Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention behavior. The health belief model and the sociocultural theory provided the theoretical underpinnings for this qualitative study. Semistructured interviews were conducted with a purposeful sample of 12 immigrants living in a rural area of Oklahoma. Data were triangulated and analyzed to identify themes and patterns. Findings indicated participants perceived susceptibility of contracting a vaccine-preventable disease if not immunized, with the severity of the disease having the potential to cause death. Identified barriers in immunization uptake were language barrier, lack of immunization information in Spanish, and fear of deportation. Recommendations include public health outreach providing culturally, linguistic appropriate immunization information to immigrants within communities. Findings provide health psychologists and other health care professionals the ability to formulate interventions targeting immunizations in female Mexican immigrants. These interventions could promote positive social change by decreasing immigrants' and their children's risk of morbidity and mortality related to lack of immunization uptake.

Intimate partner violence (IPV) is a significant public health problem that affects approximately 2.4 million individuals in the United States each year. Race, age, gender, and household income are established correlates of criminal victimization and diverge across various victimization experiences for these individuals. The purpose of this study was to investigate relationships between IPV victimization and the demographic variables of race, age, gender, and household income using race, class, and gender theory as a framework. Logistic regression analyses on data from 3,492 adult male and 3,637 adult female IPV victims obtained from the 2013 National Crime Victimization Survey showed that race was not significantly associated with IPV, while age, gender, and household income were significantly associated. Respondents 65 years or older reported less victimization and men were 2.09 times at lower odds to experience IPV than women. Respondents in the household income category of less than $7,500 were 1.62 times at higher odds to experience IPV than were those in the $75,000 or greater income category. Positive social change could result from an increased awareness of circumstances related to IPV victimization so public health practitioners can work to reduce its incidence impacting individuals, families, and communities.

Epidemiologic surveillance indicates an increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without. The present study investigated this disparity in weight severity between both groups, with a focus on the provision of obesity management counseling by physicians. This study consisted of a retrospective medical record review that acknowledged the effect of patient-provider interactions on health behaviors and risk perceptions. An independent sample t test compared the incidence of clinician-initiated obesity management counseling received by children with SHCN to that which was received by children without SHCN. This t test revealed a statistically significant difference between the weight management frequency received by youth with SHCN (M = 1.0, SD =.46498) and the weight management frequency received by youth without SHCN (M = 2.0, SD = .74975), t(100) = 7.826, p = .000, α =.05 over a 2-year timeframe. Bivariate correlation analysis validated a correlation between weight severity among children with SHCN and the incidence of clinician-initiated obesity management counseling. The results indicated a small but significant association between weight severity and weight management frequency among children with SHCN, r(50) = .287, p = .044, α =.05. These results support the need for a transformation in the delivery of preventive health services for children with SHCN, such as providing clinician-based obesity management strategies and increasing access to validated diagnosis-specific preventive health screening tools. These results promote positive social change by informing efforts to improve health outcomes and decrease health disparities experienced by people with SHCN.

The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a review of patient satisfaction results, reduction in patient readmission rate, and emergency room consults. Two years of data from a community-based health care program were collated from a sample of 819 individuals with chronic disease between 65- and 85-years-old who had a 30-day hospital readmission after a nurse practitioner home visit and a 30- day readmission for an exacerbation of their CHF, DM II, or COPD. The secondary data were analyzed, using SPSS, to determine changes in rates of readmission. Descriptive statistics were used to represent and compare changes in rates. After implementation of the nurse practitioner home visit program, the 30-day readmission demonstrated an 81.07% reduction and the 30-day readmission for exacerbation of COPD, CHF, and DM II was reduced by 36.77%. The project findings contribute to social change by identifying how a reduction in the frequency of hospitalizations could contribute to decreased health care expenses and improved health outcomes. Home care and chronic health care organizations, as well as advanced-practice nurses working in home care settings, may use the results of the study to establish effective community interventions that reduce health care costs.

Cancer patients worldwide receive care from multidisciplinary teams, and patients sometimes have little or no knowledge about the different treatment options available, making communication with their care providers an important influence in how they perceive their care. Patient satisfaction with care is an important factor in determining survivorship. The increasing prevalence of cancer worldwide has become a huge public health issue. The World Health Organization has warned that the potential gains from combatting infectious diseases in Nigeria might be lost because of the increasing prevalence of cancer. The purpose of this grounded theory study was to obtain the perceptions of 30 cancer survivors in Nigeria about their care in federally funded hospitals to improve cancer care in the country. Through a constructivist grounded theory (CGT) approach, data from 30 in-depth interviews with the cancer survivors were analyzed. Data analysis included open coding, selective coding, theoretical coding, and memo writing. Three themes emerged from the data analysis: positive perception of care (P), service improvement (S), and good care experience (G), all of which were cyclically related to form the PSG substantive theory, which indicates that better health care to cancer patients will improve preventative and curative cancer care services in Nigeria. This theory was validated by relating it to 3 theories in the literature as recommended in CGT research. The implication for positive social change is that the results might provide information that can help health care professionals to improve how they communicate with, relate to, and care for cancer patients and their families in Nigeria and other countries.

