The current epidemic of overweight and obesity has been partly credited to a growing trend for snacking and sedentary work behaviors. The purpose of this quantitative, cross-sectional survey was to investigate whether the difference between snack food reinforcement during work and non-work hours and work food motives predicted BMI among U. S. office workers. This study was based on the theoretical framework of the individual differences theory, in the context of the behavioral choice theory and reinforcement theory. The independent variables were food reinforcement and food motives; the dependent variable was BMI. Descriptive, correlational, and exploratory analyses were used. The survey was administered to a sample of 100 adult male and female office workers using SurveyMonkey. The results of the study determined that there was a statistically significant difference in food reinforcement during work hours versus non-work hours; however, only change in intensity was a statistically significant predictor for the workers' BMI class scores (p < .05). Moreover, during work-hours, office workers were willing to exert more effort (pay more) to obtain these snack foods than during non-work hours. An increase in work intensity was associated with an increase in the odds of being obese, with an odds ratio of 1.050 (95% C.I. [1.016, 1.084]). Food motives were not associated with BMI class scores (p < .05). These analyses have provided support for the hypotheses that food reinforcement is greater during work hours among office workers. As a result, they have significant positive social change implications which include relative policy changes within companies, tailoring the workplace environment to meet individual needs, providing healthier snack food choices, and increasing prices on high energy-dense foods. The workplace environment can provide opportunities for dietary, physical and worksite environmental change as well as individual behavior changes. It is important to continue to investigate how the workplace food environment may influence energy intake and weight-related behaviors to create awareness among this population. The more individuals and organizations know about these environmental food-related behaviors, the more opportunity they may have to take action in mitigating risk for weight gain during work and non-work hours.

Approximately 8.3% of the U. S. population has type 2 diabetes. Preventing the onset and improving the management type 2 diabetes are crucial for health care professionals. The purpose of this project was to develop and evaluate a type 2 diabetes prevention and management education program in a primary care setting using group medical appointments (GMAs). The chronic care model provided the framework for the study. The education program consisted of information from the Centers for Disease Control on the management of type 2 diabetes to be delivered by clinic staff using a GMA approach, a timeline for implementing the education program, and evaluation strategies for assessing patient health outcomes. Staff participants included 9 females and 1 male. One week after the presentation, staff responded to open-ended questions addressing the plan for prevention and management of type 2 diabetes. Findings indicated that staff unanimously approved the content of the program, thought the program could realistically be implemented, thought the proposed evaluation methods were appropriate, and thought the program would have a positive influence on patient health outcomes. Prevention and management education programs using a GMA approach may be used to reduce incidence and improve management of type 2 diabetes.

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and posttest scores were used to determine RNs' competency levels. The Statistical Package for the Social Sciences software was used for data analysis, and a paired t test was used to determine the impact of the program. Of the 22 participants, 4 (18%) scored within the culturally competent range on the pretest, compared to 17 (77%) on the posttest. These findings were statistically significant (p < 0.000) and demonstrated a positive outcome from the educational project. Key recommendations are to continue this education for other RNs in the facility and at other facilities in the network. The implications of this project for positive social change include raising the cultural competency of nurses, which has the potential to improve patient outcomes.

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while breastfeeding has been shown to reduce its occurrence. In the current study, a consecutive sample of all infants less than 5 years of age with otitis media and breastfed for at least 6 months was collected from a busy urban clinic for analysis. A survey tool was administered to those meeting study criteria. Primary analysis examined the odds ratio of developing otitis media among breastfed infants between those whose mothers smoked tobacco and those whose mothers did not. As a result, the association between the protective effects of breastfeeding and the detrimental effects of maternal smoking was evaluated in relation to the development of otitis media. Secondary variables including demographics, family history, past medical and birth history, and secondhand smoke exposure were also assessed. Results failed to demonstrate a significant difference in otitis media between the 2 cohorts in this study, and of the secondary variables, only cranio-facial deformities and/or a family history of these conditions resulted in higher otitis media occurrence. Further study with larger populations with higher tobacco use rates may offer additional insights into this matter.

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed environment of Afghanistan with the goal of discovering mechanisms to improve interpersonal safety for that population. Grounded theory was used to analyze data obtained from U.S. military women in Bagram, Afghanistan and their environment concerning interpersonal safety. This information was used to generate a relational social theory based on themes, patterns, and relationships; the theory of US Military Interpersonal Safety, Violence Prevention, and Response. This theory is intended to improve interpersonal safety as well as prevent and counter violence in the deployed setting. Applying this theory is expected to promote better assessment, development, implementation, and evaluation of violence prevention and response healthcare programs meant to mitigate violence and assist military members who have been victims of violence. This study promotes positive social change by identifying precursors of interpersonal violence in a deployed environment and creating a strong foundation for understanding how to prevent interpersonal violence and create response programs to address this issue.

Lung cancer is a disease with a high mortality rate for the U.S. Black population. There had been considerable research done on different population demographics, necessary to achieve the Healthy People 2020 overarching goals to eliminate health disparities, gain health equity and maintain quality health. Yet, the African-born Black (AFBB) population has been understudied for nonsmall cell lung cancer (NSCLC). This study sought to determine whether within race differences in stage at diagnosis and treatment of NSCLC exists between AFBB and American-born Blacks (AMBB) populations in the United States. The study data is secondary data collected as part of the National Cancer Institute's Surveillance Epidemiologic and End Result (SEER) Program from 2004-2011. Athough no significant difference was found between AFBB (n = 119) and AMBB (n = 238) relative to NSCLC stage at diagnosis, differences in treatments were found. The proportion of AFBB patients with early stage (I and II) NSCLC who underwent surgery differed significantly from that of AMBB (p < 0.05); AFBB patients were more likely to receive surgical therapy. The proportion of AFBB patients with stages I-IV of the disease who received radiation treatment also differed significantly from that of AMBB patients (p < 0.05); the latter were more likely to receive radiation therapy. Results from logistic regression analysis indicate that AFBB patients were more likely to receive surgical treatment while AMBB patients were more likely to receive radiation treatment. This study outcome can inform other NSCLC research to provide better insights to the cause of the treatment differences within the race from differing birth places, and efficient planning, evaluation of control programs and management of the disease.

