The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. A combination of the Orem's Theory of self-care and the Bandura's social cognitive theory (SCT) guided this study. The sample included 96 diabetic Hispanic Americans aged 18 and older residing in Fairfax County, VA. Multiple linear regression analysis showed a statistically significant relationship between diabetes knowledge, education level, health literacy, self-efficacy, and self-reported diabetes self-care behaviors. The score of the self-reported diabetes self-care behaviors was related at statistically significant levels to the score of diabetes knowledge (rs = 0.5230, p = 0.00), to the score of education level (rs = 0.2831, p = 0.01), to the score of health literacy level (rs = 0.6332, p = 0.00), and to the score of self-efficacy (rs = 0.7783, p = 0.00). The results of this research study could contribute to positive social change by providing the public health workforce in Fairfax County, VA with insights for developing culturally sensitive education programs that best fit the needs of Hispanics and fight against Type 2 diabetes.

Preventive health care is effective in reducing both infectious diseases and chronic conditions among the elderly. Despite efforts to prevent or decrease the risk of illness, unmarried men are less likely to receive selected preventive services compared to married men. The purpose of this cross-sectional survey was to describe disease prevention attitudes and behaviors of retired, unmarried, male baby boomers residing in Harlingen, Texas. Further, the study examined the effects of socioeconomic status on disease prevention attitudes and behaviors. The health belief theory framed the study. A validated questionnaire collected disease prevention attitudes, behaviors, and sociodemographic characteristics data. Data inquiry included ANOVA, multiple regression and moderation analysis. The findings did not show any differences in disease prevention attitudes and behaviors among retired, unmarried male boomers. Multiple linear regression indicated that the socioeconomic factors explained 24% of the variance in disease prevention behaviors (p = .001). Moderation analysis showed that 29% of the variability in the dependent variable could be explained by the independent variables and interaction terms. The only significant predictor was education, p= .002); none of the interaction terms were significant. Positive social change from the study is the possible increase in disease prevention behavior among the retired, unmarried male baby with a low level of education. The study results may help in developing policies that would target education barriers and raise awareness of disease prevention behavior among the retired, unmarried male baby boomers.

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial classes, (b) increased scheduling of 1:1 classes, (c) education of more staff to meet patients' needs, (d) automatic phone call reminders to patients, (e) increased mailing of appointments to absent patients, (f) promoting DSME classes at physicians' meetings, (g) having clinic nurses schedule the patient's first classes at the time of physician visit (h) alteration of class times to compliment patient schedules, and (i) scheduling classes around public transportation schedules. Although there were no pre- and post-attendance data provided by the facility, recommendations of the DSME project team were to continue tracking weekly patient attendance and maintain the current recommendations for increasing enrollment. This project might contribute to positive social change for patients, their families, clinic employees, and the community by improving the health and self-management of the diabetic patients.

Latinos of low socioeconomic status are disproportionately affected by diabetes Type II complicated by poor adherence to diabetes Type II medications and management programs. Self-management of diabetes Type II is a tool used to teach health education to patients with diabetes. The objective of this retrospective quantitative study was to explore if there are predictors of nonadherence to diabetes Type II medications and programs among Latinos with diabetes Type II. Data from 200 patient records from a community clinic in Fresno County California were analyzed using both bivariate and multivariate analysis. Selected sociodemographic independent variables were age, gender, income, migrant worker status, family size, and having received health education. The dependent variable was adherence to medication and management programs. Gender and health education were the only strong predictors of nonadherence to diabetes Type II medications and programs among the study sample in the bivariate analysis. The combination of gender and health education was the only strong predictor to diabetes Type II medications and programs in the multivariate analysis. Recommendations include personalized health education that incorporates a protocol for teaching patients about diet, consumption of alcoholic beverages, exercise, medication, and the effects these behaviors have on diabetes prevention and management. The implications for positive change include decreasing complications, improving quality of life, and improving patient satisfaction. The implications also include decreasing health care cost for stakeholders, including patients, and insurance payers.

