Declining youth physical activity levels and lack of aerobic fitness have been well documented with a corresponding rise in obesity levels and health issues. Based on Bandura's social cognitive theory, healthy physical activity levels and aerobic fitness are strongly connected to positive physical activity self-efficacy beliefs. This study examined whether student physical activity self-efficacy, motivation, and effort were different for the FitnessGram-® (FG) 1-Mile Run when compared to the 15-minute Aerobic Assessment Based on Improvement (AABI). A concurrent mixed method quasi-experimental approach measured 5th grade students' physical activity self-efficacy beliefs through a pretest and posttest survey while aerobic assessment scores provided data that measured and compared student performance. Percent improvement and t-test analytic procedures found significant differences between groups and genders. The FG group (n = 131) improved 1.49% while the AABI group (n = 209) improved 22.53%; furthermore, FG girls' percent improvement decreased to -7.56% and the AABI girls' percent improvement was above the average score at 24.21%. Qualitative data collected and coded from teachers' (n = 6) found no noticeable differences in student behaviors or preparation between the FG or AABI groups. A 3-day workshop was created to initiate change in aerobic fitness assessment. Assessing student aerobic fitness based on improvement theoretically builds physical activity self-efficacy beliefs, especially for girls. Positive physical activity self-efficacy beliefs motivate greater student participation and engagement in physical education, which improves aerobic fitness. Social implications from these results indicate that students would increase their physical activity self-efficacy by assessing aerobic fitness based on individual improvement.

The birth of low weight babies in the United States has not had a meaningful decline for the last 10 years.It continues to be a major predictor of fetal-infant mortality. In addition, the rate of low birth weight infants among African American women continues to be twice that of European American women. Low birth weight babies may experience breathing problems, vision problems, diabetes, hypertension, and cerebral palsy. The purpose of this study was to examine why the high infant mortality rate persist among the African American communities of Southeast Queens, New York City as compared to European American communities in the Borough of Queens, New York City.This was a quantitative retrospective study with a correlational design that utilized secondary data derived from vital records maintained by the New York City Department of Health and Mental Hygiene. The investigation was guided by the ecological model as the theoretical framework to collect, assess, and analyze the data. Logistic regression was used to predict the association of risk factors to infant mortality. Low birth weight, preterm birth, late or no prenatal care, and smoking during pregnancy were risk factors associated with a high mortality rate among African American women. Positive social change implications for this study include the development of a social intervention that will be culturally based for the diverse communities of Southeast Queens, New York City. There will be a collaborative effort in implementing the evidence-based interventions involving interested stakeholders.

Human trafficking is a criminal act that occurs globally. It affects both women and men, but most studies have focused on female victims; few have explored trafficked men or their related health issues. Though there are many forms of trafficking, it is believed that most male victims are trafficked as forced labor. Using gender schema theory as a framework, this quantitative study examined archival data to identify the types of trafficking men are subjected to, their health ailments, and how these differ from the health ailments of trafficked women. Archival data from 124 individuals subjected to human trafficking in Florida were analyzed using the Kruskal-Wallis, one-way ANOVA, Mann Whitney U, and Fisher's exact tests. Findings indicated that males were more likely to have been labor trafficked compared to other forms of trafficking, and that labor trafficked persons were not more susceptible to health ailments than were sex trafficked persons. Also, there was a significant difference in health conditions between male and female victims, with females reporting more issues such as malnourishment, skin rash, and anxiety. These findings help to alter the misperception that men are traffickers only by recognizing them to be victims as well. Implications for social change include increased awareness of male trafficking in health care policies and human trafficking prevention efforts.

Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge of the consequences of sexual involvement, and perceived parent or peer disapproval of the behavior. The theory of reasoned action was used as a framework to guide the study. The cross-sectional study involved secondary data analysis of baseline data pooled from a program evaluation. The sample included 536 urban low-income African American and Latino youth aged 11 to 16 years at high risk of HIV/AIDS. Multiple linear regression analyses revealed that the weighed combination of the predictor variables, age, gender, race, immigration status, HIV knowledge, direct exposure to HIV/AIDS, peer pressure, and religious influence explained the greatest variance of intention to delay sexual involvement (R2 = .246, p < .05). Also observed was a significant relationship between age, gender, and sexual intentions across the regression models. These findings can enhance HIV prevention and social change initiatives because of the potential to impact youth early sexual debut, reduce risky sexual behavior, and consequently decrease the rates of HIV infection among youth.

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women in BGR and how they utilize social networking technology to improve their physical activity. Social cognitive theory provided the theoretical framework. Semistructured interviews were conducted with 13 women participants of BGR, who were selected using purposive sampling technique. Data were transcribed, organized, analyzed, and coded into common themes with the support of Nvivo 11 software. The findings revealed that social networking served as a tool that the women in BGR used to connect, encourage, and motivate physical activity, and it thereby helped to support their social and physical well-being. Study findings may contribute to positive social change by increasing knowledge and awareness of how technology can be used to promote healthy behaviors among Black women. This study may also provide useful information to stakeholders interested in health promotion strategies and programs to reduce the health disparity gap for Black women in the United States.

