Teenage pregnancy is both a social and a public health problem in the United States, with approximately 750,000 young women between the ages of 15 and 19 becoming pregnant each year. In addition, teen pregnancy is more prevalent in the African American (15%) and Hispanic (14%) communities than it is in White communities (5%). The purpose of this study was to identify risk factors contributing to teen pregnancy among racially diverse teenagers 15 to 19 years of age living in the rural south. This study, guided by social cognitive theory, used a quantitative, cross-sectional research design to determine whether living environment, educational resources, and access to healthcare impact risk of teenage pregnancy. A quantitative survey assessed factors such as sex-related attitudes, parent/peer communication, living environment, and educational attainment. Two primary research questions and 8 related hypotheses were formulated for investigation. Using binary logistic regression, the data in this study revealed that an increase in positive environmental factors (household income and parental education) and an increase in positive personal factors (parental/peer communication, teen's academic achievement, and attitudes toward sex) decreased negative behaviors (risks of teen pregnancy). This study may promote positive social change by providing information on relevant social and educational factors to those responsible for the design of comprehensive pregnancy prevention programs that target at-risk teenagers. Provision of comprehensive social and health services to teenage parents and their children may help to reduce rates of first-time and repeat teenage pregnancies and thus prevent the negative social consequences of these pregnancies.

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease (DMFT and CPI scores) in this population. Neither oral health and hygiene studies nor studies of oral health knowledge, attitudes, and practices have been examined in U.S. jails. The conceptual frameworks of this study were the health belief model and social cognitive theory. The data were analyzed with the use of bivariate correlation tests, as well as binary logistic analyses. The results of this study revealed that the total number of correct answers on the oral health attitudes (OHA) questionnaire appeared to be the strongest predictor of high DMFT, with significance of 0.05 and an odds ratio of 1.522 (95% CI [1.000, 2.334]). In the analysis that included the total number of correct answers for the OHA questionnaire, years incarcerated was the strongest predictor of high CPI (p = 0.027), with an odds ratio of 0.340 (95% CI [0.131, 0.883]). This study advances social change by aiding in understanding the oral health status and oral health knowledge, attitudes, and practices of inmates - an underserved population. Results from this study can be used to assist jail administrators in understanding the types of dental care that is needed in correctional facilities.

Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative resources enhancing comprehension of procedures, and assurance. The results of this research might motivate health care professionals to promote awareness in preventing delayed diagnosis of BC in African American women between the ages of 20 and 40 years. The findings in this study may increase health care providers' awareness and bring about social change in BC screening implementation.

This study focused on factors that influenced clinician embryo disposition decision-making in in vitro fertilization (IVF). Evidence-based medicine (EBM) should be built on the premise of shared decision-making. This paradigm is often skewed, resulting in clinician stress, a higher probability of errors, reduced productivity, or ineffective decisions. Guided by the theory of planned behavior and the self-perception theory, this study assessed the independent variables' religiosity, ethnicity, level of burnout, gender, age, years of experience, and clinical role in relationship to the dependent variable "decision-making" as measured by the Lyerly Frozen Embryo Survey, Maslach Burnout Inventory, and the Areas of Worklife Survey. IVF clinicians throughout the United States and Europe (n = 151) completed an online survey via a nonrandom, cross-sectional methodology. Study results indicated the factors were not significant. A vast majority of participants identified as: White, (84%), and female (75%), and that religion was very important (73%). The bulk of participants had a moderate level of burnout (85%), which showed that the multitude of participants were not experiencing overly high levels of emotional exhaustion, were not emotionally detached from their patients' needs, and felt a high degree of personal accomplishment. Recommendations included using a larger sample size, different variables, or developing a new survey as the decision making process may have been more multifaceted than anticipated. There are more areas to be studied around factors and decision making to fully understand these concepts. The positive social change implications include an increased awareness of factors that have the potential for impacting clinician decision-making as a reminder of the importance to be cognizant and sensitive of the needs of patients.

The relationship between suspected predictors of current HIV risk, i.e. self-efficacy, social norms, expectancies, alcohol use, past HIV risk, past history sexual abuse, social support, and behavioral intention was investigated in a sample of Latino migrant workers living and working in the United States (N=270) using baseline data from a previous study. A series of multiple regression analyses were performed by adjusting for socio-demographic characteristics such as age, gender, marital status, educational attainment, and length of stay. Zero-inflated Poisson regression analysis showed that self-efficacy was associated with behavioral intention (β= 0.03, p= 0.04) and expectancies was associated with behavioral intention (β= -0.01, p = 0.04). Binary logistic regression analysis showed that past HIV risk was associated with the dependent variable, current HIV risk (β = 0.11, p= 0.01), while behavioral intention was associated with current HIV risk (β= -0.16, p= 0.02). Bayesian path analyses showed behavioral intention to partially mediate the relationship between self-efficacy and current HIV risk (β= 0.24, 95% CI: 0.10, 0.38) and to fully mediate the relationship between AOD use and HIV risk (β= 0.11, 95% CI: -0.05, 0.26). In summary, two socio-psychological factors emerged as significant predictors of HIV risk. Lower levels of behavioral intention and higher levels of past HIV risk were associated with higher current HIV risk. These findings are relevant for informing future studies on Latino migrant workers or similar populations and for planning interventions designed to prevent and/or reduce HIV risk.

