Multiple research studies have demonstrated racial, socioeconomic status (SES), and neighborhood disparities in first-line treatment of colorectal cancer patients, including those with metastatic colorectal cancer. However, disparities in adjunct monoclonal antibody treatment disparities have not been explored. The purpose of this study was to assess racial, SES, and neighborhood disparities in adjunct monoclonal antibody treatment of elderly metastatic colorectal cancer patients. The research was rooted in 3 theories: the fundamental cause theory, the diffusion of innovations theory, and theory of health disparities and medical technology. Data from the SEER-Medicare database and logistic regression were used to assess the relationship between the variables of interest and adjunct monoclonal antibody therapy. In this study, race (p = 0.070), SES (p = 0.881), and neighborhood characteristics (p = 0.309) did not significantly predict who would receive monoclonal antibody therapy. The results demonstrated a potential improvement in historically documented colorectal cancer treatment disparities. Specifically, historical treatment disparities may not be relevant to newer therapies prescribed to patients with severe disease. The difference could be related to improved access to care or a change in treatment paradigm due to the severity of metastatic colorectal cancer. Future studies aimed at understanding the causes of this social change (i.e., reduced treatment disparities) are warranted. Understanding the root cause of the reduced treatment disparities observed in this study could be used to reduce treatment disparities in other cancer populations.

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural model. The interview participants for the study were 10 HIV interventionists employed with health institutions that partially or entirely specialize in HIV prevention in the Richmond, Virginia, area. The analysis of the data was aided by a phenomenology analytical approach. The results revealed that cultural competence training can be one effective means to enhance the quality of health messages targeting AA MSM. This investigation has social change implications, especially in the context of developing sustainable HIV prevention interventions focused on integrating culture, thereby reducing HIV disparities in the Richmond metropolitan area. The findings may also lend insight into the various ways that health establishments can engage in culturally relevant prevention and position themselves to be leaders in informing the development of culturally competent HIV prevention messages that will aid in the acceleration of changing longstanding, ineffective prevention approaches targeting AA MSM.

Gate control theory posits the idea that the brain and spinal cord have the ability to control the perception of pain sensation throughout the body. Biofeedback provides a proven way to teach a person how they may control their heart rate, breathing, and skin temperature. Through this process, individuals learn to lessen their migraine frequency and intensity. There are no studies to date that have measured the effectiveness of biofeedback in conjunction with medication for migraines in children despite established evidence of success in adults. In this study, an online format via SurveyMonkey was used to document the perceptions of parents with regard to the observation of their children's migraines. Pre€ and posttreatment measures were recorded to document migraine activity with implementation of biofeedback or medication using the Individualized Numeric Rating Scale. A total number of 48 participants reported about their children's migraine frequency and intensity. One group of 24 parents were asked to give information on medication only treatment, and an additional 24 parents provided information on biofeedback and medication. The data were processed using 2 mixed model (i.e., 1 within and 1 between) ANCOVAs. Although frequency and intensity of migraines decreased across both groups posttreatment, there was no statistically significant interaction between the within subject factors of time and type. In this particular data set, medication plus biofeedback was not more effective than medication alone. The implications for positive social change using the results of this study are the potential for happier, healthier, migraine free children who are more able to be productive and contribute positively to society.

Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of social production of disease and political economy of health guided the study. The study used a quantitative research design to investigate the relationship between neighborhood income level and the consumer nutrition environment. Organic food scores were compared by neighborhood income level using t test and ANOVA. There were significant differences in availability and variability scores of healthy organic foods between high- and low-income neighborhood stores. Organic food items, specifically 15% fat content ground beef, peanut butter, apple juice, and eggs were priced significantly higher than conventional items (p < 0.05). Pricing of organic foods varied and no significant pricing trends were noted between neighborhood income levels. This study may contribute to social change by enhancing the conversation on organic food availability and affordability. Social change may be promoted through identification of the need to expand WIC authorization of organic food items and increasing produce voucher amount to allow WIC participants to purchase higher amounts of organic produce.

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving daily physical activity. Thirty-seven nurses were recruited to use a pedometer application for 24 hours on a (12-hour) workday to track their steps for 3 consecutive days, as well as complete a final survey. A repeated measures ANOVA, with a Greenhouse-Geisser correction, determined that there was no statistical difference in the number of steps over the 3 time periods. Seventy-eight percent of the participants indicated that the project increased their awareness of physical activity. Extended research is needed to add a stronger support for the affect of wearing a pedometer and the benefits of increased awareness on health promotion. Pender's health promotion model suggests adding motivating factors such as competition. Fitness trackers now have this function and could play a large role in improving physical activity awareness and the battle of obesity for nurses and the general population. The results of this study may promote positive social change by making nurses more aware of the importance of their health and physical activity, given their long work days.

