Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene hypothesis using data from NHANES from 1999 to 2012. A cross-sectional study design was used to determine the average age of onset of T1D with respect to ethnicity and gender and to assess if age of onset is associated with ethnicity and gender. The average age of onset was 10.5 years for males and 11.8 years for females. The average age of onset was 13.0 years for Hispanics, 12.7 years for Non-Hispanic Blacks, and 10.6 years for Non-Hispanic Whites. Regression analysis indicated that there was no significant association between age of onset and gender (β = 1.1, p = 0.386) and between age of onset and ethnicity (β= 2.1, p = 0.070 for Hispanic White; β = 1.9, p = 0.101 for Non-Hispanic Black) having considered the Non-Hispanic White as the reference population. The result of this study may contribute to positive social change by providing better insight on demographic determinants of the risk of T1D, which is crucially important in the planning and implementation of prevention measures in highly susceptible populations.

In the military, excessive weight could put members at risk for training injuries, loss of potential career opportunities, and possible discharge from military service. This could increase cost to United States' national defense through increased injuries, decreased retention due to early discharge, cost of retraining, and lifelong chronic health conditions. The purpose of the study was to determine if there was a correlation or predictive value between active duty Navy members' perception of care provided for weight management and the active duty Navy member's motivation for weight management interventions. The social capital theory served as the theoretical framework for this cross-sectional survey design quantitative study. Data were collected from 241 active duty Navy members using a survey that included questions about clinical practice guidelines and motivation to change. Data were analyzed using Pearson chi-square and multiple linear regression to determine if individual demographics (body mass index [BMI], age, gender, ethnicity, military rank, and marital status) had a correlation or predictive value between reported care received and motivation to change. The results demonstrated a correlation between BMI, age, ethnicity, and care reported (p < 0.01); between BMI and motivation to change (p < 0.01) and between reported care and motivation to change (p <0.01). The potential positive social change implications from the findings of this study could lead to knowledge of individual factors and social factors that support a fit Navy force, lower cost to the nation for national defense through increased retention of highly trained members, decreased chronic health conditions, and lower cost of military health care.

Type 2 diabetes is a complex metabolic disorder characterized by hypoglycemia or hyperglycemia that affects fat, protein, and carbohydrate metabolism. Researchers have identified that for individuals with Type 2 diabetes, staying on interventions for diabetes self-management is sometimes difficult and challenging. It is an increasing public health concern, especially in certain minority populations and in many developing and developed nations. This is especially true for the population of women 40 years and older in Mgbidi, Nigeria. In the Enugu State of Nigeria, women bear most of the burden of Type 2 diabetes when compared to the males in the state. This study explored and evaluated the impediments to self-managed Type 2 diabetes among Mgbidi women in the Enugu State of Nigeria, West Africa, using a qualitative phenomenological approach. The concept of impediments influencing cultural behavior was used as the guiding framework. The participants were a group of 9 women 40 years and older who live with Type 2 diabetes. Face-to-face in-depth structured and unstructured interviews were used for the data collection. The responses of the participants were recorded using a tape recorder with their consent. Their responses were analyzed using aspects of Hycner's and Colaizzi's approach for analyzing phenomenological data. The result of this study supported and expanded on the findings of the current literature review. Individual and social challenges and barriers came to light; such as lack of or non-functioning care centers, lack of diabetes related education, and misconceptions like ignorance, social support and medications behaviors. The use of the concept of impediments influencing culturally sensitive self-management behavior of type 2 Diabetes strengthened the study. The findings could help to enhance cultural sensitive diabetes education for this population and other populations who have diabetes in this community.