The focus of this study was to provide a comparison of data collected from seventh grade students on food safety knowledge who have been through USDA’s National Integrated Food Safety Initiative program with those seventh grade students who have had no formal school instruction on this topic. Middle school students were specifically targeted because they are more likely to synthesize this information in a way that will lead to the development of new behaviors. The population consisted of seventh grade students at Burchfield, Fairview, Huntsville and Oneida Middle Schools. Burchfield and Huntsville were the two schools used as the comparison group. The following conclusions were based on findings of this study: 1. There were some substantive increases in post-test scores for the treatment group. 2. The treatment group increased in all areas from pre-test to post-test. The areas included: Science Knowledge, Language Arts Knowledge, Math Knowledge, Social Studies Knowledge, Food Handling Skills Knowledge and Food Handling Behaviors Knowledge. 3. The data suggests this interdisciplinary food safety curriculum has made a positive impact on the treatment group. The scores after the program record higher overall than the comparison group scores. 4. The data showed that the treatment group had retained the knowledge, skills and behaviors six weeks after the treatment was administered. 5. Data revealed that the overall mean score for the treatment group pre-test was higher (+7.24) than the post-test score of the comparison group. 6. There was some evidence to suggest that the treatment group had more knowledge than the comparison group before the treatment, except in science, however the gain score afterwards shows the program successful. 7. A comparison of the treatment group and comparison group, revealed an overall increase in the mean score increase of 10.04 points for the treatment group, as an impact of this interdisciplinary food safety program. 8. After going through a one week food safety program, the student’s knowledge, skills and behaviors increased, thus strengthening the evidence that the program had a positive impact on the students.

<p> Binge drinking has become common among adolescents. Binge drinking has many negative consequences and can lead to many health problems. The purpose of the present study was to explore the related factors persuading adolescents to binge drink. Several risk factors were examined in the study using a survey from adolescents between the ages of 12 and 17. Some of the risk factors examined included: parental marital status, adult supervision, missed school days, and emotional anguish. The results showed that the risk factors greatly influenced alcohol consumption among adolescents and binge drinking. The study was important to advance the literature on the subject of binge drinking among adolescents by providing greater knowledge of the potential risk factors and drinking problem.</p>

<p>Much of Sub-Saharan Africa lags behind the world in reproductive health. The nine villages surrounding Gorongosa are remote rural villages with very limited access to health care, and contraceptive options. A survey regarding the health of women and children in the community was created and every woman between the ages of 15, and 59 was surveyed, a total of 2438 in all. There were many sections but this thesis focuses on the results of the contraception and family planning segment. In this population only 4% of women are using any form of family planning, 8.2% state they would like to, but only 3% state a desire to become pregnant at the point of the survey. Only 17.2% can name a method of contraception, and 27% believe that temporary contraception can lead to permanent infertility. Significant associations were found between knowledge and positive beliefs about contraception and use, or a desire to use contraception, indicating there is a role for educational programs to help inform women of their options and give them the opportunity for reproductive self-determination. </p>

<p> Health disparities persist for lesbian, gay, bisexual, and transgender (LGBT) identified people. Disparities can be combated through health care provider training and education in cultural competence. Improved health outcomes have been noted in primary care provider cultural competence training for other special populations including people that are HIV positive, people with limited literacy or limited English proficiency, and people from different racial or ethnic backgrounds. LGBT cultural competency training can play a pivotal role in health care professionals attitude and behavior change to reduce health disparities for LGBT people.</p>

<p> There is a need for epilepsy-based health education programs to enlighten Nigerian communities and reduce the stigma associated with epilepsy. Epilepsy in Nigeria is viewed by some as a contagious and an infectious disease or a condition imposed from the gods, possessed by demons, as the work of witchcraft, or punishment from ancestral spirits, which are all related to a lack of knowledge about epilepsy leading to stigmatization of persons with epilepsy. Guided by the stigma theory, the purpose of this community-based, cross sectional study was to quantitatively examine the effect of an educational program on interpersonal, internalized, and institutional stigma of epilepsy in terms of knowledge, attitude, and treatment gained. Two hundred and fifty participants completed a general domain instrument which had been used in different countries, including South Eastern Nigeria, and revised for greater validity via a pilot study. Chi-square tests were used to examine any significant differences in participants' responses between pre- and post-test surveys regarding knowledge, attitude, and treatment gained of all 3 identified stigma levels. According to study results, the educational program reduced all 3 stigma levels in terms of attitude, knowledge, and treatment gained of epilepsy (p&lt; 0.001). This study contributed to positive social change by providing information to public health workers on how to increase the knowledge and awareness of the South Eastern Nigerian community that epilepsy is not contagious or infectious and there is no need to isolate persons with epilepsy from their societies.</p>