Full (complete) childhood immunization against tuberculosis, poliomyelitis, diphtheria, tetanus, hepatitis B, yellow fever, measles, and the maternal retention of immunization documentation are the most cost-effective interventions against vaccine-preventable childhood diseases. The full childhood immunization rate in Nigeria has not reached the expected target level of compliance at 90%. Using the social ecological model, this study investigated the influence of maternal satisfaction with postnatal services and paternal support on full childhood immunization status; it also examined the association between maternal factors and the maternal retention of immunization documentation in Owerri, Nigeria. The hypotheses were that maternal satisfaction with postnatal services and paternal support were associated with full childhood immunization status. This study was a quantitative, cross-sectional survey design that included validated modified WHO/EPI-30 cluster immunization survey information from the cluster sample of 560 mothers of children between the ages of 12 and 23 months old. The multivariate logistic regression analysis (at the .05 level) indicated that the odds of full childhood immunization status were lower for participants who indicated no maternal satisfaction with postnatal services compared with those who indicated satisfaction with postnatal services. Public health workers and policymakers should invest more resources in maternal and child health care resources to increase maternal satisfaction with postnatal services. The study outcomes may help to evolve a system that may increase childhood immunization status and reduce vaccine-preventable diseases in Owerri, and serve as a model for other countries.

Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose prevalence has been rising dramatically among men who have sex with men (MSM) in the United States since 2008. The HPV infection rate for MSM is rising even faster for MSM who are infected with the human immunodeficiency virus (HIV) and for those who have developed acquired immune deficiency syndrome (AIDS). It is not clear whether MSM in general and MSM with HIV have the knowledge necessary to prevent infection of themselves and their partners. This phenomenological study explored the knowledge, health perceptions, attitudes, and norms of the community of MSM and HIV-positive MSM relative to HPV, using private, semi-structured, detailed interviews with 37 HIV-positive MSM between 18 and 26 years of age; interviews were conducted at 3 outpatient clinics and 2 private medical practices. Interview transcripts were analyzed; these findings revealed that the study population of HIV-positive MSM had a basic understanding of HPV but knew little about the transmission of HPV or about the availability and cost of HPV vaccines. This study promotes positive social change by identifying specific opportunities to improve health education policy and programs targeting HIV-positive MSM. It also supports primary prevention efforts that have the potential to be life-saving. Through educating MSMs, the potential exists to reach more MSMs with primary prevention life-saving efforts. Study recommendations include developing inclusive education programs addressing different aspects of, and behavioral approaches to, the reduction of HPV infection risk; further exploration of a cost-benefit analysis of the HPV vaccine; and support for policy change regarding insurance coverage for male HPV vaccine in the United States.

Low immunization in Nigeria is associated with high prevalence of childhood diseases. The purpose of this qualitative phenomenological study was to describe caregivers' perceptions of routine immunization of their children ages 24 to 36 months. Caregivers' attitudes, cultural beliefs, and knowledge regarding immunization were examined. The health belief model was used to guide study. Interviews were conducted with 5 caregivers of fully immunized and 5 caregivers of partially and nonimmunized children. Digital recordings were analyzed using NVivo 10 to identify themes and subthemes. Attitudes of caregivers with fully immunized children included both perceived barriers (distance to health center, lack of information) and perceived benefits (vaccine safety and effectiveness), whereas caregivers with incomplete vaccinations reported multiple transportation-related barriers. Cultural beliefs were limited to religious beliefs and emerged as a theme among both caregiver groups, where full vaccination associated with Christian beliefs and lack of vaccination with belief in traditional healers. Caregivers' knowledge associated with full vaccination included cues to action (information from nurses and reminders by others) and self-efficacy (kept vaccination cards ready and prepared for vaccination day), and incomplete vaccination associated with lack of reminders and preparation. Perceived severity, susceptibility, and benefits were associated with full vaccination status, while lack of perceived severity, susceptibility, cues to action, and self-efficacy constituted barriers to vaccination. Social change implications include education on disease severity, susceptibility, and vaccination safety, and expanding transportation, access to vaccination centers, and religious outreach programs to increase immunization of Nigerian children.

