Despite the availability of the human papillomavirus (HPV) vaccine, African American women are still at risk for contracting HPV. This is significant because HPV is one of the main risk factors for cervical cancer. The purpose of this quantitative study was to explore the relationship between the use of HPV vaccination for cervical cancer prevention and personal history of HPV, reduced access to healthcare, and risky sexual behaviors in African American women. The theoretical framework used for this study was the health belief model (HBM). Two hundred twenty-nine (n=229) African American women living in the United States, ages 18-49, who participated in the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were the sample under study. A univariate analysis was performed to describe the population and obtain frequencies and percentages for all covariates. A bivariate analysis was conducted to determine whether there was an association between any of the independent variables and the dependent variable. A multivariable logistic regression was conducted to build a predictor model for use of HPV vaccination. Women between the ages of 18 and 34 were 7.22 times as likely to receive the HPV vaccine as women aged 35-49 years, and this was statistically significant (OR: 7.22; 95% CI: 2.36 - 22.13). This study can contribute to positive social change within the community and public health profession through an increased awareness and knowledge of HPV and cervical cancer, especially for African American women.

Numerous faith-based organizations (FBOs), denominations, and religious groups are represented in the United States. Faith leaders have the responsibility of addressing the spiritual needs of the congregation; however, the health needs of parishioners may be a point of discussion faith leaders should address. Communities surrounding FBOs may have limited health care services, lack transportation, and have serious health issues. The purpose of this phenomenological qualitative study was to explore the experiences of faith leaders on giving health counseling to their congregation. Faith leaders play an essential role in providing health counseling on various health topics to their congregation and community. A total of 15 faith leaders were recruited from 6 counties in North Carolina by convenience sampling. Face-to-face face semi-structured interviews was the data collection method. The transformational leadership theory was used to examine how faith leaders motivate parishioners through constructs of the framework. Using NVivo, a qualitative data analysis software tool, the coded results indicated that faith leaders need specialized training to provide health counseling to parishioners about health issues shared beyond their field of expertise. The insight gained from faith leaders was important to understand the health-related resources needed to improve the health of parishioners. This study may be useful for faith leaders, public health educators, health policy makers, and researchers seeking to understand faith leaders' experiences; it could impact positive social change by providing resources and training needed to combat health-related issues within congregations.

Despite an initiative to provide preconception care (PCC) and reproductive life planning (RLP) for all women of childbearing age, many women, especially those with low incomes, are not receiving it. As a result, there continues to be a high rate of infant morbidity and mortality in this population. Furthermore, low income adolescent females have not been adequately studied regarding this phenomenon. The purpose of this phenomenological study was to explore low income adolescent females' knowledge, attitudes, and beliefs about PCC and RLP in order to serve them more effectively. Five low income adolescent females, aged 18 to 21, were recruited through criterion sampling and they each engaged in 2 individual in-depth interviews. The health belief model, social cognitive theory, and adolescent affective and cognitive theory were the conceptual frameworks used to develop the interview guide, conduct the interviews, analyze the data, and formulate the recommendations for future studies. Moustakas's phenomenological interview process was used as a guiding framework to prepare and conduct the interviews. Qualitative data were analyzed using Moustakas's modified version of the Stevick-Colaizzi-Keen method of analysis. Findings were that participants (a) had no experiences with PCC or RLP, (b) lacked knowledge about preparing for pregnancy, (c) had negative interactions with medical personnel, and (d) wanted more information about PCC and RLP. Further research is recommended to examine current PCC/RLP practices, conduct additional PCC studies of adolescents, and develop culturally- and age-appropriate PCC programs. Findings from these studies could improve both the lives of the adolescents and the health of their offspring.

Low-income Hispanic women are the fastest growing minority population in the United States, and they have increased risks of obesity and secondary health issues, such as diabetes, related to their obesity. The purpose of this phenomenological study was to explore the barriers to lifestyle change among obese, low-income Hispanic women (OLHW). A health belief model lens was used. The study sample consisted of 15 OLHW who were clinic patients and ranged in age from 20-59. Recruitment occurred in a low-income, Southern California, outpatient clinic setting through volunteer participation from recruitment flyers. Fifteen women took part in 1-hour, in-depth interviews, which were digitally audio-taped with their consent. All interviews were transcribed and analyzed using both NVivo 11, and hand coding to identify common themes after word frequency and concept frequency analysis. Common themes identified included barriers of cost, time, physical health, family care, location, knowledge and education, depression and stress, and sleep issues. These findings contribute to the existing literature by increasing public health researchers' and program planners' knowledge of the experiences and obesity-related barriers to health behavior change within this underrepresented minority group, which can provide guidelines for future public health interventions in addressing these barriers. Obesity reduction efforts may help increase quality of life and create a new paradigm of public health interventions based on the stated needs of OLHW.

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between men and women. Semi-structured, open-ended questions were used to obtain data from 4 males and 5 females between the ages of 28 and 46 who had been sexually active for more than 12 months. Data was collected on participants' cultural perspectives on condom use, HIV risk behaviors, and sexual morality. The interviews were transcribed and reviewed for consistent patterns of high risk sexual behaviors prior to coding. Through the use of NVivo, seven emergent themes were common among the participants. Findings from the small scale sexual risk behavioral data showed that among these participants, condom use and partner fidelity in unequal partnerships were low. The study also indicated the importance of developing an HIV intervention that focuses on gender and power in long-term sexual partnerships. The implications for positive social change included awareness that gender inequality exists among concurrent unions and formulating an effective cultural HIV prevention strategy for couples.

