Colorectal cancer (CRC) represents a public health issue that may be prevented using the screening strategy. Black people in Africa represent the population with the lowest risk for CRC. However, in Africa as well as the United States, Black people participate the least in CRC screening. Little is known about the perceptions of CRC and CRC screening in the Black, male, African immigrants residing in Baltimore, Maryland. The low participation in CRC screening in this population was the problem addressed by this dissertation. The purpose of this qualitative study was to explore and describe Black, male, African immigrants’ experience with CRC screening in Baltimore. Two research questions focused on understanding the meaning of CRC and describing the experience with CRC screening in this population. The health belief model served as a conceptual framework. The descriptive phenomenological approach was used using semistructured interviews with 8 participants. Data collected from eligible participants in the population of interest were transcribed and analyzed thematically using Colaizzi’s 7-step strategy. Three key findings from this study included the limited knowledge of CRC, the limited perceived barriers to CRC screening, and the high level of trust in health care providers of the participants. Fear of results and negative cultural beliefs about CRC screening were no barriers to the screening. The recommendations for future studies include the consideration of the female population and the inclusion of participants resident in Baltimore for fewer than 6 months. The implications for a positive social change include the improvement of CRC awareness and physician-patient conversations, as well as the development of policies that can facilitate access to health care.

Inadequate nutrition during infancy and early childhood seriously interferes with brain development, leading to neurological and behavioral disorders. Such effects are detrimental to children under 2 years of age. The purpose of this cross-sectional study was to better understand the quality of nutrition services offered to children and pregnant women in Ntungamo District in southwestern Uganda. The cross-sectional design facilitated comparison of different variables, using a research-question-driven approach, assessing existing secondary data from SPRING Uganda database. Stepwise, backward multiple logistic regression was used to identify the independent variables that influenced the provision of quality nutrition assessment, counseling, and support (NACS) services to clients. Only the independent variables with p < 0.05 were retained in the final model. Odds ratios with 95% confidence intervals were used to estimate the strength of association between the independent variables which are: 1) training of health workers with different nutrition packages, 2) availability of nutrition assessment equipment at varied service delivery points, 3) availability of nutrition supplies for preventing and treating acute malnutrition, 4) availability of nutrition treatment protocols and IEC materials functionality of quality improvement teams, and 5) supervision and motivation of health workers. The dependent variables were indicated by percentage of children and pregnant women who were provided with appropriate NACS in outpatient departments, young child clinics, antenatal clinics, postnatal clinics and antiretroviral therapy (ART) departments in the past 3 months. Statistical analysis was performed with IBM SPSS 25.0. All associations with p < 0.05 were considered statistically significant. All surveyed facilities offer maternal health services, a positive indication that a greater percentage of the facilities in western Uganda realize the importance of nutrition assessment of pregnant mothers and children. Of the sampled health facilities supported by SPRING Uganda, 56.3% had functional nutrition assessment equipment like mid-upper arm circumferences (MUAC) tapes and weighing scales. This study showed that different nutritional services offered to pregnant and lactating mothers and children could either positively or negatively affect the quality of nutrition in Ntungamo District.

Opioid overdoses and overdose deaths have increased significantly throughout the United States. Naloxone distribution has become a harm reduction strategy that has proven effective in reducing opioid overdoses in urban areas through drug treatment centers and needle exchange programs. However, limited research is available on the efficacy and feasibility of these programs in rural locations and other nontraditional settings. Guided by harm reduction theory, the purpose of this qualitative phenomenological study was to address this gap by exploring the feasibility of implementing a take home naloxone program in rural jails. Semistructured interviews were conducted with 6 jail administrators in rural upstate New York to determine their knowledge, attitudes, perceptions, and perceived barriers of a take home naloxone program. Data analysis of the participant interviews concluded 6 themes. The first theme concluded that participants believe naloxone acts as a safety net for drug users. The second theme identified that jail personnel are knowledgeable of opioid overdose and naloxone administration. Theme three confirmed that jail personnel would likely not support a naloxone program. Theme four concluded that naloxone training within the jail would likely be appreciated by inmates. The fifth theme addressed that multiple training barriers exist. In conclusion theme six affirmed that harm reduction programs are not favored by jail administrators. The implications for positive social change include increased knowledge of barriers that surround nonmedical and nontraditional community dispensing models for Naloxone and improved community awareness of a growing public health concern and increases collaboration towards a public health and safety approach to substance use and abuse.

