Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges to seek treatment for the first time. The independent variable was the receipt of reduced-fee dental hygiene treatment/education. The dependent variables were the oral health perceptions and behaviors of socioeconomically deprived persons, as well as the perceptions and behaviors of patients provided with a referral for follow-up treatment with a dentist. Mediating variables were sex, age, race, and socioeconomic status. Wilcoxon Signed Rank test and logistic regression were applied to detect potential differences in the dependent variables before and after treatment. The most significant changes were found in categories dealing with self-efficacy measures that patients could take to improve their own oral health. Also, the oral health behaviors and perceptions of younger, African-American of low educational and financial background were significantly more improved after treatment. The social change implication of this research may be that oral health practitioners can use these results to create preventative interventions more tailored for socioeconomically deprived persons who face complicated oral health issues.

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of obesity in Central African immigrants, and what strategies could be effective in preventing and reducing the increase of obesity and type 2 diabetes in this population. Interviews with 17 Central African immigrants living in the northeastern U.S. were conducted to explore their social, cultural, and behavioral factors that influence the prevalence of obesity. Interview responses were transcribed and entered into NVivo software for data analysis. The results revealed that socioeconomic issues, cultural differences, and language gaps were the primary risk factors. Feeling stressed and overwhelmed and a lack of communication were also found to be significant. The results could provide health administrators and health educators with a platform for advancing policies and programs to foster greater health and well-being among Central African immigrants and thus contribute to the overall social welfare of Central African immigrants.

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in Nairobi. Participants completed a structured questionnaire consisting of 10 validated psychosocial scales and were followed for actual mode of delivery (MoD) from hospital records and postnatal telephone interviews. The overall prevalence of CS and ECS were 16.0% and 6.4%, respectively; the CS rate was not statistically higher than the recommended 15% (p > 0.05). The combined CS incidence rate for these 2 hospitals was 83 per 1,000 births per month. Autonomy, fear of childbirth, pregnancy related anxiety, perceived social support from friends, and outcome expectancy for birth were statistically significant predictors of ECS, given the parity and age at first pregnancy, Ï?2(df = 19) = 77.735, p

Genetically modified (GM) foods technology is a novel idea for improving food and crop production, but the supposed health risk of GM foods, such as possible negative long-term health effects to humans, animals and the environment, have provoked the European Union to create assessment protocols to monitor and regulate the safety of GM foods and crops. This research investigates the perception and attitudes of unlabeled GM foods of the WKU faculty and staff. A survey was administered via WKU Qualtrics, and chi-square tests were performed to see how the benefits and disadvantages of GM foods may affect the purchasing decisions of the educated consumer, and to see if the WKU faculty and staff wants GM foods to be labeled or not. The research confirms that the benefits and disadvantages of GM foods do affect the purchasing decisions of the educated consumer. The survey revealed that about 60% of the WKU faculty and staff buys GM foods, and 40% do not buy GM foods, and approximately 92% of the WKU faculty and staff wants GM foods to have proper labeling and information. The research provides information about how the educated consumer of Kentucky may feel about unlabeled GM foods. The research also recommends some trade-off benefits of GM foods, including that approximately 35% of the WKU faculty and staff reported that they would buy GM foods if it helps to lower cholesterol and fight diabetes, and 20% say they would buy GM foods if it is cheaper than other foods. Some of the disadvantages of GM foods are that the pesticide chemicals used in the production methods of GM foods are toxic to humans, animals, and the environment. Approximately 54% of the participants say they would not buy GM foods because they are concerned about how it may affect their long-term health, and about 35% reported that they don’t buy GM foods because of improper labeling and information.