Most people have had an episode of foodborne illness at one time or another; however, the majority of those stricken with foodborne illness fails to associate ill health with something consumed within the past 72 hours. The World Health Organization (WHO) estimates that foodborne diseases affect 30% of the population in developed countries, and that in developing countries, about 2 million people die yearly due to foodborne illness. Previous researchers have indicated that food handlers with poor personal hygiene are potential sources of infection. Although public health agencies in many countries already regularly inspect food facilities to control potential foodborne illnesses to some extent, the question of the most appropriate and effective means of achieving the goal of food safety remains unanswered. Therefore, the purpose of this study was to determine whether a color-coded placard grading system is an effective tool for achieving this goal while simultaneously educating the public about food safety. This study involved 1,410 randomly selected food service establishments, consisting of traditional restaurants, take-out restaurants, grocery stores, public school cafeterias, and institutional food facilities located in Alameda County, California. Inspection data were analyzed for the first 12 months of placard grading and compared to the following 12 months during the placard grading period. Statistical analysis results did not show significant differences in the CDC major violations and in confirmed foodborne illnesses between the 2 years. However, it is expected that the new program will provide improved food handling practices in the future. Improvement in food handling practices will contribute to social change by reducing the number of foodborne illnesses, promoting better health for the community, and educating the public about food safety.

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was used to check for multicollinearity. There was not a statistically significant difference between those who were depressed (Mdn = 32.76, IQR = 7.8) and those who were not depressed (Mdn = 33.27, IQR = 5.0) in terms of BMI (U = 774.0, p = 0.47). When depression, BMI, an interaction term for depression*BMI, and other predictor variables were entered into the regression model, these variables did not account for a significant increase in shared variance in HBA1C (Î?R2 = 0.17, F (14, 74) = 0.17, p = 0.37). Social change implications generated from this study include better resource utilization, improved quality of care, increased veteran satisfaction and improved veteran experience across the healthcare system. The findings from the study can be used to expand access to specialized services for chronically ill veterans, coordinate resources, better outcomes and facilitate seamless care coordination between mental health and primary care providers

Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs and through document review. The document reviewed were reports of coordination efforts, and outcome evaluation reports. Data were managed using NVivo, while coding and themes were adopted for data analysis. Findings revealed the partial coordination efforts in the health system development. Coordination efforts should be at both national and state level to ensure adequate implementation of the health program. Most participants reported a need for the government of the recipient country to strengthen their commitment and own coordination process for development partners to adhere to the guidelines of the coordination platforms. These results could have implications for positive change by identifying the bases to achieve sustainable effectiveness of health aid in Nigeria through development of Country Coordination Mechanism for all health programs to provide guideline of harmonizing activities of development partners.

Childhood obesity rates among Mexican Americans have risen along with the concerns of public health professionals. The purpose of this cross-sectional study, based on social cognitive theory, was to investigate the relationships among parental self-efficacy, parental feeding practices and styles, and childhood obesity, as measured by the parental perception of child weight, among Mexican Americans in Texas. Mothers and fathers (n=83; 33 males, 64 females), with at least 1 child between 8 and10 years, formed the sample. Relationships were assessed using the Tool to Measure Parenting Self-Efficacy questionnaire, the Parental Feeding Practices Questionnaire for Mexican American parents, the Parenting Dimensions Inventory – Short Version, and a figure rating scale of child’s weight. Data were collected through SurveyMonkey and analyzed by gender using linear regression. Feeding styles of reasoning [β = -.065, 95% C.I. (-.124, -.007), p < .05] and greater parental control [β = -.158, 95% C.I. (-.294, -.023), p < .05] decreased parents’ perceptions of their male child’s weight; feeding styles of letting situations go [β = .049, 95% C.I. (.005, .093), p < .05] increased parents’ perceptions of their male child’s weight. Feeding practice of the use of food to control behavior [β= .029, 95% C.I. (.009, .049), p < .05] and restriction of food [β= .041, 95% C.I. (.016, .065), p < .05] increased parents’ perception of their male child’s weight. There were no significant results for female children or parental self-efficacy. This study has implications for positive social change: changes in feeding practices and styles for Mexican American parents could improve the effectiveness of obesity interventions for PH staff and thus decrease morbidity and mortality among Mexican American children, especially boys in Texas.

Research has indicated that effective parenting programs for pregnant and parenting teens greatly improve educational and career opportunities for teen parents. Such research underscores the need for schools to use these programs in their efforts to increase high school graduation rates for this population. The aim of this case study was to assess if a school-based parenting program was successful and, if so, how elements of this program might be useful to educators who are planning similar programs. The study included an examination of archived program data, which included end-of-year reports related to the program and participants, and interviews with 12 key program administrators and teachers. Outcome evaluation theory and a logic model served as the conceptual framework. The research design had 2 parts: a quantitative secondary analysis of archived data and qualitative interviews. The program data were analyzed using descriptive statistics. The interview data were downloaded into a computer-assisted qualitative software program to organize the data, code the data, and to determine major themes. Major findings were that the program met goals and objectives due to: (a) clearly stated and specific program objectives;(b) a high level of program support from district and administrative staff; (c) a major asset of the program, its curriculum; (d) adequate resources and funding, and (e) the active participation of, and open communication between, parents/guardians of program participants, faculty, and staff. This study contributes to social change by showing educators and parents that an effective school-base parenting program can result in improved high school completion and brighter outcomes for pregnant and parenting students.