach some students.

Background: Type II diabetes, which is known as non-insulin dependent diabetes, has become an epidemic worldwide. In the United States, diabetes affects 25.8 million people which represent 8.3% of the population. Out of 25.8 million, 23.22 million people have Type II diabetes. According to the National Statistics Vital Report, Type II diabetes was the number seven cause of death in the USA and it can be prevented. The primary purpose of this study was to assess the overall knowledge and health beliefs about Type II diabetes among a sample of undergraduate students; the second purpose was to assess the relationship between the overall knowledge and health belief subscale. Methods: A cross-sectional and descriptive survey design was used. An existing knowledge and health belief instruments was adapted. In the 2014 spring semester, a non- random convenience sample of over 200 undergraduate students who enrolled in Foundation of Human Health 101- class were surveyed in order to assess knowledge and health belief about Type II diabetes. The Health Belief Model provided the theoretical framework for this study. Results: Overview of the participants in this study was provided through conducting a descriptive analysis. Majority of the participant were female, aged between eighteen and twenty, and Caucasian. Data analysis revealed that the overall knowledge about Type II diabetes among participants was low. For the individual health beliefs, perceived susceptibility, perceived severity, and perceived barriers to Type II diabetes were low; however, perceived benefits to engaging in healthy behaviors was high. Having other problems more important than worrying about diet and exercise, and not knowing the appropriate exercise to perform to reduce the risk of developing Type II diabetes were the major barriers among participants. A positive, weak, statistically significant correlation was found between overall knowledge and total belief of benefits to engaging in healthy actions. At the same time, a negative, weak, statistically significant correlation was found between overall knowledge and total belief of barriers to engaging in health lifestyles. Results from multiple regression revealed that knowledge was best predicted by race/ethnicity. Family history, stress level, and level of exercise were the best predictors of perceived susceptibility, perceived benefits, and perceived barriers, respectively. Perceived severity was not predicted by any of the independent variables.

AN ABSTRACT OF THE DISSERTATION OF VICTOR NOLLEN WHITE, for the Doctor of Philosophy degree in Health Education, presented On November 14, 2014, at Southern Illinois University Carbondale. Title: THE USE OF THE EXPANDED HEALTH BELIEF MODEL (EHBM) TO EVALAUTE OSTEOPOROSIS ATTITUDES, KNOWLEDGE, BELIEFS AND SELF-EFFICACY OF NEZ PERCE TRIBAL AND NON NEZ PERCE TRIBAL MEMBERS IN NEZ PERCE COUNTY, IDAHO. Major Professor: Dr. Dhitinut Ratnapradipa According to the State of Idaho, the National Osteoporosis Foundation, and the U.S. Department of Health and Human Services, osteoporosis is a public health concern nationally among non-Native American (NNA) and Native American (NA) populations. The purpose of this research project is to obtain written survey data on osteoporosis attitudes, knowledge, beliefs, and self-efficacy among male and female members of the Nez Perce Tribe (Nimiipuu) and non-Tribal members, aged 18 and over via voluntary completion of a written survey questionnaire based on the expanded health belief model (EHBM). The study was conducted in Nez Perce County, ID. The research involved determining whether or not there is a statistically significant difference in osteoporosis attitudes, knowledge, beliefs and self-efficacy among males and females, aged 18 and over Nez Perce Tribal members as compared to Non-Tribal members in Nez Perce County, ID. Non-Nez Perce tribal members are individuals whom are 1) Native Americans who are not members of the Nez Perce Tribe and 2) all Non-Native Americans in the research study. Exercise self-efficacy and gender seem to be the most significant variables showing evidence against the null hypotheses and in favor of the research hypothesis (Null Hypothesis: H0: Native American=Non-Native American. Research Hypothesis: H1: Native American ≠ Non-Native American). Age also shows evidence against the null hypothesis and in favor of the research hypothesis, but not as strongly as exercise and gender. Seriousness of osteoporosis was the most concern to all respondents and female Native Americans perceived the greatest barrier to preventing osteoporosis was being unable to access dietary calcium on a regular basis.

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Patients diagnosed with Multidrug-resistant(MDR) and Extreme drug-resistant (XDR) tuberculosis (TB) have to be hospitalised for a period of six to twelve months, according to the MDR/XDR Policy Guidelines on the treatment of drug-resistant TB – until the patient recovers, and is no longer infectious. There are factors associated with both the patients’ and their partners’ (spouses) resistance to long-term hospitalisation. This has resulted in several acts of violence against the hospital property and members of the health-care team. However, there are a small number of partners who assist the health-care team – by ensuring compliance from the patients and providing their continued support to the patient – despite their own risk of being infected with MDR and XDR TB. This qualitative study was aimed at exploring and describing the resilience factors that have been observed amongst a small number of partners of patients with MDR and XDR TB at an in-patient treatment centre in Port Elizabeth. The research design was exploratory, descriptive and contextual in nature; and the researcher interviewed eight spouses or live-in partners of patientsfor this study, until data saturation was achieved. The data were collected through semi-structured interviews; and the data analysis was conducted, according to the eight steps proposed by Tesch model of data analysis (in Creswell, 1998).Guba’smodel of trustworthiness was used to assess the data collected during the interviews. The findings from this study will inform the health-care team on methods of how the support of the patients’ partners could be mobilised in the holistic treatment plan of MDR and XDR TB patients in an in-patient treatment centre.

Smoking, physical activity, and insufficient fruit and vegetable consumption have been linked to increased instances of coronary heart disease, stroke, peripheral vascular disease, chronic obstructive lung disease, type 2 diabetes, osteoporosis, depression, hypertension, numerous cancers, and complications surrounding blood pressure and blood cholesterol. In the United States approximately 22% of college students have smoked at least one cigarette in the past 30 days; 70-85% are not meeting recommended levels of physical activity; and 75% are not consuming recommended levels of fruits and vegetables. The purpose of this study was to investigate differences in physical activity and fruit and vegetable consumption behaviors of self reported smokers and nonsmokers, and to determine the predictors of healthy behaviors at a mid-sized university in the southern region of the United States using the Theory of Planned Behavior and the Health Belief Model. Students in this study (N = 461) completed a written questionnaire during March-May 2012. Results indicated that 20% of the population smoked at least one cigarette in the past 30 days, with men being more likely to smoke than women. Physical activity was found to be significant to smoking status; however, fruit and vegetable consumption was not significant. Multiple regression determined the following constructs significantly predicted smoking status: attitudes and intentions from the Theory of Planned Behavior and perceived severity, perceived benefits, perceived barriers, and cues to action from the Health Belief Model. The results of this study may be utilized to address differences in college student engagement in adverse health behaviors, and in the enhancement of future smoking interventions on college campuses.

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