In 1964, the Surgeon General issued the first report that linked smoking cigarettes as a direct cause of emphysema, heart disease, and lung cancer. Despite this landmark publication, the primary cause of preventable deaths each year in the United States continues to be related to the use of tobacco. Regardless of decades of health education and resources available to inform society that the use of tobacco products can have deleterious effects on health, adolescents continue to experiment with them. The purpose of this study was to gain a better understanding of the influences of adolescent tobacco use. Based on the social cognitive theory, this qualitative study involved adolescent individual interviews and community adult focus groups to compare the perceptions of what influences adolescents to use tobacco. Responses of both the adolescents and community adults were coded, categorized into themes, and ranked based on their similarities and differences. The most notable findings in the adolescent group was their indifference to smoking, whereas the community adults had strong negative perceptions of smoking. Moreover, the media was not felt to be a strong influence; however; adolescents thought it was somewhat of an influence. Tobacco use of peers was not determined to be a strong influence in the perceptions of either groups. The impact for positive social change is a better understanding among both adolescents and adults of the perceptions of adolescent smoking. This enhanced understanding indicates a need to denormalize smoking behavior to subsequently decrease the number of adult smokers and tobacco-related deaths.

Obesity is a significant global issue, and its incidence has increased over time. A substantial percentage of the U.S. population suffers from this disease with a relatively high prevalence seen in individuals from the Caribbean. The purpose of this phenomenological study was to explore Caribbean women's perception of how migration to South Florida may have impacted the onset of obesity in this population. The social ecological model provided the framework for the study. Data were collected from 1-on-1 interviews held with 12 female participants between the ages of 18 and 35, who previously resided in the Caribbean at a healthy weight but became overweight after migration to the United States. The information collected were analyzed using manual coding to identify 5 themes: consciousness of weight gain, challenges associated with weight gain, factors causing weight gain, attitudes toward weight gain, and efforts aimed at weight loss. Participants reported they felt that migration adversely affected their health by causing weight gain which eventually developed into obesity, caused by a modification to their lifestyle as well as an overall change in attitude towards weight gain. The social change implications of these findings are that they may be used to raise awareness of the risks of obesity among Caribbean immigrant women and to develop interventions to address the issue. Such interventions may result in increased well-being, healthier lifestyles, and prevention of obesity associated morbidity and mortality among this population.

Prescription opioid abuse in the United States is an alarming health issue. In 2015, approximately 2 million people abused prescription opioids, and 12 million individuals misused their prescription opioid pain relievers. The percentage of individuals who died as a result of opiate abuse increased from 22% in 2013 to 76% in 2014. The purpose of this project was to evaluate the influence of an inner-city drug treatment (DTBF) program on opioid users' behavior. The practice question addressed whether knowledge of signs and symptoms of opioid withdrawal obtained from the DTBF program resulted in a significant behavioral change in opioid use in 45 adults ages 18 to 25. The Centers for Disease Control and Prevention framework for program evaluation was used to guide the study. Data were collected using a pretest and posttest with the Clinical Opiate Withdrawal Scale (COWS) over a 6-month period. Results of t-test analysis indicated a significant change in drug use (p = .000). Recommendations to clinic administrators included encouraging all staff to use the COWS in screening individuals and observing them at each clinic visit. The implication of this study for social change is that findings may be used to reduce drug abuse and misuse among prescription opioid users.

The southwest and northwest regions of Cameroon have experienced high rates of intimate partner violence (IPV). Limited information is available about IPV victims' experiences with social support systems. This phenomenological study was aimed at investigating IPV victims' lived experiences with social support systems in Cameroon. Some of these systems are the judicial system, police officers, hospitals and clinics, and domestic violence agencies. The Health Belief Model (HBM) and the Transtheoretical Model of Change (TTM) were used to understand how 8 self-identified victims of IPV were able to discuss their lived experiences with social support systems. The research questions addressed women's experiences with social support systems as victims of intimate partner violence. The study also addressed participants' willingness to use social support systems again if the systems were made available to them. Data were gathered through face-to-face interviews using a purposeful-criterion sample that discussed the themes developed after the interview. The participants were selected with the help of 2 local domestic violence organizations based in the northwest and southwest regions of Cameroon. Study findings, which were generated via inductive analyses, indicated that victims sought the help of social support systems at least 3 times in hopes of changing their situation but were not satisfied with these systems. The study conveys social change by encouraging the need to educate social support systems in implementing and developing culturally-sensitive programs to eradicate IPV in Cameroon.

