The purpose of this research study was to describe course content on unintentional injuries in undergraduate personal health and wellness courses at four year public and private colleges and universities identified by the Eta Sigma Gamma directory in the United States. An instrument was created, validated and tested for reliability, and used to assess course content areas related to unintentional injuries in undergraduate personal health and wellness courses. The sample for the study included 106 participants (N=106) from public and private colleges and universities in 36 states. Chi-square analysis, ANOVA, factor analysis, and MANOVA tests were used to determine if significant differences existed in course content areas based on selected demographic characteristics. Results indicated that college and university faculty members report teaching about unintentional injuries. Findings indicated that significant differences do exist in unintentional injury course content areas. The top five content areas identified by faculty members include water-related injuries, firearm safety, motorcycle injuries, motor vehicle passenger safety, and motor vehicle impaired driving. Factor analysis results revealed that unintentional injury course content areas can be categorized into three groups: personal content, motor vehicle content, and injury content. The level of statistical significance was set at 0.05.

All terrain vehicles (ATVs) are a popular source of recreation. For some rural adolescents, ATVs are frequently used for agricultural work. Whether for work or recreation, many adolescents operate ATVs improperly either from a lack of knowledge, poor judgment or they engage in risky behaviors resulting in injuries and fatalities. The Kentucky Department of Agriculture (KDA) has devoted resources to provide ATV safety programs to educate adolescents statewide. However, there are no known studies evaluating the effectiveness of this KDA intervention. Therefore, a pilot study was proposed to determine the effectiveness of The KDA ATV safety program in improving ATV safety knowledge, attitudes and behaviors of adolescents ages 12 to 18. Following HSRB approval, a pre-experimental one group, pre-test, post-test design pilot study was conducted. A convenience sample (n=18) was drawn from adolescents registered to attend an ATV safety program provided by the KDA. The study was conducted in a south central Kentucky city. Haddon’s Matrix was used as the theoretical framework using the dual axis approach to injury prevention and injury control. On one axis are the host, the agent and the environment. In this study the host is the adolescent ATV driver, and the agent is the all-terrain vehicle. The environment includes the terrain, applicable ATV laws and societal attitudes toward ATV safety. On the second axis are the pre-event, event and post-event phases. Haddon’s Matrix is a process mechanism in which opportunities to reduce ATV related injuries and fatalities can be identified. It is believed that knowledge, attitudes and behaviors regarding ATV safety can be positively influenced through effective educational strategies, ATV engineering design changes and ATV law enforcement issues as identified through the use of Haddon’s Matrix. Descriptive statistics and paired t-tests were used to analyze the data. The analysis revealed no statistically significant changes in adolescent knowledge following the intervention. However, there were statistically significant improvements in ATV related safety attitudes and behaviors. In conclusion, efforts should continue to prevent ATV-related injuries and fatalities via educational strategies to change behaviors and attitudes regarding ATV safety in communities and individuals. Implications include the need for further research to determine best practice ATV educational strategies that create positive change.

Abstract In the summer of 2009, Tampa General care providers met with Hospital Administration to express concern that violence on care units was a growing problem and making it difficult to provide quality care. Nurses stated that such violence was one important reason many of their peers choose to retire. Administration took this situation seriously and formed a committee to gather information and submit suggestions to reduce the violence. The committee consisted of representatives from several nursing units, human resources, risk management, security, and administration. Duties assigned included investigation of the actual number of reports on all units and trends. The committee was also charged with the production of a report regarding reviewing other hospital data, literature review, and developing recommendations. Internal reports indicated that the total prevalence of reported violence as well as the incidence per patient had increased annually since 2005. The hospital reports contradicted the national literature regarding the emergency department (ED) and psychiatric unit (Psych) being the two hospital units with the highest number of violent events. One possible reason for the difference is that these departments require all care providers to attend de-escalation and self-defense classes annually. Based on these findings, the researcher developed and adapted training similar to that of the ED for other units reporting aggressive, abusive, and violent patients. The committee approved a draft plan for implementation. Following presentation to Nursing Administration, some modifications were made, and the Internal Review Boards of the hospital and University of South Florida (USF) approved the project. The hypothesis tested in this study was whether training in de-escalation and self-defense modifies providers' behaviors to prevent or reduce aggressive, abusive, or violent behavior by patients and visitors. The independent variable was training. The dependent variable was requests for assistance with unruly, angry, or violent patients or visitors. Event reports of the year prior were used for historical comparison. Event reports for the experimental period were assembled subsequent to the training for comparison. Nursing Administration selected two units to receive the training intervention. The two units selected were neither the worst nor the best in numbers, but rather the middle. Nursing required that all training be scheduled in normal department meetings and that Nurse Managers of the units agree to participate. The research design presumed that at least 85% of care providers on a unit would attend the training. Schedules were developed to accommodate all care providers. The training was presented during June of 2010. Experimental and comparison units were monitored each month for the number of reported violent events (Code Grays) on each unit. During the fourth months of monitoring, there was a data spike in the Cardiac Care unit. No action was taken until another spike occurred during the sixth month. It was determined that an error had occurred that partially invalidated the data from the Cardiac Care unit: the 85% participation rate among staff had not been reached. Monitoring continued for 12 months after the training. The Eldercare unit showed reduced requests for assistance. Overall, the Cardiac Care unit increased requests for assistance from the year before. Results were adjusted for patient census. Wilcoxon Signed Ranks Testing was performed and displayed using box plots to show how far the median changed during the research from one group to the next. The analysis compared prior year with the year following the interventions, and indicated that there was a movement toward a reduction of Code Grays. To determine if there was a difference between comparison units and experimental units 12 months after the training, Poisson Regression Analysis was utilized. When the comparison units were set as the reference, Poisson analysis indicated the events were decreasing on both units. The Cardiac Care unit did not have a statistically significant p value. The Eldercare unit had a p value of .019. In conclusion, the results are mixed and statistically inconclusive. From the care providers' perspective, any reduction in violence is significant. The data regarding the training interventions indicates that there was an empirical, albeit not a statistically significant, change in Code Gray reports. Training may have reduced the violence on the Eldercare unit by nearly half.