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open heart surgery can influence young adults' attitudes and behaviors towards adopting a heart healthy lifestyle. The theory of health belief model and the theory of reasoned action were used in guiding this research. A quantitative design involving observation and administration of surveys was used. A survey with questions about participants' lifestyle practices was administered prior to observation of open heart surgery and 3 or more months afterwards. A total number of 179 young adults at baseline were considered eligible for the study. Ages of the research participants were between 18 and 35 years old. The t test and ANOVA results showed no significant differences between baseline and follow up data with regards to changes in behaviors of young adult students towards adopting a heart healthy lifestyle. The study concluded that observing live heart surgery did not significantly change behaviors of the students in adopting a heart healthy lifestyle. In order to achieve the desired changes in attitudes and behavior of students, looking into other evidence based options and pursuing those that can influence and motivate young adult students to adopt a heart healthy lifestyle can be a positive social change.

The college student population has a high prevalence of sexually transmitted infections (STI)s due to their participation in higher risk sexual behaviors such as serial relationships, drug and alcohol use and abuse, and inconsistent use of condoms. The purpose of this study was to examine the relationship between student exposure of sexual education and their sexual behaviors among college going students in Virginia. Guided by the health belief model, this quantitative cross-sectional study involved a random selection process to recruit college students to test the hypothesis. The research questions were designed to examine participants' exposure to sexual education, sexual behaviors, perceptions of contracting STIs with no condom use, and their perceptions of STI education added to college curriculums. The sample included 656 participants who ranged between 18-24 years old and were enrolled in a Virginia 4-year public university. Data were collected through an online survey. A multivariate logistic regression analysis was used to analyze the variables sexual education (independent) and sexual behaviors (dependent). Prior research has indicated that STI prevention education programs implemented within a schools' curriculum has assisted in bridging the gap between public health and education. The study results have shown that the students who had some form of sexual education and were sexually active are less likely to participate in risky sexual practices. The study also indicated that 92.5% of the participants perceive that adding STI courses to the college curriculum will help prevent STIs among college students. These results highlight the sexual health of Virginia college students and promote positive social change among Virginia's college campuses by identifying the inconsistencies of STI knowledge and practices, which can encourage better education.

The current exploratory study, as part of the Massachusetts Farm Fresh (MAFF) research project: 1) examined the effect sensory attributes (i.e. taste profile, color, shape, texture, growth pattern) of the target vegetables have on children’s willingness to explore and consumption and 2) compared these outcomes for: facilitator-guided (FG), vs. children’s self-guided (SG) exploration. We conducted a 6-week multi-sensory nutrition education intervention with Western Massachusetts Head Start preschoolers (3-5 years of age; n=94 children) using eight vegetable pairs; outcome measures were recorded by observers. Data were analyzed using SPSS version 20.0. Results are reported for 50 children with complete data at both baseline and follow-up. Willingness improved from baseline (40-50% of children = SCORE O) to follow-up (20-40% = SCORE 0) for all vegetables. Willingness scores (1) increased for “lower-sugar” vegetables (broccoli, cauliflower, green bean, radish) (p=.013) (2) were lower for white vegetables (cauliflower, parsnip) versus the other color categories (red, green, orange) and (3) were higher for both pod (sugar snap peas, green beans) and long-root (carrot, parsnip) versus root vegetables (beet, radish). Pre-post mean (SE) consumption (g) increased for carrots (p=.013) (2.45+/-.39 vs 3.49+/-.43) and radishes (p=.023) ( .90+/-.22; vs 1.45+/-.29) ). At follow-up consumption of ”higher-sugar” vegetables was greater (p=.000) and carrot-parsnip pair was higher than broccoli-cauliflower (mean difference 1.49+/-.51) (p=.005) and beet-radish1.01+/-.55) (p=.071) pairs. Overall, children’s willingness and consumption varied by sensory attributes of the vegetables. The multi-sensory approach successfully activated children’s senses while providing exposure to a variety of local vegetables in the Head Start setting.

Background. A 2012 IOM report is just one of an increasing number of recommendations to incorporate a population health approach into training of all health professionals. In light of the emphasis on and necessity for all future health professionals to possess core public health competences, a medium sized public University incorporated Introduction to Public Health as a required course in their undergraduate, interprofessional Health Sciences curriculum. Purpose. The purpose of this study was to assess the change in core public health competencies of undergraduate Health Sciences students who completed an Introduction to Public Health course. Methods. The Tier 1 Public Health Professionals Competency Assessment was administered in the online Introduction to Public Health courses for undergraduate Health Sciences students; the pretest was administered during the first week and the posttest during the final week of the 15 week course. Purposive sampling was used to assess how the course increased the student’s acquisition of core public health competencies within the designated eight domains. Results. Results of this study showed an increase in the competency scores of the participants from pre to posttest across all of the eight domains. Conclusions. This study demonstrates that an Introduction to Public Health course can increase the core public health competencies of undergraduate Health Sciences students, and the Public Health Professionals Competency Assessment can be used to assess the acquisition of these competencies with and guide curriculum for future health care providers.