Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to manage their disease. The Diabetes Self-Management Questionnaire measured patient understanding and self-care management of diabetes before and after the education intervention, and the Diabetes Self-Efficacy Scale measured the self-efficacy of the patients before and after the intervention. Paired sample t tests were calculated to compare the pretest to posttest scores on the full questionnaire and subscales. The full scale and the glucose monitoring control and physical activity subscales showed statistically significant improvement pretest to posttest. An increase in the pretest to posttest Diabetes Self-Efficacy Scale scores was not significant. Results indicated that the diabetes education was an effective way to improve self-reported daily blood glucose monitoring and physical activity. The project may result in positive social change from the better self-management of some diabetes control skills among Hispanic adult patients when education is delivered in Spanish.

As of 2010, there are approximately twenty one surface water locations classified as impaired for Escherichia coli (E. coli) contamination in the State of Arizona. Of note is the San Francisco River (SFR) which is currently listed on the US EPA 303d list of impaired waters due to E. coli bacteria present at higher concentrations than the US EPA standards for partial- and full-body contact. In 2010-2011 surface water samples were collected at sites within the impaired region to monitor E. coli and areas known for heavy recreational uses. Of 70 samples collected over 1 year, 81% were positive for universal Bacteroides marker (Allbac). Of the 57 Allbac-positive samples, 68% show contributions of the human-specific marker and 60% were positive for bovine-specific marker. While 28% of the total samples assayed showed elevated levels of E. coli (>235 MPN/100mL), there were minimal significant correlations between Bacteroides and generic E. coli across all samples. While this information is significant, past research has suggested that successfully distinguishing the sources of fecal contamination will not alone reduce or eliminate disease associated with contaminated water unless these investigations are coupled with public outreach and education. With this in mind a survey was developed to gather information about water quality perceptions, water use, peoples' attitudes, knowledge, and behaviors related to the water resources in Clifton, AZ. Survey questions consisted of multiple choice and Likert scales questions and were provided in both English and Spanish and were conducted during the summer of 2012 and winter of 2013. A total of 150 surveys were deployed with 38 surveys completed for a response rate of 25%. Our study findings indicate mixed attitudes on water quality with 80% reporting the SFR has poor water quality for drinking and 39% agree the SFR has poor water quality for swimming. Yet, 84% consider the river safe enough for picnics and activities near the water. Also, it was interesting to note participants' opinions regarding consequences of poor water quality with 66% of respondents indicating that they are concerned with poor water quality and their health. Clifton is a very tight knit community so it was not unexpected that the majority of the respondents (61%) get water quality information by having conversations with other people and 68% from newspapers, factsheets and brochures. Based on the survey responses, our team worked to develop two peer reviewed Extension publications entitled; Microbial Source Tracking: Watershed Characterization and Source Identification (Arizona Cooperative Extension, #AZ1547) and Water Quality, E. coli, and Your Health (#AZ1624). Publications have been developed in both English and Spanish and will be part of future outreach to this and other Arizona communities. It is our goal that these survey findings can be used to better tailor outputs appropriate for the targeted audience, namely the local Hispanic population. These results are important because they add to understanding perceptions of water quality and health risks in this rural community; and can lend towards enhanced outreach practices in other similar communities.

No description available.

Low or marginal health literacy affect nearly 90 million citizens in the United States, compromising health outcomes, including oral health. Oral health literacy has been studied in diverse populations, yet the assessments used were developed and validated for English-speaking populations. A validated Spanish-language oral health literacy assessment was needed to help researchers and practitioners evaluate oral health literacy in the Hispanic population. Using the oral health literacy framework, the purpose of this study was to translate, culturally adapt, and validate a Spanish version of a previously validated English-language oral health literacy. A translation-back-translation process was applied to the English version of the REALD-30. Face and content validity were established using a panel of dental and health literacy experts. The Spanish version was field tested among Spanish-speaking community health center patients (N=114), and included a random subsample (N=11) to check for test-retest reliability. The results showed that the Spanish REALD-30 has a good internal reliability (=r=.687) and an acceptable convergent reliability (r =.857), when assessing health literacy against the SAHLSA-50. This study's implications for positive social change include providing the dental profession and research community with an assessment tool for oral health literacy. This tool may allow oral health professionals to understand the dynamics and challenges among Hispanics regarding oral health literacy, while the study fills an existing gap in scholarly literature.