Children between the ages of 6-17 years suffering from childhood attention deficit hyperactivity disorder (ADHD) need constant attention as they are more likely to be accident proned, hospitalized, disruptive, and educationally challenged. The constant attention required for children with ADHD may impose stress on mothers and primary caregivers, yet this stress has not been sufficiently studied. The objective of this study was to fill a gap in literature by studying the stress experienced by African immigrant mothers living in the United States who are living with and caring for a child with ADHD, and then comparing the level of stress reported by African immigrant mothers and African American mothers caring for children with and without ADHD. The study had a quantitative, case-control design, and used the parental stress index-short form (PSI-SF) and a 9-item demographic questionnaire as the survey instruments. One hundred twenty-five African immigrant and African American mothers participated in the study. Data collected from the mothers were analyzed for descriptive. ANOVA and Regression analysis were performed using SPSS version 21. The results showed that African immigrant mothers caring for a child with ADHD had significantly higher stress levels than those not caring for a child with ADHD. African American mothers also caring for a child with ADHD had significantly higher stress than African American mothers not caring for a child with ADHD. African immigrant mothers caring for a child with ADHD had significantly lower stress than African American mothers caring for a child with ADHD. These findings may initiate interventions that would help mothers provide quality care of life for themselves and for their children suffering form ADHD.

The stressful nature of deploying to a disaster makes it necessary for a good emergency manager to be capable of coping in high-pressure situations. When intensified by extended work hours, deployments can often lead to burnout, job strain, and emotional stress, which can have a significant impact on an employee's well-being. The purpose of this study was to examine the effects of burnout and perceived stress amongst emergency managers working for FEMA and to determine if social support was an effective intervention. The theoretical foundation used for this study was the job demands-resources theory, which aided in understanding, explaining, and predicting the well-being of employees, job performance, and organizational outcomes. The key research questions included to what extent do psychological job demands predict burnout, to what extent does the perception of stress lead to feeling burnout, and to what extent does peer support affect burnout. A quantitative correlational design utilizing secondary data from the Work, Family and Health Network was performed (N = 4,776). Results from linear regression found a relationship between psychological job demands and feeling burned out as well as a relationship between perceived stress and feeling burned out, as experienced by emergency managers. The model did not support a significant relationship between peer support and burnout. The social change implications include advancing the understanding of the stressful nature of deployments and stress from the psychological demands of the job that often leads to burnout. This study can be a resource to create and implement training programs for burnout prevention, and as a tool illustrating how to care for and support colleagues while also assisting disaster survivors.

The lack of knowledge of pharmacogenetic testing for cardiovascular disease (CVD), coupled with their increased risk for CVD, may impair nurses' cognitions and attitudes toward pharmacogenetic testing for CVD. The purpose of this quantitative cross-sectional correlational study, conducted with 230 RNs without CVD who worked in acute-care settings in Georgia, was to determine if their years of education, years of experience, and gender significantly influenced their perceived risk for CVD (Questions 1-3) and their perceived knowledge of pharmacogenetic testing for CVD (Questions 4-6), and if their perceived risk for CVD significantly influenced their acceptance of pharmacogenetic testing for CVD (Question 7). Various regression analyses (hierarchical multiple linear regression, multiple linear regression, hierarchical, linear regression) were conducted for hypothesis testing. Results showed that: (a) gender significantly predicted perceived risk for CVD, in that male nurses perceived themselves to be more at risk for CVD than did female nurses; (b) years of education was a significant predictor of knowledge of pharmacogenetic testing for CVD, in that as nurses' education level increased, so did their knowledge; and (c) knowledge of pharmacogenetic testing for CVD, but not perceived risk for CVD, significantly predicted acceptance of pharmacogenetic testing for CVD. This study may act as a catalyst to promote empirical work and inform practice in nurses' CVD health and their knowledge and acceptance of pharmacogenetic testing for CVD.