A well-known fact relating to health care in the 1990s is the delimma being faced by small rural hospitals across the United States. They are now at a crossroads between survival and closure. This thesis addresses the influence that effective marketing strategies can have on the outcome of rural hospitals if such strategies are targeted to the right populations Although the patients, the community, and the physicians are important target groups, this thesis addresses the impact marketing can have on the employee population and how that population can, in turn, affect community perception. This is the first study to be done at Caverna Memorial Hospital to indicate employee perception as a result of marketing, and careful research of available literature shows that it may well be one of the first done in a rural hospital in Kentucky on this particular relationship An important premise to this study is the fact that employees need to know that their success as an employee is dependent upon the hospital and, just as important, the hospitals survival can be dependent upon the employees' influence on potential customers. The study concentrated on outpatient services and took place in a 30-bed hospital located in south central Kentucky. This hospital has economic problems and conditions that make it typical of small rural hospitals across the country. The instrument utilized for this study is a pretest and posttest questionnaire presented to the entire employee population before and after a period of time when marketing endeavors were undertaken by the hospital. To test the difference of scores between the pretest and posttest, repeated measures Analysis of Variance was used to compare means of both groups. The principle finding was that employees viewed the hospital and its' outpatient services in a more positive light after marketing endeavors had been undertaken. Since effective marketing endeavors do have the potential of positively influencing employees in a small rural hospital setting, and since hospital employees have the potential of influencing potential customers, hospital administrators may do well to consider budgeting for marketing and directing such marketing tactics to the often forgotten employee population.

Quality of life (QOL) is an important aspects of overall well-being in older adults. QOL is associated with functional, physical, and psychological health; all of which can be improved with increased physical activity. A high fall risk is associated with low physical function and QOL. One in four older adults experiences a fall each year, making it necessary to focus public health interventions towards decreasing fall risk and improving QOL in older adults. Bingocize® is a health promotion program designed to promote health, health knowledge, physical activity, and social engagement among older adults. The purpose of this study was to determine the effects of the new version of Bingocize® on QOL and fall risk in community-dwelling older adults (N=36; mean age 73.63 ± 6.97). Participants were clustered and randomly assigned to (a) experimental (n=19; participating in Bingocize® program, which included the bingo game, exercise, and health education) or (b) control (n=17; only played bingo). Each group completed a 12-week intervention that consisted of two 45-60 minute sessions per week. Pre and post data assessments included the TUG, 30-second chair stand, 4-staged balance, handgrip strength, WHOQOL-BREF, PANAS, and a health knowledge quiz. A mixed design analysis of variance (ANOVA) was used to compare intervention effects. There were no significant interactions for any of the variables, with the exception of positive affect (PA) (F (1,34) = 5.66, p = 0.02, 𝜂𝑝 2 = 0.15, power = 0.64) and handgrip strength (F (1,34) = 8.31, p = 0.007, 𝜂𝑝 2 = 0.196, power = 0.80).. There was also a significant main effect for time for health knowledge. Post hoc analysis using independent samples t-tests were conducted on PA (t (33) = 2.39, p = 0.023, two-tailed) and handgrip strength (t (34) = 2.85, p = 0.007, two-tailed). Participating in the Bingocize® health promotion program can produce a meaningful and detectable change in handgrip strength and PA in community-dwelling older adults.

Despite the many weight loss options available, the majority of overweight and obese individuals who try to lose or maintain weight loss are unsuccessful. This lack of success has been the focus of extensive research. In an attempt to develop more effective modalities, researchers have identified several predictors of weight loss success. However, the efficacy of diets is still limited. For many, this lack of weight loss success may be due to issues such as depression, loneliness, anxiety, lack of support, or other environmental factors that may be imperceptibly related to food and exercise. Repeated dieting failures may produce feelings of deprivation, low self-esteem, reduced self-efficacy, and dietary rebellion. For these individuals, a more holistic approach to addressing weight-related issues may be more effective and is the impetus for the development of this project. This project was developed utilizing several previously identified predictors of weight loss success, holistic and weight loss models, along with several self-help lay publications. This resulted in the development of a unique, holistic, self-care guide that is easily individualized and based on personal weight management needs. Individuals can potentially identify their unique physical, emotional, and spiritual motives for overeating or lack of physical activity, and design their own plan of action; potentially providing themselves with a new level of health and happiness not previously realized.