A disproportionate number of African American women are at increased risk for uterine fibroid tumors (UF) compared to their Caucasian, Asian, and Hispanic counterparts. Researchers have indicated that women diagnosed with UF can have a poorer health-related quality of life (HRQOL) when compared to women who do not have a diagnosis of UF. The overall aim of this study was to explore the impact of UF symptoms on the HRQOL of African American women. A quantitative, cross-sectional design was employed utilizing the revised version of Wilson and Cleary's model of HRQOL. A sample was gathered of 80 participants who were African American women between age 30 and 45 years with a current diagnosis of UF. Linear and multiple hierarchical regressions were performed to determine the relationship among UF symptom severity and HRQOL based on 6 subscales of HRQOL (as measured by the UFS-QOL). There was a statistically significant association between symptom severity, the 6 subscale variables of HRQOL, and employment. No significant associations were observed with age, family history (hx) of UF diagnosis, body mass index, general health perception, overall quality of life, and symptom severity. The social change implication for this study is to provide information that can direct health care providers in the development of health maintenance programs that are sensitive to the needs of African American women diagnosed with UF. In addition it will promote the need for public health professionals and medical organizations to increase the availability of information related to UF symptoms and the impact of UF symptoms on HRQOL among women.

Sickle cell disease (SCD) is a genetic disorder that affects millions of people worldwide. According to the Centers for Disease Control and Prevention, over 100,000 Americans have SCD, and more than 2 million Americans have a sickle cell trait (SCT). People with SCD are more likely than others to suffer premature mortality. Genetic screening is an important step in improving quality of life and increasing longevity for those with SCD. Early detection may lead to effective management of the disease and reduction of complicating factors. The purpose of this quasi-experimental study was to determine whether health education about SCD would impact college students' knowledge, attitudes, perceived risk, and intention to seek genetic screening and counseling in relation to the disease. The theoretical foundation for this study was the health belief model (HBM). This study involved 80 college students selected from a North Texas college. These students completed pre and post versions of an SCD questionnaire. Independent samples t tests were used to determine if there were significant differences in pre- and posttest scores of participants in both groups, and a MANOVA was used to determine differences among the scores of participants in the experimental group when grouped by age, gender, race, religiosity, and socioeconomic status. The results of this study showed that SCD health education improved the knowledge of and attitudes towards participants. Future research could explore barriers to seeking SCD screening and genetic counseling. Results of this study may further social change by encouraging the development of college-based health education efforts to increase awareness about SCD.

Bisphenol A (BPA), a widely used chemical in plastic, has drawn wide attention due to its presence in many consumer products and the environment. The purpose of this study was to examine the association between urinary BPA and the reporting of cardiovascular diseases (CVD), and then to examine the effect of C-reactive protein (CRP) as a moderating variable. The data used in this research were extracted from the National Health and Nutrition Examination Survey collected in 2009-2010. Guided by the advanced epidemiological triangle, analysis involved 2 stepwise binary logistic regressions. The first step suggested that the controls were significant in predicting CVD (Ï?2 (5) = 83.72, p < .001, R2 = .15). The Nagelkerke R2 coefficient of determination indicated that the controls explained approximately 15% of the variance in instances of CVD. The second step of the binary logistic regression included the controls and BPA level in the model together. The regression analysis suggested that the Nagelkerke coefficient of determination (Ï?2 (6) = 83.76, p < .001, R2 = .15) did not increase from the 15% explained by the controls, and BPA level was found to be a nonsignificant predictor of CVD (p = .853). Due to lack of association between BPA and CVD, the analysis was shifted to examine the association between urinary BPA and serum CRP. The association between urinary BPA and serum CRP was also statistically nonsignificant (Spearman correlation coefficient, rs= .06, p = .015). The results may have positive social change by contributing to the body of knowledge on BPA and by increasing scientific scrutiny for substances used in people's daily lives.

