An increased exposure to the sexual content of traditional mass media (i.e., television, magazines, movies, music) affects real life sexual behaviors among adolescents. Engaging in online risk behaviors such as sharing/posting sexual content using social networking sites, cellphones, smartphones, IPads, or other new media devices has become common among adolescents. The purpose of this quantitative, correlation study, based upon the theory of reasoned action and three pre-existing national surveys, was to determine whether significant associations exist between attitudes, intentions, and behaviors related to online risk behaviors and real life sexual behaviors among African American female adolescents in Metro Atlanta. Data were collected from 111 African American female adolescents residing in the Metro Atlanta. Statistical analyses included the Pearson r correlation, phi coefficient correlation, and logistic regression tests. According to study results, there were no significant relationships between attitudes and behaviors concerning online risk behaviors and real life sexual behaviors, age and attitudes of online risk behaviors, or relationship status and online risk behaviors. However, a significant relationship was found between age and engaging in online risk behavior. The positive social change implications include further insight for those working in the area of adolescent sexual health prevention and promotion. The findings can be used to better understand the impact of online risk behaviors on adolescent sexual health and how new media platforms can be effectively used to tailor prevention programs and campaigns.

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical activity and dietary behaviors. The primary research question for this quantitative, retrospective, cross-sectional study asked whether there is a statistically significant interaction between dietary fruit and vegetable intake and physical activity on the BMI of Black adolescent females. In this study, data from 1,211 Black female adolescents in the Center for Disease Control Youth Risk Behavior Survey database were analyzed using multiple linear regression statistics. BMI was the dependent (outcome) variable, physical activity was the independent (predictor) variable, and fruit and vegetable intake was the moderator variable. Physical activity had a significant negative association with BMI while intake of fruits and vegetables showed no significant association with BMI. Unlike previous research that was not focused specifically on Black adolescent females, Fruit and vegetable intake did not significantly moderate the relationship between physical activity and BMI. This study has positive social change implications for practitioners designing obesity prevention programs for Black female adolescents, which should focus on increasing physical activity levels towards controlling BMI, leading to a healthier life for Black female adolescents.

Assistive technology may delay cognitively impaired elders' need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah's 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer's or other dementia by 2037. Data were collected from a focus group of 10 seniors at a senior center in a large mid-Atlantic city, as well as survey data from with 5 family members of the cognitively impaired elderly and 16 technology developers from an engineering society. These data were coded according to the thematic content analysis and causal layered analysis. The future triangle analysis served as a second layer of analysis. Findings indicated that the most desirable outcome for 2037 is that of the "happy retiree," characterized by flourishing cultural and financial opportunities, and the least desirable is that of the "struggling pensioner" characterized by monetary gains of the social elite at the expense of the poor and working class. The most expected outcome, though, is the "caring robot" that is characterized by the use of technology and artificial intelligence to promote equitable social and health care benefits to aging citizens. Positive social change may be achieved through recommendations to state, local, and national policy makers that support the improvement in the elders' well-being, the delay of hospitalization, and greater support for the duties of family members, and greater caretaker independence.

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health and Nutrition Examination Survey to study whether there was an association between SDB and AMD, including neovascular AMD and geographic atrophy in adults 40 years and older. Descriptive statistics and logistic regression analyses were used. The results suggest that AMD is associated with diagnosed sleep disorders, including sleep apnea and insomnia, as well as sleep apnea symptoms of gasping snoring, snorting, and stopping breathing. The findings of this study highlight the importance of diagnostic screening and therapeutic intervention to treat SDB. Early diagnosis and therapy for SDB could address not only the comorbidities associated with SDB, but could also prevent or slow the progression of AMD. In turn, this would yield lower rates of vision loss, reduced comorbidities associated with vision loss, and reduced impact of AMD on the health care system and social and financial costs to society.

Over the past 13 years, the United States Army has been engaged in armed conflict within Afghanistan. Unfortunately, the United States Army has been forced to evacuate soldiers from the battlefield because of malaria, a parasitic disease that is endemic in Afghanistan. Even though the U.S. Army has adopted an effective chemoprophylaxis protocol, soldiers' adherence to their prescribed medication has been historically low. This research addressed a gap in literature regarding the adherence rates of U.S. Army enlisted soldiers to their prescribed oral malaria chemoprophylaxis. In addition, this research investigated self-reported reasons for soldiers' nonadherence to this medication. The study employed an experimental, correlational research design to aid in understanding the relationship between adherence to malaria chemoprophylaxis and age, gender, military rank, education level, and previous deployment experience. Ninety-four active-duty U.S. Army personnel deployed to Afghanistan participated in the study. The frequency distribution of responses to the 8-questions Morisky Medication Adherence Scale were presented and indicated that for almost all of the questions, the percentage of participants who answered yes was larger than the percentage who answered no, indicating low levels of adherence among the study participants. The findings indicated that age, gender, and perception of risk all significantly contributed to the models predicting medication adherence. With the scientific and medical advances of the 20th and 21st centuries, few if any military personnel should contract malaria. These findings contribute to a greater awareness of medication adherence, which directly supports positive social change within the Armed Forces of the United States.

