STDs are a major public health epidemic in the United States with an estimated 19 million new cases occurring annually. Associated direct medical costs are estimated at $17 billion annually (CDC, 2010). Chlamydia is the most prevalent of all STDs and is also the most reported notifiable disease in the United States. While adolescents only account for an estimated 25% of the sexually active population, they account for nearly half of the 19 million cases. The higher prevalence of STDs among adolescents is most likely a reflection of multiple issues within a national socio-economic context. Additionally, the burden is even more disproportionate when examined by race. African American adolescents aged 15-19 experience the greatest burden of STDs. The purpose of this study is to examine proportions of risk behaviors reported among groups and the differences that are found. From the estimation of differences that were determined substantial, an analysis of was conducted in order to determine if adolescents in the study population exhibit clustering in regard to risk behaviors for STD acquisition and describe the where the potential clustering occurs as well as identify which factors that may serve as important indicators for STD positivity among this population. This paper examines data that was collected as part of a National Institute of Health grant-funded project entitled: “Behavioral Clustering in Adolescents with STDs”, conducted by Dr. Richard Rothenberg, Principal Investigator. This paper presents descriptive statistics for selected behavioral characteristics for four groups from the original study and each group’s contacts. The proportions for each characteristic are also analyzed for to see if behavioral clustering occurs within and between groups. The scope of this paper does not allow for the statement of conclusive results however, substantial differences did exist for variables among each sub group. Comparing data by group cluster and interview type proved to reveal the most about the study population. Negative males and their contacts may have extensive clustering as this group was only found to have substantial differences for two variables. Comparison of the positive and negative ego groups for both males and females also indicated clustering as only two (ego females) and three (ego males) variables were found to be substantially different. Proportions for variables regarding education, incarceration, sexual initiation, and number of partners were compared between several groupings of the study population. This paper recommends further analysis of the data in order to identify the patterns of assortativity which will be valuable in understanding the STD transmission dynamics among the social and sexual networks of the adolescents in the study population as well as have important implications on future research.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2002. / Includes bibliographical references.

<p> Antenatal care is a proven integral component in helping reduce maternal mortality rates around the world. Women who reside in the poor, rural regions of developing countries such as India are at an increased risk for not utilizing these services due to living in resource-poor regions, lacking financial support and being influenced by social normative mechanisms. The purpose of this study was to explore and understand the role culture and social factors play in influencing the use of clinical services and taking part in traditional customs. Key constructs from the Theory of Normative Social Behavior were used to inform the theoretical framework for this study to help in understanding the role social norms play in affecting behavior. Semi-structured interviews were conducted among new mothers and their mothers/mother-in-laws/grandmothers in the southwestern region of Karnataka, India. All of the women who took part in this study resided in rural, tribal colonies and were part of the Schedule Caste/Schedule Tribe category. The participants reported that their main understanding of care for a woman during the pregnancy time period was through food consumption. They also reported the strong presence of injunctive norms influencing behaviors during the pregnancy time period than descriptive norms. This study uncovered several important cultural and social components that impact care for pregnant women. Future studies and public health efforts should, 1) focus on understanding social and generational changes and their influence on health seeking behaviors, 2) examine how an exposure to modern technology affects behavior and, 3) explore how standardization of health education may influence women&rsquo;s understanding of care during the pregnancy time period.</p>

The increasing prevalence of childhood obesity and physical inactivity continues to threaten the health of our nation's youth. Schools provide the opportunity for children to accumulate physical activity and can become proactive in promoting healthy behavior. This study features the practices of three public elementary schools in San Diego County that are implementing quality physical education and other types of physical activity programs to improve the wellbeing of their student population. Elementary schools were purposefully selected and observed over the school year. Direct observation tools were used to measure physical activity levels and semi-structured interviews were conducted with school administrators, teachers, and community members. Documentation along with photographs related to the school environment and physical activity programs were collected as supportive records. Key themes emerged after data were transcribed, coded, and analyzed for patterns and themes. Five common themes emerged: 1) Having administrators and educators who valued physical education and physical activity and were leaders and champions for student wellness; 2) Having involved parents and established community partnerships to support and sustain programs through monetary contributions, donations, and volunteer time; 3) Implementing programs which promoted cooperation and personal responsibility; 4) Offering physical education instruction that actively engaged students; 5) Having levels of moderate to vigorous physical activity that varied among grade levels and gender. Public health and education must share the responsibility for teaching students and family's important techniques for adopting and maintaining healthy practices. The findings from this study have implications for educators and administrators trying to increase opportunities for physical education and physical activity with limited resources and competing academic priorities. The collective practices of the three elementary schools will inform school administrators, enhance teaching strategies, and influence physical activity policies and practices among individuals seeking to advance student wellness.

