Mexican Americans, one of the fastest growing segments of the population, have been identified as having above-average rates of obesity. Yet, among this group, obesity rates seem to differ by immigrant status: recent immigrants, immigrants who have lived in the United States more than 15 years, and U.S.-born Mexican Americans. Guided by the acculturation phenomenon and the social ecological model, the current study assessed all 1,732 Mexican American children 12-19 years old who participated in the National Health and Nutrition Examination Survey between 2003 and 2008 to determine the association between body mass index (BMI) and language, years living in the United States, citizenship, birth country, household income and size, and school attendance. Analysis of variance and linear regression were used for statistical analysis. All of these variables were significantly associated with BMI in both the bivariate and linear regression analysis, although the R-squared value was small at .138, indicating that additional factors not included in this study also influence BMI. Measuring obesity and the correlated acculturation variables with currently available data sets will provide insight in the planning and administering effective interventions for Mexican American children 12-19 years of age and promote the global social change goal of healthy weights for all children.

Every year, more than 400,000 Americans die prematurely because of tobacco use, and most users began smoking during their teen years. Adolescent tobacco use remains the nation's most preventable threat to life and health. A better understanding of the relationships between susceptibility to smoking and intention to smoke on smoking behavior by ethnicity, age, and gender is useful for program planners and health educators in designing ethnic, age, and gender specific strategies for tobacco control and prevention initiatives. The purpose of this study was to test the relationships between susceptibility to smoking and intention to smoke on smoking behavior among adolescents by ethnicity, age, and gender. The theory of reasoned action by Ajzen and Fishbein formed the basis of this study and supports the findings and conclusions. To get good representation of the study populations, the study utilized secondary data from the 2007 National Survey on Drug Use and Health. The study population includes person ages 12-17 years old, smokers and nonsmokers, who represent White, African American, Hispanic, Asian, Multi-Racial, American Indian, and Native Hawaiian race/ethnicities. Data were analyzed with Kruskal-Wallis test, analysis of variance (ANOVA), multiple regression analysis, and bivariate Spearman correlation. A statistically significant positive relationship was found between participants' susceptibility to smoking and their intentions to smoke (r = .57, p < .01). More specifically, a significant difference was found among ethnic groups on smoking intentions and among age groups on susceptibility to smoking. Positive social change can occur through improved efforts geared toward primary, secondary, and tertiary interventions. This can result in empowerment programs and enhanced decision making, useful for adolescents of different ethnic groups to resist social and environmental pressures.

While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for this study were grounded in the developmental psychopathological perspective which examines both environmental and biological influences as they interact to promote or impede social, emotional, and behavioral development. Mediation modeling employing both linear and logistic regression techniques indicated that, after adjusting by select covariates, psychological distress (as assessed using the SF-36 Mental Component Summary score) partially mediated the relationship between several of the ACEs examined and smoking in women. These same relationships were not found in men. This research contains several key findings with social change implications. First, additional research should be conducted to examine the causes, developmental paths, and critical points that link ACEs and psychological distress to smoking among women. Second, given the gender differences in the association between ACEs and smoking, gender-specific intervention programs that build resiliency, increase positive social support, and provide tools for developing alternative coping strategies may be important adjuncts to smoking cessation programs, particularly for women with a history of ACEs.

The bacterium Staphylococcus aureus has been an important human ailment for centuries, and with the overuse of antibiotics, methicillin resistant Staphylococcus aureus (MRSA) has emerged as a deadly, costly pathogen worldwide. Healthy carriers can become sick or can spread MRSA without symptoms. The amount of asymptomatic colonization among healthy college students and risk factors for colonization by MRSA are not well understood. According to the epidemiologic triangle model, the host (students who take antibiotics or have a history of skin infections), the infectious agent (MRSA) and the environment (direct contact with people, animals, or objects that may harbor MRSA) all play an important role in this disease. This study explored MRSA colonization rates among healthy students at a community college and explored the possibility that students exposed to sources of MRSA might have a higher colonization rate. Using a cross-sectional quantitative design with stratified sampling, risk factors to include student's discipline, gender, race, work, and leisure exposure were surveyed. In tandem, Mannitol Salt Agar and MRSA Select Agar were inoculated from nasal swabs to identify students colonized by MRSA. The data were analyzed using contingency tables and Chi Squares. Significant risk factors identified included students who had a major that involved touching shared equipment and/or those who were in majors such as nursing, students who had close contact with animals, and students who had a skin infection. The implication for positive social change include improved awareness of MRSA colonization and risk factors which can lead to better prevention strategies and increased awareness among the student population.