The research problem is the increasing numbers of overweight and obese nurses working the night shift. Study on overweight and obesity among female Filipino nurses has not been conducted. It was important to conduct a research study among female Filipino nurses to find out if there are statistically significant associations between night shift work and weight gain. The purpose of this correlational and cross-sectional study was to determine if there are statistically significant associations between insufficient sleep, abnormal eating patterns, working 12-hour shifts, years of working night shift, age, stress, marital status, nursing units, decreased physical activity, and level of weight gain among female Filipino nurses working the night shift in the hospital. The theoretical base of this study was the locate evidence, evaluate evidence, assess evidence, and informed decision model. The survey questionnaire was constructed and an online survey through Survey Monkey was used to access nurses via a convenience sampling. Data were analyzed using Spearman correlation, multiple regression, and ANOVA. According to study findings, there were significant associations between insufficient sleep, abnormal eating patterns, marital status, 12-hour shifts, number of years working on night shift, and increased in body mass index. The implications for social change include information that nurses can use to better understand the negative implications of night shift work on health. At the organizational level, this study provides information for administrators and nursing leaders that might facilitate change in policies by improving working conditions for nurses.

Chronic conditions are public health threats. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based disease management program that addresses personal self-management of chronic conditions. The CDSMP involves peer trainers who instruct and assist with chronic disease preventive measures. Although disease management demonstrates promise to improving patient self-maintenance, previous researchers have not evaluated how the program affects program leaders. The purpose of this study was to discover how self-help leaders feel about the CDSM program. The overarching research question asked about perspectives that self-help leaders had toward the program. Through a narrative qualitative approach, the perceptions of peer leaders were examined to determine if the program was personally beneficial. Guided by the social cognitive theory, a purposeful convenience sample of 20 participants completed the study. The participants were practicing peer trainers in the CDSMP program. Data analysis included hand coding using open and axial coding and content analysis. Study findings included themes surrounding how the CDSMP program benefits health in general as well as the management of facilitators' own chronic diseases, health behaviors, and increased quality of life. The ability for chronic disease management leaders to experience positive effects of the program they administer may result in positive social change. This awareness can positively affect social change by enhancing an already established evidence-based community health program with stronger and better-equipped leaders.

In the United States, motor vehicle crashes are one of the leading causes of unintentional injury death and disability for children ages 1'15 years. Despite local, state, and federal legislative and educational efforts, children continue to be restrained improperly and thus face harm. Identifying behaviors and barriers that place child occupants at risk is crucial for implementing focused, injury-prevention programs and policies. The purpose of this study was to evaluate the effectiveness of Connecticut's child passenger safety law that was strengthened in 2005. This study involved a multifactorial approach to predicting child seat use, guided by Roger's diffusion of innovations as the theoretical framework. The analysis determined if there was a difference in the prevalence of car seat use before as compared to after law implementation and identified variables that best predicted the use of car seats and premature transition to a seat belt. Using Connecticut's Crash Data Repository, a logistic regression analysis indicated that car seat use was 1.3 times more likely post law (OR 0.75; 95% CI: 0.65-0.86) and that in particular, children ages 4, 5, and 6 (combined) were most positively affected by the law (OR 0.67; 95% CI 0.54-0.82). Driver sex, crash time of day, child age, and child seating position were all determined to be significant predictors of whether or not a child was in a child safety seat. Additionally, these variables were also determined to be predictors of early transition to use of a lap/shoulder belt (versus child seat). The social change implication of this study is that identifying predictors of car seat use and early transition helps to formulate and implement injury prevention measures that could in turn help to decrease medical costs, save lives, and prevent injuries.

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost and Utilization Project (HCUP) agency. According to the findings, males (n = 61,040) were at a higher risk of developing CAUTI compared to female (n = 66,792) (p < .001) in New York and North Carolina between 2012 and 2014. The odds of getting CAUTI were much higher among age > = 45 compared to the < 17 years. These findings fit in with previous literature identifying age and gender as having a significant relationship with CAUTI occurrence. The outcomes in this study may guide the formulation of policies that are age-appropriate, gender-specific, and facility-tailored to reduce the incidence of CAUTI.

Since the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was first reported in Sierra Leone in 1987, its prevalence rate has stabilized at 1.5% in the nation's general population. However, concerns exist regarding the potential increase in high-risk populations, particularly among mineworkers and commercial sex workers. The potential spread of HIV/AIDS as a result of labor migration may threaten the mining sector, which has been identified as a critical driver of recent economic growth and development. A gap remains in the literature regarding the contextual factors in mining communities that lead to high rates of HIV/AIDS. Therefore, the purpose of this study was to quantitatively examine the association between labor migration and of sexual risk behaviors among mineworkers in the Marampa Mines in Lunsar, Sierra Leone. Grounded in the ecological model and using a cross-sectional design, 296 mineworkers from the Marampa mining communities were surveyed using a standardized survey questionnaire. Research questions were answered using simple linear and binary logistic regression analyses. Analyses of the results indicated a significant relationship between labor migration and condom self-efficacy, where migrants were predicted to have condom self-efficacy scores 7 times higher than nonmigrants. However, the results showed no statistically significant relationship between labor migration and engagement in multiple sexual partnerships and commercial sex among the mineworkers. These findings will provide important implications for positive social change in the development of multilevel HIV intervention programs to reduce sexual risk behaviors that transmit HIV, thereby improving the health and wellbeing of miners and that of their partners and families in the mining communities.