Obesity or being overweight is a prevalent health concern around the world. Despite the growing problem in developing countries such as Kenya, there is scant literature available on obesity or being overweight among women in rural Kenya. This research study provides information necessary for bridging the gap in understanding the perceptions, beliefs, and knowledge of obesity among women in rural Kenya. This study used the social cognitive theory (SCT) framework to assist in understanding the impact of obesity or being overweight among women living in rural Kenya. Participants were women aged 20 to 45 recruited from a local church in rural Subukia. Using a phenomenological inquiry, in-depth interviews were conducted. Data obtained were analyzed by open coding. Themes that emerged from data analysis showed that less than half of the study participants had an appropriate knowledge of obesity. Participants desired to have big round bodies, as it was perceived as desirable and as being healthy. However, this perception put these women at increased risk of obesity and associated health risks. Implications for positive social change include the use of study findings by policy makers to develop obesity prevention programs. Such programs may promote obesity awareness and obesity prevention strategies. This promotion may include providing education on topics such as healthy nutrition and the importance of physical activity. Policy makers may develop obesity prevention programs aimed at not only educating, but also empowering rural communities to practice healthy lifestyles based on their cultural and social norms. Such empowerment may encourage the adoption of obesity reducing lifestyles and positive behavior change.

Numerous studies have shown a rising HIV/AIDS epidemic among U.S. Hispanics/Latinos. Risky sexual behavior, alcohol, drug abuse, and sociodemographics contribute to Hispanics/Latinos' elevated risk for contracting HIV and other STDs. There is a need for additional research to understand the combination of factors associated with HIV and other STD infection among Hispanic/Latino youth. Based on social cognitive theory, this study examined the influences of peer pressure and relationship knowledge on risky sexual behavior among Hispanic/Latino young adults as measured by the Peer Pressure Inventory (PPI), the Teenage Research Unlimited Survey (TRU), and the Youth Risk Behavior Survey (YRBS). A group of 18-to-24 year olds (n = 173) from the 6 wards of Harris County, Houston, Texas completed the PPI, TRU and YRBS via paper questionnaires. Logistic regression determined a marginally significant association between relationship knowledge and number of lifetime sex partners. The remaining logistic regressions indicated no significant relationships between the variables of peer pressure, relationship knowledge, and risky sexual behavior. Descriptive statistics revealed that a large proportion of participants were engaging in several risky behaviors, including sex without condoms, sex while using alcohol or drugs, and sex with multiple partners. The results of this study also confirmed that Hispanics/Latinos aged 18-24 years are at risk for HIV and other STDs. Implications for positive social change include evidence to inform peer- and community-driven prevention programs targeting Hispanic/Latino young adults living and working in Harris County, Houston, Texas as a means to reduce transmission of STDs and HIV/AIDS in the Hispanic population.

There is a gap in infertility research regarding resource availability within rural communities, yet existing research declares infertility a public health concern. This qualitative study was grounded in the Heggerian phenomenological framework by way of assessing participants' perceptions of and experiences with infertility resources in a rural community. The purpose was to analyze the meaning of those experiences within their world. To accomplish this, Antonovsky's salutogenic theory was applied to investigate the strengths and weaknesses of infertility resources including the availability of resources, participant understanding of, and participants' experiences. Purposive sampling was used and in-depth interviews were conducted with 12 women, ages 24 to 39, who reside within rural communities. Interviews consisted of 60 questions that were designed to examine 13 research questions. Data were analyzed following Ritchie and Spencer's framework, requiring documentation and data classification, through 3 phases: open coding, focused coding, and axial coding. Emerging themes included a need for more resources on infertility, assistance with locating infertility resources, and an association between insurance coverage and use of infertility treatments. Findings from this study indicated a need for additional resources and knowledge regarding infertility in rural areas, also confirming a need for additional research on the topic. Social change implications for this research include developing resources for consumers and health care providers as well as improved provider knowledge. With increased knowledge and resources, these individuals may be able to achieve their goals and cope with the challenges of understanding and dealing with infertility.