This study used secondary data collected in 2006 to assess the prevalence and severity of three common soil-transmitted helminths in schoolchildren in rural, mountainous, eastern Haiti, and using a case-control design looked at age and gender as independent risk factors, and at anemia and growth failure as potential outcomes of infection. The primary aim was to determine if prevalence and severity were high enough to meet World Health Organization (WHO) population-based deworming criteria. Results do support mass deworming, but overall, indicate no correlation between the other independent variables or outcome measures with presence of disease. A secondary data set from the coastal town of Leogane, Haiti was used as a comparison population where a similar study was performed in 1996. Based on findings, recommendations will be made to Haitian health authorities.

Considerable evidence exists that little cigars and cigarillos are popular among young adults and that the prevalence is higher among African American young adults.1,2,4 Two brands of little cigars appear most appealing to young smokers - Swisher Sweets and Black and Mild.2,3 This cigar product have been designed by the tobacco industry to appeal specifically for African Americans. In a survey of tobacco use among freshman at a historically black university, there were high rates of little cigar use.4 Little cigar sales have also benefited from the high visibility offered by many celebrities quoted and photographed with cigars, and the success of Cigar Aficionado and Smoke magazine.5 Perceptions include that smoking little cigars is less addictive and less harmful than smoking cigarettes, and these perceptions may be enforced by students rationalizing that because they smoke fewer cigars than cigarettes, there is less exposure to toxic chemicals. Other perceptions uncovered include that little cigars are less harmful than cigarettes because little cigars are not addressed in antismoking messages.4 A collaboration between Georgia State University Institute of Public Health, Southside Medical Center Accountable Communities Health Together, and the American Legacy Foundation has produced an effort to reduce little cigar and cigarillo use in the NPU-V. The program is known as the Little Cigar Prevention Initiative (LCPI). The primary objective of the collaboration is to engage the community into focus groups, forums, and action teams to: 1) Understand perceptions and use patterns of little cigars/cigarillos among African American young adults and youth 2) Educate the community about dangers of little cigars/cigarillos 3) Understand marketing mechanisms influencing use of little cigars/cigarillos 4) engage NPU-V neighborhoods for action to address marketing, use, and sale of little cigars/cigarillos towards young African Americans 5) Understand important implications for prevention and health promotion in this underserved community. The first objective of this capstone is to examine the effectiveness of several tobacco control policies in curbing smoking among young people. The second objective of this capstone is to provide information on how communities can increase awareness of key little cigar issues using current tobacco practices in communities. The third objective of this capstone is to provide information how to engage the community in the policy process by providing current successful policies and communities that have enacted policy. Lastly, the final objective is to identify ways to promote cessation efforts. This capstone will serve as a guide for community action in regards to little cigar/cigarillo prevention in the NPU-V. This capstone will produce two products. The first product will be a paper that will cover topics of youth tobacco use, little cigar and cigarillo use, the current state and nature of prevention activities, and recommendations. The second product will be a policy brief to inform the community on the urgency of little cigar/cigarillo prevention and the need to adopt a plan of action. 1. Maxwell JC. . (2009) The Maxwell Report: Year End & Fourth Quarter 2008 Sales Estimates for the Cigarette IndustryRichmond, VA. 2. Soldz S, Huyser DJ, Dorsey E. (2003) Youth preferences for cigar brands: rates of use and characteristics of users. Tobacco Control;12(2):155-60. 3. U.S. Department of Health and Human Services. (1999)Youth use of cigars: patterns of use and perceptions of risk. Washington (DC): Department of Health and Human Services, Office of Inspector General. Available at: http://oig.hhs.gov/oei/reports/oei-06-98-00030.pdf. 4. Jolly D.H. (2008) Exploring the use of little cigars by students at a historically black university. Prev Chronic Disease 2008;5(3). Available: http://www.cdc.gov/pcd/issues/2008/jul/07_0157.htm. 5. Delnevo C.D., & M. Hrywna. (2007). A Whole ‘Nother Smoke or a Cigarette in Disguise: How R Reynolds Reframed the Image of Little Cigars. American Journal of Public Health. 97, 1368-1375.