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions and perceptions were conducted. Data were collected using hand-written notes and audio-taped responses from participants. The data were analyzed using NVivo12 Plus qualitative software program to discover themes and patterns. The findings resulted in 3 themes and 2 subthemes. The themes that emerged from the responses were (a) breastfeeding is the best feeding option, (b) breastfeeding barriers, and (c) breastfeeding intentions and duration. There was identified support in terms of intentions to initiate breastfeeding immediate postpartum and continuing some breastfeeding through 6 months. Further results include subthemes of encouragement and outside influences and recommended future breastfeeding support. Breastfeeding barriers ranged from previous negative experiences, negative comments and advice from family and friends, perceived lack of milk, and pain. This study contributes to positive social change within the community by providing some insight into possible interventions or approaches to improve breastfeeding intentions and to ultimately improve the lives of infants.

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the time from admission to early mobilization in the acute stroke patient within the first 48 hours of admission. Rosswurm and Larrabee 6-step model was used for this staff education project. A review of the literature indicated sources of evidence from peer-reviewed journals, which were used to support the staff education project and establish best practices in mobilization for the acute stroke patient. A before-and-after design was used to evaluate time from admission to mobilization within the first 48 hours in 40 acute ischemic stroke adult patients following educational intervention for 35 acute stroke staff. Data were collected and analyzed using descriptive statistics. Findings revealed a decrease in time from admission to mobilization by 18.59%. Findings may be used to promote best practices in other units within the hospital and may be used to decrease the residual long-term effects of a stroke, improve activities of daily living, decrease the length of hospital stay, and decrease the long-term cost and burden of stroke.

The purpose of this study was to gain insight into the risk within the African American population of developing diabetes, its complications, and the benefits associated with timely management and treatment of diabetes. The study also looked at how such knowledge may be related to preventive health behaviors. The Risk Perception Survey-Developing Diabetes and the Behavioral Risk Factor Surveillance System questionnaires were employed in this study. The theoretical basis of this study was the health belief model. This was a cross sectional, quantitative study with 126 participants. Descriptive analysis was employed to calculate the mean scores and frequencies across each sub-scale of the scoring tool. Among the participants, only 28.57% were found to be knowledgeable of the risk factors of diabetes, and 74.60% were found to be knowledgeable of the benefits of treating diabetes. Although 75.40%, 61.11%, and 64.29% of participants were found to be knowledgeable of healthy dieting, physical exercise, and body weight control, respectively, fewer than 10% in each group indicated they had implemented any of such behaviors. These data suggest a lack of knowledge of the risk factors of diabetes amongst this population. These results remained unchanged even when considering those with diabetes and their counterparts without the disease separately and also across the different socio-economic groups of the sample. The outcomes of this study may enhance understanding of diabetes among the African American population. Similarly, the above findings might be able to facilitate interventions that promote diabetes management within this population.

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience sampling was used to recruit 21 participants at 2 HIV testing facilities. Interview data were collected from 9 clients, consisting of Black women ages 24-35, and 12 providers, consisting of HIV testing coordinators and administrators. Data were subjected to an inductive coding procedure and were then organized around themes. Findings suggest that clients perceived a lack of education and limited access to healthcare, due to socioeconomic status and rising medical costs, as contributing factors to the sexual decisions of Black women. Providers differed in suggesting that community distrust and lack of provider empathy and awareness were the primary factors due to broken relationships between provider and client. By understanding the sexual decision making of Black women in Georgia, this research can foster social change by identifying and creating educational programs heavily focused on the delivery of positive sexual health messages aimed at reducing the spread of HIV/AIDS among this group.

In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is missing from the literature. The purpose of this qualitative phenomenological study was to gain an understanding of the perspectives, beliefs, and level of knowledge of low-income uninsured patients about primary care services and to explore whether patient education can improve access to primary care. The health belief model was used to explore 6 concepts: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Criterion sampling was used to recruit 10 participants, an interview tool was used to collect data, and the data was analyzed deductively. Results revealed that members of the low-income uninsured population believed primary care to be better than the ED because it offers cost-effectiveness, preventative care, efficiency, and familiarity. Results indicated that lack of money or insurance prevented participants from using primary services. This study may bring awareness that leads to the improvement of patient education and navigation, the reduction of ED usage, and an increase in primary care utilization.