Antigua and Barbuda, in the eastern Caribbean, is one of several countries with exclusive low breastfeeding rates and premature weaning. Researchers have demonstrated that babies exclusively breastfed for the first 6 months of life are better protected from childhood diseases and experience a better quality of life into adulthood, while early weaning is associated with morbidity and mortality. However, at 6 weeks postpartum, only 30% of Antiguan and Barbudan mothers are exclusively breastfeeding. Researchers have explained why mothers in general cease exclusive breastfeeding prematurely: insufficiency of breast milk, returning to paid employment, lack of social support; but an explanation specific to Antigua and Barbuda has not been identified. This qualitative phenomenological study, therefore, initiates research concerning breastfeeding attitudes and practices specific to this country. It explores the experiences and perceptions of 13 Antiguan and Barbudan 1st-time mothers on exclusive breastfeeding and weaning. The theory of planned behavior provided the theoretical framework. Data collected from semistructured interviews were coded using key word as themes. Manual analysis of the research data was also conducted. The findings indicated inadequate lactation education and counselling for mothers, poor levels of lactation education among nurses, and minimal statutory maternity leave as the reasons for premature weaning among the research participants. The findings of this research can contribute to social change in Antigua and Barbuda by providing evidence-based information to strengthen breastfeeding policies and interventions and become part of regional scholarship on this issue.

Physical inactivity and obesity, both of which are modifiable cardiovascular disease (CVD) risk factors, increase substantially during the transition from adolescence to young adulthood. CVD is the 5th leading cause of death in people ages 18 to 29. This disease has enormous social and financial repercussions; however, many college age students do not see chronic disease as a personal threat. Few researchers have examined chronic disease risk in young adults or used a consistent, objective measurement of physical activity. A pre-post, quasi-experimental study was conducted to evaluate the association between a health and fitness class, physical education 215 (PHED 215) and chronic disease risk, cardiorespiratory fitness (CRF) level, body fat percentage, self-motivation, exercise self-efficacy, and transtheoretical model (TTM) physical activity stage of change progression among male and female college students (n = 64). The TTM was utilized as the theoretical framework for this study. Secondary data were analyzed via descriptive statistics, paired t test (or Wilcoxon signed-rank test if data were not normal), and Bowker's test of symmetry. Results showed a statistically significant association between PHED 215 and 2 dependent variables: cardiorespiratory fitness level (p = 0.0001) and progressive movement through the TTM stages of change (p = 0.0061). Because college age students are shaping their adult behaviors, positive health change adopted during this critical time could increase CRF, establish lifelong exercise habits, improve quality of life, and delay and decrease obesity risk and chronic disease and related costs. While further study in different settings is warranted, PHED 215 could be used as a blueprint for other interventions in the education, community, and healthcare settings.

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the development of implementation and evaluation plans for the newly adopted policy. The theoretical framework was based on the social, cognitive, and behavior change theories. The program logic model served as a framework to monitor its progress. Existing peer-reviewed literature, including research studies, state and national teen pregnancy prevention projects and curriculum, and publicly available statistics, were gathered and reviewed by the project team as background to be used for developing and changing policy at the institutional level. Project monitoring involved tracking processes surrounding policy and practice guideline development and adoption, as well as implementation and evaluation plan development for the adopted policy and whether these processes progressed as the empirically-derived teen pregnancy prevention projects should when changing sex education policy at the organizational level. This project resulted in policy adoption and developing a policy implementation and evaluation plan to be disseminated within a county school system that could decrease teen pregnancy rates and demonstrate positive outcomes.

Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically ill ICU patients. The theory of knowledge to action was used to guide the development of the educational program. The practice-focused question addressed whether an educational program would improve nurses' perceptions of their knowledge of EM and if they would promote the use of EM among ICU patients. After a literature review to identify evidence-based practices and a protocol on EM, an educational program was developed that included a 25-item Likert-style pretest and posttest to measure percent agreement with perceptions of knowledge gained and likelihood of behavior change related to the practice of EM. Participants included 60 ICU nurses. Results demonstrated improvement in perceptions of knowledge of EM (from 74% before education to 88% after) and in likelihood of behavior change related to EM (from 69% before education to 91% after). Findings may be used to integrate EM into the ICU setting to reduce complications such as neuromuscular weakness, muscle wasting, and pneumonia. Results may also include improved patient outcomes, reduced length of stay, and increased quality of life for patients and their families, and thereby promote positive social change.

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 families and 42 schools in Lower Nyakach, Kenya. From February to May, 2015, adjacent districts had serious cholera outbreaks, but in Lower Nyakach, where education and the use of chlorine were nearly universal, there were no cases of cholera and steadily decreasing rates of diarrhea. A cross-sectional study was conducted to verify self-reported water treatment practices with evidence-based microbiological testing. A random sample of 377 households revealed that 95% treat their water each and every time they collect. Microbiological verification found 96% of household safe water storage vessels were low risk compared to their very high risk source water. A strong association (p < 0.001) existed between the observed decrease in diarrhea trends from health facilities in Lower Nyakach and exposure to the novel training. The strategy used by FOTO could be replicated to empower communities worldwide to identify contaminated drinking water sources and to reduce the incidence of waterborne disease.