Health literacy (HL) plays a significant role in health care communication and patient compliance. Low health literacy leads to noncompliance with health instructions, poor health choices, failure to participate in recommended health screenings, frequent hospitalizations, and higher health care costs. Using the health belief model (HBM) as the conceptual framework, this quantitative, cross-sectional study addresses a gap in the literature related to the research questions of this study. The research questions are: (a) Is there a relationship between HL and the level of hypertension (HTN) in hypertensive urban Latinos?, and (b) Will HL predict the level of control of HTN in these participants? Purposive sampling resulted in 136 hypertensive Latino adults, English, Spanish, or both, consenting to participate. They completed the health literacy test (STOFHLA) in Spanish or English. Information regarding participants' demographics, hypertensive history, and status came from the emergency department (ED) visit intake form and participant medical records. The data were analyzed using the complementary log-log model of ordinal logistic regression and multiple regression. Although a statistically significant relationship (p< .05) was found between at least one of the independent variables and the level of HTN (Ï? 2 (8) = 20.498, p = .009) in hypertensive Latinos seeking health care in an urban ED, a statistically significant relationship between HL and HTN was not. The social change implication is that the findings of this study can be used in health education programs to inform individuals that increasing age, and smoking can increase the level of HTN.

Suicide, ranked as one of the top five causes of death among adolescents, aged 15 to 19, claims numerous lives within the state of New York. Driven by the social cognitive theory, the objective of this quantitative cross-sectional study was to investigate the association among being offered, sold, or given illegal drugs, illegal drug use, being bullied, age, gender, ethnicity, suicidal ideation, and attempted suicide among adolescents in New York. The Centers for Disease Control 2015 Youth Risk Behavior Surveillance data for 89,068 New York adolescents, Grades 9-12, were utilized in this study. There was increased risk of suicide ideation among those who were offered/sold/given drugs on school property (OR = 1.665), used heroin (OR = 2.735 - 4.186), Hispanic/Latino (OR = 1.466) or American Indian/Alaskan Native (OR = 1.802), aged 12 or younger (OR = 6.762), were bullied (OR = 2.728), and female (OR = 2.248). There was an increased risk of attempted suicide among those who were offered/sold/given drugs (OR = 1.578), currently used marijuana on a monthly basis or more (OR = 1.366-1.634), used heroin (OR = 5.023-20.267), aged 12 or younger (OR = 3.209), Black (OR = 1.443), Hispanics/Latino (OR = 1.976), American Indian/Alaskan Native (OR = 2.497), or of multiple races (OR = 2.121), were bullied (OR = 2.032) and female (OR = 1.822). These results served to support all the study's alternative hypotheses and the theoretical foundation of this study, and were consistent with findings of previous research. This study has implications for positive social change: the results could be used by Public Health practitioners to affect adolescent suicidal ideation and potentially suicide with the possibility of reducing adolescent morbidity and mortality.

Physical activity is a critical factor in preventing obesity and other chronic illnesses. African American women experience higher rates of physical inactivity than the general population. As a key figure in the family, African American mothers should model healthy behaviors to the family, especially their children. This qualitative study explored the physical activity attitudes of African American mothers who frequently visit a recreation center in the Columbus, Ohio, area. The research questions focused on the possible barriers and motivators for physical activity engagement. The theory of planned behavior, which emphasizes behaviors, intentions, and attitudes when exploring health behaviors, guided the study. Purposeful sampling was applied to recruit a sample of 17 African American mothers over the age of 18 from 5 recreation centers. Participants who met inclusion criteria participated in a semi-structured one-on-one interview. Data were analyzed by hand coding and NVivo to capture and analyze themes, including (a) physical movement, (b) physical health, (c) environment, (d) schedule, (e) physical appearance, and (f) well-being. The findings indicated that African American mothers are aware of the value of physical activity for themselves and their families. However, personal responsibilities may prevent them from engaging in regular physical activity. The study contributes to social change by providing community center directors and public health professionals with information that they can use to create more culturally sensitive physical activity interventions.