Previous research examining high-risk sports participation has yielded discrepancies between the role assigned to risk and the perceptions of climbers regarding risk. Risk, as it applies to high-risk sport participation, has not been sufficiently defined in the literature. The current study sought to develop, by means of a grounded theory approach, a new, dynamic operational definition of risk as it applies to rock climbers, and to examine the role of risk management as a modifying factor in the perception of risk and its impact on motivation and participation. Nineteen subjects (twelve male and seven female) averaging 14.7 years of climbing experience were interviewed. A model for the processing of risk in high-risk sports participants is presented in which risk is perceived by the participant as operating on three levels: actual risk, assessed risk, and mental or perceived risk. The exposure to actual and assessed risk does not appear to be a goal of the climbers interviewed, but does provide meaning to decisions made by the participant, as well as defining limits and boundaries. Mental or perceived risk serves to provide a mental challenge to be overcome by the climber, and may provide a thrill or "adrenaline rush" that is sought out by some participants. The elimination of risk would change most participants' perceptions of climbing. Motivation would be negatively affected in most cases. The model presented describes a process of risk awareness, assessment, acceptance, mitigation, results, and consequences that is situation specific. The perception and assessment of risk varies from individual to individual, as well as across time. Individual climbers have a well defined risk threshold: a point at which the risk to which they are exposing themselves becomes too great and the decision will be made to reject risk. This threshold is stable and does not shift as the result of experience. It is suggested that future research which seeks to examine the role of risk in high-risk sports participation focus on the process by which risk is identified, evaluated, and accepted, as this will be of the most benefit to the participants.

Ki, Japanese for living energy (Chi in Chinese), is at the absolute core of the Oriental model of medicine and wellness. Complementary to this model, many Oriental martial art exercises have evolved to cultivate Ki for optimal health. However, the concept of Ki remains poorly understood and relatively unexplored in traditional Western health and medical literature. Further, the health focus of martial art research has remained primarily concerned with the arts' contribution to psychological health. This has left a significant gap in our understanding of the other health benefits that these arts and Ki have to offer. To begin closing these gaps, Moustakas' phenomenological research method was used to develop an enhanced understanding of Ki. Twelve advanced practitioners of the traditional martial art of Aikido were asked to illuminate how they perceive and describe the experience of Ki in their lives. Aikido was an excellent art through which to study Ki because of the art's focus on developing the Ki of its practitioners and its recognition in the literature as psychologically beneficial. The co-researchers described Ki as a force that they perceived to be influencing their lives in multiple ways. They believed that the Ki they developed through their Aikido practice enhanced the health of their minds, bodies, and spirits. Ki was described and explained through its perceived immediate and long term effects. They expressed Ki as an integrated part of their beings that enhanced physical and psychological health and well-being, and fostered calmness and clarity of mind. Ki was also perceived as a tool for recove1ing from injuries and illness and for achieving personal goals. Further, over time they perceived that Ki engendered great trust in the universe and that Ki protected their health. Several key differences between the traditional definition of Ki and the co-researchers' everyday experience emerged from the analysis. These were the differentiation between the long and short term effects of Ki, the description of Ki as a tool, and the attribution to Ki of the feelings of trust in the universe.

Effects of hydraulic fracturing (HF) have become a controversial public health issue in the United States. The purpose of this qualitative case study was to explore community members' perceptions of economic, health, and environmental effects of HF in Gibson County, Indiana. The conceptual framework was adapted from the health belief model and was named the HF health impact belief model (HFHIBM). Data were collected from stratified purposeful non-randomly selected 32 Gibson community members, using semi structured questionnaires, complete observations, and existing documents. Stratification was based on factors influencing perception, such as, gender, race, level of education, age or technology exposure, and level of media use. The observed community showed no economic boom or prevalent diseases, with functional and few abandoned pump jacks located on some of the farmlands. Data collected from the returned questionnaires were analyzed using hand coding and software. The results revealed that 72% of participants lacked awareness of HF, 90.6% reported lack of involvement in the decision-making process to locate HF near their community, and 21.6% of the 40.6% of participants with awareness reported that HF should be continued if the benefits outweigh the negative effects. Based on the constructs of HFHIBM, the low awareness of HF has implications on the community's acceptance of HF, and the use of sustainable and environmentally safe alternatives may result in better acceptance of HF. Increased awareness of HF may lead to the development of environmentally friendly, sustainable preventive actions, better community health outcomes such as reduced morbidity and mortality rates, and improved drinking water quality in neighboring communities.