Research has revealed that underutilization of breast cancer screening by ethnic minorities often is related to language difficulties and cultural values and beliefs about cancer. The problem addressed in this secondary data analysis was the late diagnosis of breast cancer in the Chinese immigrant community. The purpose of the quasi-experimental study was to test the efficacy of a theatrical preschool performance, guided by the diffusion of innovation theory, in educating Chinese American women about breast cancer detection. The research questions sought to determine whether the performance increased the participants' knowledge of breast cancer screening guidelines and whether country of origin, length of stay in the United States, and self-reported attentiveness were associated with knowledge gain of breast cancer screening guidelines. The preschool performance was performed by Chinese children ages 3 to 5 who displayed breast health guidelines from the Susan G. Komen for the Cure. One hundred and seventy-seven pre- and postperformance surveys were collected from a sample of Chinese women (84% foreign born). The secondary data were analyzed using standard linear regression analyses and bivariate logistic regressions. The findings demonstrated that promoting breast health screening guidelines among Chinese American women through a preschool theatrical performance significantly increased the participants' knowledge of the guidelines. However, no major impact was detected between knowledge score and attentiveness to the theatrical performance and any of the demographic variables. Health care professionals can foster social change by adapting a preschool theatrical performance to educate ethnic communities on cancer control guidelines for early detection.

Currently, little is known about patients' perceptions and beliefs in discussing complementary and alternative medicine (CAM) with their conventional medical (CM) doctor. The purpose of this descriptive research was to show whether CAM-using patients have an interest in discussing CAM treatments with their CM doctor for comprehensive care as described by the health belief model (HBM) constructs of perceived susceptibility, perceived seriousness, and perceived benefits of taking action. A sample of 165 participants age 18 or older from 2 chiropractic clinics in the midwestern United States completed a Likert-scaled survey. The data were analyzed using descriptive statistics and multiple regression to determine if there is a relationship between the variables of the need for a CAM discussion with a CM as the outcome using HBM constructs as the independent variables. The primary findings from this study were that (a) the participants were interested in discussing CAM with their physicians, with the majority of the participants stating that they discussed CAM either often (33.5%) or always (29.3%); and (b) perceived susceptibility, perceived seriousness, and perceived benefits of taking action were not predictive of a CAM discussion. Future studies should be conducted to (a) examine samples with varying demographic characteristics to assess the generalizability of the current findings; and (b) to include additional predictors of CAM discussions from the HBM such as barriers, cues to action, and self-efficacy. The results of this study add to the limited literature on CAM usage and may prompt future research. Implications for positive social change include understanding patient interest in discussing CAM which can help improve the overall quality of patient service.

Sexual activity among unmarried adolescents is a major public health problem in Nigeria, because unmarried pregnant girls are more likely to have multiple sex partners and are less likely to use contraceptives, putting them at greater risk for sexually transmitted diseases (STD), unplanned pregnancy, abortion, social isolation, and poverty. Teen pregnancy and STD rates are on the rise in Nigeria, yet few data exist on the experience of the adolescents themselves. This phenomenological study was designed to explore the in-depth experiences of 10 pregnant, unmarried adolescent girls aged 16-19, including the factors contributing to their sexual activity. An ecological model served as the conceptual framework to permit individual experiences to be understood in their social and ecological context. Semistructured interviews and Hycner's method of analysis were used to collect and analyze the data. Results showed that the decision to initiate sexual activity among these girls was influenced by many factors, including: the need for financial support and a socially condoned system of "sugar daddies" who support girls in return for sex; peer pressure to have a sex partner; a romantic knowledge of sexual behavior based primarily on the mass media; and inadequate sex education. As a result of their pregnancy, the girls experienced negative reactions from their families and community, and serious psychological and financial concerns about their prospects for future marriage and their child's identity. A comprehensive community-based reproductive health program is called for, with reliable sex education, cooperation from the mass media, and support from family and community members. The social change implication of this study is to potentially lead to a decrease in unplanned pregnancy, STDs, social isolation, and poverty among adolescent girls in Nigeria.

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also known as the readiness to change model. This study was conducted using secondary data from the Rhode Island Department of Health PRAMS data set. The research questions determined if African American women received preconception care education at the same rate as White women, if African American women had a higher rate of infant mortality than other races, and if African American women had a higher rate of unintended pregnancies than White women in the state of Rhode Island. Independent t tests and chi square tests were used to answer the research questions. The results indicated a difference between the infant mortality rates for African American women compared to other races as well as a difference between African American women compared to White women with regard to unintentional pregnancies in Rhode Island. However, there was no difference in African American women compared to White women receiving preconception education in the state of Rhode Island. The implications for positive social change include micro- and macro-level changes in support of how planning for a pregnancy in advance can reduce poor birth outcomes.

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Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public health appropriation during fiscal years 1947-2015. The theoretical framework for this study was based on the punctuated equilibrium theory. The population of this study included 68 years of time series data and analyzed using bivariate linear regression to determine the relationship between the independent variables of congressional hearing days and the policy mood scores and the dependent variable of federal public health appropriations. The results of the regression models indicated that congressional hearings days and policy mood scores did not have a statically significant effect on the change in the level of public health appropriations. Policy implications include informing public health officials and advocacy groups targeting public health messages to Congress that focus on increasing resources to targeted programs. Social change implications include informing health officials in planning congressional outreach and appropriations strategies, which can be used to improve the implementation of public health programs benefiting the community and promoting positive social change.