The centrality of the church in African American communities makes it a culturally compelling sponsor for health promotion activities targeting health disparities among the medically underserved. Pastoral support is critical in determining whether a church initiates or supports a health promotion agenda, but there is little understanding of the variables that influence this decision. The aim of the qualitative study was to investigate the perceptions of African American pastors regarding the decision to incorporate health promotion programs in their churches. This study was guided by the health belief model using a phenomenological approach. Data were collected using both semi-structured and open-ended interviews. Ten pastors of North Carolina African American churches, with and without health promotion ministries, were recruited for the study. Eight pastors agreed to participate in the study. They were interviewed, and interviews were recorded and transcribed. The data were open coded and analyzed. NVivo 11 was used to manage the data. Five themes emerged from the study: the importance of health promotion, pastor support of a health promotion program, pastor influence on individuals in the congregation, the health status of church members, and barriers and facilitators. Positive social change may be realized by using this information to increase the effectiveness of culturally sensitive health information and developing health education programs that specifically target the African American faith community. Information from this research could help guide public health agencies on how to approach health programming in this specific area and for this population.

Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors of hearing level or deaf acculturation style using the Health Belief and Deaf Acculturation Scale surveys, respectively. A total of 241 participants from Gallaudet University participated in this study. Independent sample t tests and multiple linear regressions were used. There were no differences in BMI (t = -0.285, p = 0.777) and nutritional and physical activity self-efficacy (t = -0.962, p = 0.338 and t =0.766, p = 0.446) between deaf/HoH adults and hearing adults. Among deaf/HoH adults, there were no associations between obesity as well as self-efficacy and factors of average hearing level and deaf acculturation style. This study offers evidence to the literature regarding the relationships between obesity or self-efficacy and factors of average hearing level or deaf acculturation styles among deaf/HoH adults. In addition, this study provided implications for social change as a basis for further research and reducing obesity through adopting current obesity programs while ensuring communication and information access for all deaf/HoH adults with varying levels of hearing and acculturation styles.

Childhood and adolescent obesity are pervasive among single mother households. Obesity causes many health risks including psychological/emotional illnesses. The purpose of this secondary analysis study was to examine the association between the parental feeding styles of single mothers and the degree that ethnicity moderates the rates of childhood obesity. Data from the National Longitudinal Survey of Youth were used with a total of 1,630 children in the study for a total of 842 minorities (African American and Hispanic American); 788 participates were not minorities (European American) with an average body mass indent of 15.9. Using the cross-sectional design, the quantitative study analyzed an association of parental feeding style and overweight/obesity. According to study findings, there was no statistical significance between the parental feeding style and ethnicity status. There was no statistical significance between the child's compliance with the mother's food choice, the child's frequency of compliance nor the child's compliance even when they don't want to eat with overweight/obesity when moderated by ethnicity. Finally, there was no statistical significance when moderated by ethnicity. Educating single mothers about habits and perceptions concerning food is critical so that they are aware they can offer wholesome nutritional food as food choices. Education is a determinate of health that would moderate the parental feeding style

Youth gun crime is an important public health issue that affects many communities in the United States. Since 2012, there were over 30,000 gun-related deaths in the United States. Gun violence remains the leading cause of death for young people ages 15-24. This phenomenological study examined single female parents' attitudes, beliefs, and perceptions of the influences and causes of youth gun crimes. The purposive sample drew from 10 single female parents of youth ages 14-17 charged with gun crimes. Sutherlands' (1974) differential association theory provided the theoretical framework for the study. The mothers participated in a series of in-depth, face-to-face interviews; these data were analyzed via inductive and emergent analysis. Results of the study indicated that these 10 parents were attempting to convey the correct message to their children to avoid gun violence. This message did not resonate due to environmental peer influence. One finding was the perception that peer influence and environmental factors favorable to gun violence hampered the impact of the parents in getting the message to youths to avoid youth gun violence. The study findings suggest that curtailing gun violence will require collaboration amongst community members. In addition, mothers need to be armed with resources that address the issues of peer pressure and community violence. The results of the study can impact positive social change by informing parents to be more empowered to seek resources to combat peer pressure and gun crimes. For this reason, the study should provide information useful for individual families in curtailing youth gun violence, thus impacting the community and the lives of many.