Diabetes Guidelines Implementation Toolkit is a capstone project aimed to help the Grady North Fulton Health Center to implement the American Diabetes Association (ADA) “Standards in Medical Care in Diabetes, 2011” guidelines. This toolkit can also be used to implement the diabetes guidelines in any other primary or community healthcare facility to improve diabetes care. Diabetes can affect many parts of the body and can lead to serious complications such as blindness, kidney damage, and lower-limb amputations. Working together, people with diabetes, their support network, and their health care providers can reduce the occurrence of these and other diabetes complications by controlling the levels of blood glucose, blood pressure, blood lipids, and by receiving other preventive care practices in a timely manner. Once the decision to put into practice the evidence-based diabetes guidelines has been made, this implementation toolkit will serve as a guide to help go through the process of implementation. The toolkit will suggest practical ways to implement the use of the guidelines using a stepwise approach, resources and template materials such as information handouts, flow sheets, referral forms, sample patient letters, etc. will be provided in the toolkit to facilitate the implementation. The final goal of the implementations is to improve the delivery of effective preventive health care services and promote diabetes preventive behaviors in order to prevent diabetes, its complications and disabilities, and the burden associated with the disease.

STDs are a major public health epidemic in the United States with an estimated 19 million new cases occurring annually. Associated direct medical costs are estimated at $17 billion annually (CDC, 2010). Chlamydia is the most prevalent of all STDs and is also the most reported notifiable disease in the United States. While adolescents only account for an estimated 25% of the sexually active population, they account for nearly half of the 19 million cases. The higher prevalence of STDs among adolescents is most likely a reflection of multiple issues within a national socio-economic context. Additionally, the burden is even more disproportionate when examined by race. African American adolescents aged 15-19 experience the greatest burden of STDs. The purpose of this study is to examine proportions of risk behaviors reported among groups and the differences that are found. From the estimation of differences that were determined substantial, an analysis of was conducted in order to determine if adolescents in the study population exhibit clustering in regard to risk behaviors for STD acquisition and describe the where the potential clustering occurs as well as identify which factors that may serve as important indicators for STD positivity among this population. This paper examines data that was collected as part of a National Institute of Health grant-funded project entitled: “Behavioral Clustering in Adolescents with STDs”, conducted by Dr. Richard Rothenberg, Principal Investigator. This paper presents descriptive statistics for selected behavioral characteristics for four groups from the original study and each group’s contacts. The proportions for each characteristic are also analyzed for to see if behavioral clustering occurs within and between groups. The scope of this paper does not allow for the statement of conclusive results however, substantial differences did exist for variables among each sub group. Comparing data by group cluster and interview type proved to reveal the most about the study population. Negative males and their contacts may have extensive clustering as this group was only found to have substantial differences for two variables. Comparison of the positive and negative ego groups for both males and females also indicated clustering as only two (ego females) and three (ego males) variables were found to be substantially different. Proportions for variables regarding education, incarceration, sexual initiation, and number of partners were compared between several groupings of the study population. This paper recommends further analysis of the data in order to identify the patterns of assortativity which will be valuable in understanding the STD transmission dynamics among the social and sexual networks of the adolescents in the study population as well as have important implications on future research.

Thesis (M.P.H.)--University of Michigan, 1945.

Thesis (Ed. D.)--Teachers College, Columbia University, 1962. / Typescript; issued also on microfilm. A type A project. Sponsor: Herbert Walker. Dissertation Committee: James L. Malfetti, Elizabeth C. Stobo. Includes bibliographical references (leaves 247-252).