Citizens within the United States of America (USA) and the Commonwealth of Kentucky exhibit indicators of lessened health status in a variety of areas. Many chronic diseases and conditions are due to individual lifestyle behaviors, which can be modified through the implementation of dedicated health and wellness programming. Such programs, often housed within institutions of higher education, have the ability to impact many individuals including students, faculty, staff, and community members. This dissertation is a report of a mixed-methods study that begins to explore how state-supported postsecondary institutions may be able to impact individual behavior and thus, resulting health outcomes. This relationship is not only beneficial for the targeted individuals but also for the institutions, which may experience heightened success and sustainability. This research employs both quantitative and qualitative methods to gain an understanding of the current level of influence of state-supported postsecondary education in Kentucky on the health of its citizenship. Those working in various on-campus health and wellness departments at the University of Kentucky, University of Louisville, and Eastern Kentucky University were surveyed. Next, key leaders at each university involved with these programming efforts were interviewed along with Kentucky Council on Postsecondary Education officials, to gain an understanding of the leadership perspectives surrounding this issue. Finally, site visits at each university were completed to elicit knowledge regarding campus environments and how supportive they are in positively influencing individual health and wellbeing. It is possible that with more extensive findings across the Commonwealth of Kentucky and across the USA, a greater rationale can be made for institutional and state-wide leadership support of health and wellness programming efforts on college campuses. Resulting outcomes have great potential to be both robust and reciprocal to the university and its community members.

This study examined the knowledge, sources of information, reasons for and against Gardasil® uptake, and possible relationships between unhealthy behaviors and vaccination for undergraduate college females at a public university. Utilizing an online survey, 2400 random students were emailed as well as recruited through online classes. The final sample size was 516 females. The study determined how many participants had been vaccinated and their rationale for or against vaccination. The majority of study participants were knowledgeable about HPV and Gardasil®. The primary sources of information about HPV and Gardasil® were doctors and television; however parents and friends were also common sources of information. Predictors for HPV inoculation included race, the belief that the vaccine would protect against HPV, alcohol use, and engagement in anal intercourse. Over 50% of participants had received at least one dose of Gardasil®, and 82% had completed the series. The most common rationale for not getting the vaccine, or not completing the vaccination series, was concern about side effects. The most common rationale for completing the vaccination or intending to complete the series was protection from cervical cancer. In conclusion, there is a continued need provide health education about HPV and HPV vaccination for college females.

The purpose of this study was to assess the relationships between energy drink consumption (with and without alcohol) and other risky behaviors; students’ overall awareness level of the risks for consuming energy drinks; and overall behavioral intention to consume energy drinks among college students at the University of Kentucky. A total of 277 students enrolled during the Spring 2012 semester responded to the online survey, 46.5% (n=129) of which were considered energy drink users. Students classified as energy drink users participated in other risky behaviors more often than non-users (p=0.001). In addition, energy drink users exhibited a higher awareness level for the risks associated with energy drink consumption both with (p=0.000) and without (p=0.000) alcohol. Those who were more aware of the risks associated with energy drink consumption, both with (p=0.001) and without (p=0.001) alcohol, were found to have increased intention to consume energy drinks within the next month compared to those with lower awareness levels. There is a need for future research on this topic, as well as a need for expanded education and intervention programming for college students regarding the risks of energy drink consumption (with and without alcohol).

Fruit and vegetable (FV) intake continues to decline among sub-population in the United States. Current policies and interventions have aimed to improve intake by improving access to fruits and vegetables. One Centers for Disease Control and Prevention suggested strategy is to improve access to farmers’ markets in rural areas. The aims of this study were to determine if the frequency of shopping at Farmers’ Markets is associated with fruit and vegetable intake, adjusted for age, income and education and to compare rural and non-rural areas frequency of Farmers’ Market attendance based on Kentucky farmers’ market interview participants (n = 102). The results of the descriptive, cross-sectional study determined that the Kentucky farmers’ market customers Fruit and Vegetable Score was positively associated with frequency of purchase of locally grown fruits and vegetables at farmers’ markets. However, the frequency of farmers’ market attendance was most commonly limited to ‘once a week’ (as a result of participants attending ‘Only attends market when need something’). It was concluded that alleviating the barriers customers face to use farmers’ markets is the best way to increase the attendance of farmers’ markets and as a result increase the purchases of fresh fruits and vegetables.