The rate of HIV/AIDS infections among African American men who have sex with men (MSM) is alarming. There has been a challenge in reducing HIV/AIDS among the African American MSM population due to internal and external factors that affect their decision making. The theory of social support and reasoned action were applied to gain knowledge on the lived experiences and perceptions of African American MSM as related to social support and seeking health care, which can help fight the heavy impact HIV/AIDS has placed on this population. Data was collected from 14 African American men who openly identified as MSM. Following the in-depth face-to-face interviews, themes were developed using Miles and Huberman's 6-step analytical process to gather a better understanding from this population's perspective. The participants' responses yielded that, although they felt support should come from family, most judgement came daily from family. Participants indicated that judgement tended to cause them to shy away and hide their sexuality from family and turn to people who were more like themselves whom they could trust. Social support has an impact on positive behaviors and choices as related to health among the African American MSM population. Social support can encourage regular testing among this population as well as provide comfort in discussing risky behaviors to ones' health. Knowing ones' health status helps promote HIV/AIDS awareness which helps decrease the prevalence of HIV/AIDS within the African American MSM population as a whole.

The prevalence of obesity in the United States was stable at 17% from 2011-2014 among approximately 13 million children and adolescents 12-19 years of age, according to the Centers for Disease Control and Prevention. Nutritional counseling has been recommended, and while most physicians agree that it is necessary, it is not happening consistently. The purpose of this study was to examine the association between dietary intake, physical activity, and body mass index (BMI) characteristics of youth 12-17 years old in California and the receipt of nutritional counseling. Social cognitive theory guided this quantitative cross-sectional analysis of archived data from 814 youth in the California Health Interview Survey (CHIS) 2015-2016. Independent variables included demographics (age, gender, and race), BMI, unhealthy and healthy foods, physical activity and being sedentary; the dependent variable was receipt of nutritional counseling. Findings showed that 73.5% of children who were obese or overweight received counseling. BMI was the strongest predictor of dietary counseling. Independent of diet, physical activity, age, gender, and race, youth who were obese (BMI, kg/m2, -?¥95th percentile) were almost 100% more likely to talk to their doctor compared to children of normal weight (multivariable-adjusted OR=1.98, 95% CI: 1.23, 3.20). The number of cans of sweet fruit/sports drinks was significantly associated with the outcome (p=0.04). There was no significant association between fruit and vegetable consumption (adjusted OR=1.02, 95% CI: 0.95, 1.10) or physical activity (adjusted OR=0.99, 95% CI: 0.71, 1.39) and nutritional counseling. The implications of the study findings for social change include potential improvements in obesity screening and counseling to improve adolescent health outcomes. Addressing weight issues and diet /lifestyle education earlier in life, could reduce chronic disease in the youth.

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and obesity, social support, and self-efficacy were associated with breastfeeding initiation and duration among African-American women; and (b) self-efficacy mediated this association. The study design was a quantitative retrospective analysis of a subset of secondary data from the 2009-2011 Pregnancy Risk Assessment Monitoring System (n = 10,926). SPSS 21.0-® was used for analyses. Obesity was significantly associated with breastfeeding durations of 9-16 weeks and 17 or more weeks. Self-efficacy was significantly associated with breastfeeding initiation only. Social support was negatively associated with breastfeeding durations of 9-16 weeks among obese women. Positive social change implications include increased knowledge of the associations between overweight, obesity, social support, self-efficacy, and breastfeeding outcomes among African-American women. This knowledge could be used to inform the development of interventions to improve breastfeeding and weight related health outcomes.