The incidence of venous and arterial thromboembolic events (VTEs/ATEs) varies greatly by cancer type and age, with increased risk in the elderly. Very little research has been reported specific to elderly kidney cancer patients. Retrospective cohort analyses of Medicare patients, 11,463 with and 11,463 without kidney cancer, between 2003 and 2010 were conducted to compare incidence rates of VTEs/ATEs in cancer patients with matched noncancer patients and to assess independent risk factors for VTEs in cancer patients. The advanced epidemiology triangle was the theoretical framework used to interpret the association between incident events and other factors. Using Cox proportional hazard regression, the first 2 research questions examined whether the incidence rates of VTEs/ATEs were higher in kidney cancer patients than noncancer patients; the third research question assessed which factors were associated with VTEs after kidney cancer diagnosis. In the year prior to index date, cancer patients had higher incidence rates of VTEs than noncancer patients; the incidence rate of myocardial infarction was higher in cancer patients than noncancer patients for patients with a history of cardiovascular disease. Elderly kidney cancer patients with transitional cell tumors had lower rates of pulmonary embolism and ischemic stroke compared to patients with clear cell tumors. Recent history of VTE and Charlson comorbidity score were strong predictors of VTE after cancer diagnosis. These results can lead to positive social change by helping healthcare providers to determine who may benefit from closer observation or prophylaxis to prevent or minimize morbidity from these thromboembolic events, thus improving health and quality of life for elderly kidney cancer patients.

Childhood obesity is a growing challenge in the U.S. Hispanic American population. There is a need for evidence-based approaches to combat this problem. Social Cognitive Theory (SCT) is one such approach. The purpose of this study was to examine the extent to which selected constructs of SCT (expectations, self-efficacy, self-efficacy in overcoming barriers and self-control) could predict five childhood obesity prevention behaviors, namely time spent on television watching, time spent on physical activities, water consumption, consumption of fruits and vegetables, and meal portion size among Hispanic American children. A quantitative cross-sectional research design was employed for this study. Data were collected from a sample of 235 Hispanic American children between the ages of 11 and 15 years, using a cluster sampling method. A reliable survey instrument used for data collection in this study Promoting Healthy Lifestyle Survey, was developed and validated by Sharma, Wagner, and Wilkerson (2014) from three community churches in three different Georgia counties. Multiple regression analyses were used to determine the predictability of the independent variables, which were the constructs of SCT, and the dependent variables, which were the five behaviors. Significant SCT predictor of television-watching behavior was expectations (p = 0.004; adjusted R2 = 0.08). The statistically significant physical activity SCT predictor was self-efficacy (p < 0.001, adjusted R2 = 0.24). It is envisaged that the results of the study will assist public health education practitioners in developing concerted interventions among Hispanic American children and families designed to reduce childhood obesity facilitating a positive social change.

Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a sample of West African immigrants (N = 339) in the Dallas-Fort Worth Metroplex of Texas, using a demographic data/screening sheet, the Perceived Stress Scale and the Personal Financial Wellness Scale. Multivariate logistic regression analysis was used to determine the effect and degree of association between the dependent variable (DV), Hypertension, and the Independent Variables (IV), SERFFO, Perceived Stress, Age, Gender, Family HTN Status. Results indicated an association of SERFFO and Perceived Stress on the increased likelihood of HTN among Foreign Born African Americans in the United States of America. Family HTN Status recorded a greater likelihood of HTN. The results of this study will contribute to positive social change by leading public health agencies to target FBAA populations with HTN control programs.