Primary-care-related emergency department (PCR-ED) visits by Hispanic patients enrolled in a not-for-profit Medi-Cal and Medicare health plan resulted in longer wait times in the emergency department (ED) at a regional medical center in Southern California. This congestion decreased access for those with true emergencies, created capacity issues, increased ED length of stay, and resulted in potential safety risks. This project focused on decreasing PCR-ED visits in the Hispanic population using patient navigators in Southern California. Applying the health belief model and Lippitt's theory of change, this doctoral project involved the creation and implementation of a culturally appropriate, population-specific patient navigator model for the Hispanic population. Evaluation of outcomes was accomplished using electronic health record (EHR) results, which demonstrated a reduction of PCR-ED visits and revisits. The project exceeded the goal of 10% reduction in PCR-ED visits and revisits in the target population and resulted in a 14.31% reduction of PCR-ED visits and revisits within 1 month of implementation. Emergency Severity Index levels, wait time associated with each Emergency Severity Index level, and visits of the targeted Hispanic population enrolled in the health plan were analyzed to evaluate the success of the program. This project may lead to improvements in nursing practice and positive social change by supporting population health management and continuum of care to a primary care physician through safe and efficient patient navigation to treatment and care.

This study examines the similarities and differences between males and females from the Hispanic and Non-Hispanic White population in the Central Florida labor force regarding recruitment strategies and techniques of the Baby Boomers, Generation X and the Millennial population. The purpose of this study is to identify those Human Resources recruitment practices that are most effective in retaining: (1) males and females from the Hispanic population, and (2) whether or not theses recruitment tactics affect the generation groups differently. The proposed issues will be assessed by collecting information from organizations, current employees, and job applicants. This study will use three research methods in addressing the stated purpose and objectives: literature review, focus groups, and questionnaire surveys. The literature review will explore present recruitment techniques, social and cultural similarities and differences between Hispanics and Non-Hispanic White, and generational differences. The main goal of the focus groups is to identify relevant recruitment issues as stated by Central Florida organizations, current employees, and job applicants. From the literature review and results of the focus groups two surveys will be develop to determine: (1) present recruitment practices used by Central Florida organizations; and (2) preferred recruitment practices among Hispanics and Non-Hispanic Whites. The results of this study will identify whether certain recruitment practices perceived as being most appealing and desirable vary among Hispanics and Non-Hispanic Whites. Based on the findings, the study will provide recommendations for designing effective recruitment strategies for Hispanic and Non-Hispanic White males and females while accounting for possible generational differences.

This thesis deals with differences between individual states of the United States from the demographic point of view, and searches for causes of these differences. United States are composed of several disparate areas, which are different from each other in their location, size, number and composition of the population, and historical evolution. All this affects the demographic characteristics of those territorial units. Probably the main cause of differentiation of individual states is racial composition, since the intensity of demographic events is specific to each race or ethnicity. The states differ in levels of fertility, mortality, marriage or education. To confirm these assumptions, the statistical method canonical correlation was used. Using cluster analysis has revealed that there are groups of states that have similar demographic profile. Most notably, it shows the influence of ethnic and racial composition in the south of the United States, where the highest proportion of populations is composed by black race and hispanic origin. The differentiation of levels of infant mortality and life expectancy are mainly influenced. Key words: United States of America, race, ethnicity, black population, hispanic population, total fertility rate, life expectancy, canonical correlation, cluster analysis