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which they describe how the experiences of educators and learners affect the way information is perceived, formed the conceptual framework for this study. An illustrative case study paradigm was used to identify the perceptions of licensed health care practitioners regarding the current adult teaching methods for modifying dietary carbohydrate and excess weight. Using a purposeful sample, data were collected in 2 phases with 5 licensed health care practitioners: Phase 1 entailed an open-ended electronic questionnaire and semistructured telephone interviews with open-ended questions during phase 2. Data were analyzed through coding and aggregation by NVivo and Tosmana software, respectively. The findings indicated that the American Diabetes Association (ADA) plate method was the most effective teaching model for controlling weight and carbohydrate intake. Consequently, the ADA plate method was used to create a professional development program to teach health care educators about nutrition instruction methods for adults. The study contributes to positive social change by enhancing preventive health measures for the local adult population through diet therapy education.

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by comparing data from Nigerian immigrant adults residing in the United States to data from the African American adults in the United States. Socio-cognitive theory and the social behavioral model served as the conceptual framework for this study. There were 291 adult Nigerian immigrants in the cross-sectional survey using a purposive sampling technique. The data were analyzed using the Levene's test for homogeneity of variances, the Pearson's Chi- Square test and the Kruskal-Wallis non-parametric test. The Kruskal-Wallis results showed that there was a significant difference in screening for preventive care services among the 4 immigrant status categories (p = .000) based on length of residency in the United States. Understanding the health disparities of this population according to their country of origin and immigration status will assist health providers with awareness of population-specific health needs, and may be beneficial in designing public health programs for this population group.

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the analysis were age, gender, and marital status. Findings yielded no statistically significant relationship between asthma status and tobacco smoking (p = 0.19, x2 = 1.74, OR = 0.59, 95% CI = 0.27-1.30), alcohol use (p = 0.92, x2 = 0.01, OR = 0.98, 95% CI = 0.61-1.58), health insurance (p = 0.63, x2 = 0.23, OR = 0.85, 95% CI = 0.44-1.65), income level (p = 0.99, x2 = 0.00, OR = 0.99, 95% CI = 0.44-2.24), or education level (p = 0.47, x2 = 0.52, OR = 1.51, 95% CI = 0.49-4.59). Although this study did not find significant associations between asthma and study variables, study limitations, mainly the small sample size, may have prevented the detection of small associations. Future research should involve a larger sample size to investigate whether the findings reported remain true. This study is a step in the exploration of the problem and has the potential to promote positive social change by increasing asthma awareness among foreign-born African Americans in California and among public health policy makers.

As a validation study, this study addressed an under-researched area of bronchopulmonary cancer mortality and incidence. The association between altitude and bronchopulmonary cancer mortality and incidence was investigated using data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research. The theoretical framework for my study was Bronfenbrenner's ecological model. This model emphasizes the relevance of social and physical environments that influence patterns of disease and injury and shape responses to these patterns of disease and injury. The age-adjusted bronchopulmonary cancer mortality and incidence rates per 100,000 people in the highest elevation and lowest elevation states were investigated. The data used in this study spans from 2006 to 2014. In this study, bivariate statistics were used to analyze the data. The relevant technique of performing an unpaired t-test was used. After performing age, gender, and race-stratified analysis, no significant difference in cancer mortality and incidence was found within the following three groups: Black or African American, Asian or Pacific Islander, and American Indian or Alaska Native. This was a new finding, as previous studies did not stratify for race. Cancer mortality and incidence were found to be lower in both the male and female groups for the highest elevation states. Cancer mortality and incidence were also found to be lower in all age categories for the highest elevation states. A positive social change impact of this study is that this research provides the groundwork for future studies to probe what in the environment is lowering the bronchopulmonary cancer mortality and incidence for the White population.

Abstract The purpose of this qualitative study was to examine domestic violence victims' perceptions of advocacy and counseling programs that provide women with safe refuge, prevention education, mental health treatment, and other services. Many women in the United States are victims of intimate partner violence. Review of existing literature found that little is known about the extent to which the needs of these victims are met from available advocacy and counseling services. The health belief model was used to theorize victims' perceptions of services and risk factors for re-abuse. A phenomenological design was used to answer research questions, and in-depth interviews were conducted with 8 women who stayed at a domestic violence shelter and used shelter services, such as advocacy, emergency shelter, and individual and family counseling. Data from the transcripts were inductively analyzed using NVivo 10.0 and hand coding techniques for emergent themes. The findings revealed that women were pleased with the services received, and most had no awareness of advocacy or counseling services until they sought shelter. Also, most agreed that counseling and advocacy services could help prevent re-abuse. Recommendations include establishing a google page for domestic violence shelters, which can provide information on available advocacy and counseling services and how they can assist victims of domestic violence. Study findings can promote positive social change by increasing awareness of advocacy and counseling programs and their importance to prevent re-abuse. This may also provide useful information for implementing new programs to help victims of domestic violence.