Type 2 diabetes mellitus (T2DM) is a disease that affects the body's ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief model. Participants selected for this study were at least 18 years of age, self-identified as AA, self-reported a family history of T2DM, and were not diagnosed with the disease themselves. Transcriptions of 20 face-to-face interviews were stored and organized via a qualitative research software NVivo Version 12 for Mac and later analyzed for data outcome. Participants demonstrated a strong awareness of T2DM with an accurate definition of T2DM and explanation of signs, symptoms, and prevention. Participants recognized family history as a risk factor in only 55% of the responses. However, family history played a major role in prevention in the lives of the participants. The participants reflected on personal barriers to health behavior changes and were encouraged to incorporate better life choices in their own lives. This research offers communities, healthcare providers, and stakeholders a better understanding of the importance of family history as a risk factor to T2DM as programs are developed to mitigate health disparities in the AA community.

This study examined the prevalence rate of obstructive sleep apnea (OSA) as an independent variable in association with hypertension as an outcome. Studies conducted outside of the United States suggest that differences in craniofacial features among middle-aged Asians increase the prevalence of OSA in comparison to Caucasians with similar age and lower BMI. No similar study had been conducted in the United States. The sufficient component cause theory guided this study and was able to describe the association between OSA and hypertension among middle-aged Asians. The objective of this cross sectional retrospective study was to determine the prevalence rate of OSA and the association between OSA and hypertension among a sample of 462 middle-aged Asian patients. Also, the study evaluated the association of 8 clinical parameters: age, gender, smoking, body mass index, Mallampati score, Epworth Sleepiness Scale and Apnea-Hypopnea-Index, and hypertension. The logistic regression analysis showed that OSA is associated with hypertension. The model containing the 8 variables was statistically significant, x2 (8, N = 462) = 139.59, p < .000). Age was the strongest predictor among the 8 variables. This study showed that OSA is common among middle-age Asians. This research may necessitate the need to evaluate to change current medical awareness, diagnosis, and treatment of OSA and hypertension among Asians, which could reduce the cardiovascular disease (CVD) morbidity and mortality.

Unsafe food handling practices are implicated in many restaurant-associated foodborne disease outbreaks. Factors that contribute to unsafe food handling in restaurants include inadequate food safety knowledge, employees who perceive that safe food handling is not under their control, and restaurant cultures that do not prioritize food safety. The purpose of this study was to determine whether temporary restaurant closures were associated with reduced food handling violations after closure in restaurants from the Vancouver Coastal Health Authority and the Fraser Health Authority, in British Columbia, Canada. The theoretical foundations used were the health action process approach and the theory of planned behavior. Mixed-effects Poisson regression analyses showed that the typical restaurant had an estimated 16% increase in the average number of overall food handling violations per inspection after temporary closure, compared with before closure. Restaurant- and employee-related factors responsible for unsafe food handling practices likely result in the continuation of unsafe food handling practices, despite temporary restaurant closures. This study may contribute to positive social change by challenging the assumption that temporary restaurant closures motivate food handlers to improve their food handling practices. To protect the public's health, additional interventions must follow temporary restaurant closures for reasons such as insanitary conditions and improper food handling. Suggested interventions include the provision of targeted learning resources to restaurant managers, the issuing of directives requiring food handlers to attend recognized food safety training courses, and environmental health managers requiring a reduction in problematic menu items.

Approximately 35.1% of live births for the state of Georgia were delivered by the cesarean delivery procedure with significant variation among hospitals. The purpose of this research was to develop a population-based hospital profiling methodology for study of the cesarean delivery procedure. This was a retrospective, observational design, using a 2012 linked dataset that included maternity deliveries from all nonfederal hospitals. The research was guided by Robson 10 Group Classification System, propensity score methodologies, and ethical precepts, for the development of hospital profiles and the study of variations in the cesarean delivery procedure. Key research questions aimed to determine whether hospital profiling methodologies differed according to risk adjustment methods and statistical techniques. Propensity score matching with stratification methods aimed to determine whether there were differences in patient treatment effects on the cesarean delivery outcome. Findings suggested there was a significant difference in hospital ranks and model effects according to the statistical technique and the risk adjustment methods applied. Propensity score matching with stratification demonstrated an increased risk of the cesarean delivery procedure across strata, with the majority of high risk patients situated in the 90th percentile ranges and questionable utilization practice among other strata. Applying profiling methodologies at the facility and population level could advance statewide quality improvement programs for the timely reduction in the variation of inappropriate utilization of the cesarean delivery procedure.

The health of the veteran population within the United States has become a matter of ever-increasing concern, and many individuals who have attained veteran status are experiencing health issues following their discharge from the military. Despite such concerns, there are often not enough resources available to assist these individuals to the degree necessary in an expedient manner. The purpose of this case study was to use social cognitive theory to understand the physical activity of veterans following their time in service. Through the use of social cognitive theory, this study explored the thoughts, perceptions, and behaviors of 11 veterans to determine how their physical fitness levels were affected following their time in the service. Data were collected by interview over the course of a 1-month period by visiting the U.S. Department of Veterans Affairs hospital a minimum of 3 days per week and a content analysis of interview transcripts led to the presented results. Results indicated that expectations of physical activity were realistic post service, and self-efficacy and self-control levels were high. Veterans indicated the beneficence of physical activity as a means of promoting overall wellbeing; however, paticipants also indicated dissatisfaction with the available options to them through the U.S. Department of Veterans Affairs. The results provided clear direction as to the steps that can be taken to work to increase the physical activity levels of veterans. Potential social change implications resulting from the study could lead to improvements in understanding of veteran health statuses.