The purpose of this phenomenological qualitative study was to examine the etiology of water quality perceptions and beverage preferences of Black children and adolescents, which addressed a current gap in the literature on this topic. This study was guided by Festinger's social comparison theory, which supports the notion that children and adolescents' perceptions and preferences are influenced by their social network and those with whom they have a close association. In this study, children and adolescents' water quality perceptions were examined as well as the development and factors affecting those perceptions. Whether social factors such as peer or parental influence have an impact on children and adolescents' beverage consumption were also investigated. The study participants (n = 20) were recruited from two cities in a Midwestern state for semi-structured interviews from which information was coded into themes. Participants who met the inclusion criteria were Black youths between the ages of 9 to 18 years. The data were analyzed using latent content analysis with open and axial coding.The key findings in this study indicated that Black youths had negative perceptions of tap water quality and positive perceptions of bottled water, and stronger preferences for sugar-sweetened beverages than for water. These perceptions and preferences emanated from their parents and were also influenced by their peers, tastes, and the social environment. This study's implications suggest the need for improved health literacy through programs that educate participants in making informed decisions to impact the quality of health; this will also increase the overall health of society in terms of productivity and economic growth.

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from 10 women, ages 18 to 59 who had undergone FGM/C. Participants were voluntarily recruited using purposeful snowball sampling techniques. Data were analyzed through inductive coding techniques to extract and compare recurrent themes and patterns. Four major themes emerged: (a) traditional beliefs; (b) pain, happy, and approval; (c) pain, distress, and disapproval; and (e) ignorance of the law. Results indicated that ethnocultural beliefs, religion, and customs had a strong influence on the decision to undergo FGM/C. Women who viewed themselves as heroes of the practice strongly supported the continuation of FGM/C. The women who viewed themselves as victims of FGM/C disapproved the practice as an instrument to instill fear and control. The potential for social change could improve the knowledge of public health professionals, international organizations, federal, state, and local governments to influence policies on decreasing FGM/C without undermining the culture of communities regardless of any personal belief that sees FGM/C as detrimental to women.

Low Human Immunodeficiency Virus [HIV] test uptake and multiple partnerships among men in Nigeria are contributing factors to HIV transmission. The purpose of this quantitative cross-sectional study was to examine the relationship between HIV test uptake, sociodemographic characteristics, HIV knowledge, attitude, and multiple sexual partnerships. The health belief model provided the framework for the study. Data were collected from the 2013 Nigerian National Demographic Health Survey, which surveyed 17,359 Nigerian men ages 15-49 years. Chi-square and binary logistic regression analysis showed that sociodemographic variables (age, residence, marital status, religion, wealth status, ethnicity, and educational level), HIV test uptake, HIV knowledge, and attitudes toward negotiating safer sex are significantly associated with multiple sexual partnerships. Findings showed that multiple sexual partnerships were higher among middle-aged men (25-39 years) in Nigeria and lower among Hausa Muslims. Findings showed that HIV testing is a significant predictor of multiple sexual partnerships, those that have been tested are more likely to be engaged in multiple sexual partnerships than those never tested. A well-tailored intervention that will promote follow up with men after HIV test uptake is essential to reduce the practice of multiple sexual partners among them. This may result in positive social change by presenting public health experts, donor agencies, and health teachers with valuable information about how multiple sexual partners and HIV testing can influence sexual risk behaviors among men. This may advance HIV prevention and control practices among men in Nigeria.

Approximately 35% of women in the United States experience intimate partner violence (IPV). IPV could be linked to symptoms of posttraumatic stress disorder (PTSD) that result in long-term mental health issues. Public health professionals, college counselors, and educators require information to assist in identifying college-age women who may be affected by IPV. The purpose of the study was to explore the association between the occurrence of symptoms of PTSD and IPV among college-aged women. The socioecological model was the theoretical framework for the study. A total of 199 cases were selected from National Intimate Partner & Sexual Violence Survey dataset for analysis. Data were analyzed using chi-square analysis and Welch's t test. The results of the study indicated significant association in the relationships between PTSD symptoms and IPV, which displayed p < .001, and significant association between PTSD symptoms and socioeconomic status, which displayed p = .026. The results also indicated that age (p = .313), ethnicity (p = .178), social support, and education (p = .079). have no significant relationship with PTSD symptoms and IPV among college-aged women. The potential positive social impact of this study is that findings show predictive factors that may have influenced a type of behavior as it relates to IPV, which could create and improve IPV prevention programs for college women, college educators, college counselors, local authorities, and health care workers. Providing focused attention on the education of these individuals could assist in early detection, which could reduce the potential for IPV/PTSD symptoms to occur among college-aged women.