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers to treatment adherence for this subgroup. This quantitative, cross-sectional study was guided by the epidemiologic triad model. A researcher-designed self-administered questionnaire including Part A of the Brief Medication Questionnaire was mailed to 4,335 U.S. microbiologist members of the American Society for Clinical Pathology. From the 1,628 eligible respondents, results showed that prevalence of positive TSTs (17.0%) and treatment noninitiation (9.8%) was low. Multivariate analysis identified BCG and foreign birth, as well as age, nonoccupational exposure, history of TB, work in mycobacteriology, and work outside of microbiology as predictors of a positive TST; foreign birth was a predictor of treatment noninitiation. Additional research is needed to identify other laboratorian groups at increased risk for developing TB. These results enhance positive social change by helping to inform recommendations in the global fight to stop the spread of TB, as well as improve allocation of resources among this specific group of HCP.

Maintaining due diligence on safety practices at the workplace of battery technicians is the most cost-effective intervention against lead-related hazards. The safety practice on lead poisoning in Nigeria is below average, and the compliance level is far from the expected target of 90%. Using Dejoy's workplace self-protective behavior theory, this study investigated multilevel factors that influence safety practices on lead poisoning and compared the rate of utilization of personal protective equipment by battery technicians in the organized and roadside settings. The study was a quantitative, cross-sectional survey design, and a multistage and systematic sampling technique was used to select 293 adult battery technicians aged 18 years and above. Hypotheses were tested with chi-square and multivariate logistic regressions at the significant level of p < 0.05 and 95% confidence interval. The outcome of the safety practice status of battery technicians is 20%, and the rate of utilization of personal protective equipment is 18% in Lagos, Nigeria. Findings revealed that workplace conditions, blood lead levels, knowledge, education, and the rate of utilization of personal protective equipment are predictors of the safety practice status of battery technicians. There was no significant difference between battery technicians in the organized and roadside setting considering the perceived risk of lead poisoning and utilization of personal protective equipment. The positive social change implications of this study include recommendations for battery technicians to use the evolved alternative safety approaches to reduce lead-related hazards. Public health professional and policymakers should invest resources towards reducing the impact of lead poisoning on battery technicians at the workplace.

Osteoporosis is a serious disease which often brings pain, disability, hospitalization, and even death. An increasing number of studies have been conducted on the prevention and treatment of osteoporosis in White women, yet a paucity of research exists to explain disparities in screening and treatment of osteoporosis in Black women. This narrative study describes the perspectives of Black women regarding individual barriers to osteoporosis screening. The purpose of this study was to better understand the perspectives of Black women regarding prevention of and screening for osteoporosis. Selections included purposive, criterion sampling of 10 Black women who were 50 years and older, could speak and write English, and lived in Southeastern Virginia. Recruitment flyers were distributed to Black women who were members of 3 local churches. The conceptual framework for this study was the behavioral model of health services, which holds that individual's acceptance to use health service is partly controlled by that individual's predisposing, enablement, and need. Data were collected by in-depth face-to-face interviews and analyzed using open, axial, and selective coding. Four major themes emerged in this study including awareness of osteoporosis, knowledge of the screening, health beliefs, and sharing of information. While the narratives indicated positive effects from engaging in osteoporosis screening, there was a discrepancy in understanding the disease and explanations of screening results. This study addresses social change by identifying how awareness and knowledge may help Black women become more effective when they engage in osteoporosis screening, which can help to ensure health and a better quality of life.

Failure of emergency response personnel to communicate effectively with different cultures can have dire consequences during an emergency, including loss of lives and litigation costs. For emergency response personnel to communicate the risk of an emergency, it is important to understand how different groups, especially newly arrived foreign immigrants, perceive warnings and related messages. This study addressed how one of the largest category of immigrants in Michigan perceived severe tornados, influenza pandemics, power outages, severe floods, and snowstorms. The research question examined the degree to which the equation, Risk = Hazard + Outrage, explained perceptions of these hazards in Michigan among newly arrived Iraqi immigrants. A concurrent mixed-method design was used. In-person interviews were conducted using quantitative and qualitative questions based on the equation and the PEN 3 model with 84 immigrants from Iraq who lived in the United States 4 years or less. Respondents' levels of outrage and hazard were compared using ANOVA. The calculated levels were compared with the qualitative comments made during the interviews. Snowstorms measured the highest outrage, and power outages measured the least. The reported awareness level was lowest for snowstorms with the highest being power outages. More information needs to reach Iraqi immigrants regarding unfamiliar hazards. Communicators should use Iraqi immigrants' experience with familiar hazards to identify effective ways of responding to this population. The results of this study may promote social change of more effective communication and saving lives in the future should an emergency occur in Michigan that affects Iraqi immigrants.

Many people in the United States suffer from substance dependence, which leads to depression, anxiety, work impairment, difficulties in interpersonal relationships, crime, and health care problems. Mindfulness meditation has been applied in many aspects of mental health treatment and all belief systems. The purpose of this phenomenological study was to explore substance dependents' experiences related to their mindfulness meditation practice of at least 6 months and up to 3 years. A constructivist conceptual framework, which states that human beings create systems for understanding reality based on their individual beliefs, emotions, and interpretations, was used for this study. Research questions focused on 4 themes: (a) substance dependents' experiences of cravings, (b) their experiences of emotional states or feelings, (c) their experiences of their behavioral actions, and (d) their explanations about the effectiveness of mindfulness techniques. Data were collected from in-depth interviews with 12 volunteer participants from a public meditation center in Baton Rouge, Louisiana, and they were analyzed using Moustakas' transcendental phenomenology framework. According to study results, positive social change may occur through increased understanding of varied emotional and behavioral states experienced by substance dependents as they strive for sobriety using mindfulness meditation techniques.