Opioid overdoses and overdose deaths have increased significantly throughout the United States. Naloxone distribution has become a harm reduction strategy that has proven effective in reducing opioid overdoses in urban areas through drug treatment centers and needle exchange programs. However, limited research is available on the efficacy and feasibility of these programs in rural locations and other nontraditional settings. Guided by harm reduction theory, the purpose of this qualitative phenomenological study was to address this gap by exploring the feasibility of implementing a take home naloxone program in rural jails. Semistructured interviews were conducted with 6 jail administrators in rural upstate New York to determine their knowledge, attitudes, perceptions, and perceived barriers of a take home naloxone program. Data analysis of the participant interviews concluded 6 themes. The first theme concluded that participants believe naloxone acts as a safety net for drug users. The second theme identified that jail personnel are knowledgeable of opioid overdose and naloxone administration. Theme three confirmed that jail personnel would likely not support a naloxone program. Theme four concluded that naloxone training within the jail would likely be appreciated by inmates. The fifth theme addressed that multiple training barriers exist. In conclusion theme six affirmed that harm reduction programs are not favored by jail administrators. The implications for positive social change include increased knowledge of barriers that surround nonmedical and nontraditional community dispensing models for Naloxone and improved community awareness of a growing public health concern and increases collaboration towards a public health and safety approach to substance use and abuse.

Children between the ages of 6-17 years suffering from childhood attention deficit hyperactivity disorder (ADHD) need constant attention as they are more likely to be accident proned, hospitalized, disruptive, and educationally challenged. The constant attention required for children with ADHD may impose stress on mothers and primary caregivers, yet this stress has not been sufficiently studied. The objective of this study was to fill a gap in literature by studying the stress experienced by African immigrant mothers living in the United States who are living with and caring for a child with ADHD, and then comparing the level of stress reported by African immigrant mothers and African American mothers caring for children with and without ADHD. The study had a quantitative, case-control design, and used the parental stress index-short form (PSI-SF) and a 9-item demographic questionnaire as the survey instruments. One hundred twenty-five African immigrant and African American mothers participated in the study. Data collected from the mothers were analyzed for descriptive. ANOVA and Regression analysis were performed using SPSS version 21. The results showed that African immigrant mothers caring for a child with ADHD had significantly higher stress levels than those not caring for a child with ADHD. African American mothers also caring for a child with ADHD had significantly higher stress than African American mothers not caring for a child with ADHD. African immigrant mothers caring for a child with ADHD had significantly lower stress than African American mothers caring for a child with ADHD. These findings may initiate interventions that would help mothers provide quality care of life for themselves and for their children suffering form ADHD.

The stressful nature of deploying to a disaster makes it necessary for a good emergency manager to be capable of coping in high-pressure situations. When intensified by extended work hours, deployments can often lead to burnout, job strain, and emotional stress, which can have a significant impact on an employee's well-being. The purpose of this study was to examine the effects of burnout and perceived stress amongst emergency managers working for FEMA and to determine if social support was an effective intervention. The theoretical foundation used for this study was the job demands-resources theory, which aided in understanding, explaining, and predicting the well-being of employees, job performance, and organizational outcomes. The key research questions included to what extent do psychological job demands predict burnout, to what extent does the perception of stress lead to feeling burnout, and to what extent does peer support affect burnout. A quantitative correlational design utilizing secondary data from the Work, Family and Health Network was performed (N = 4,776). Results from linear regression found a relationship between psychological job demands and feeling burned out as well as a relationship between perceived stress and feeling burned out, as experienced by emergency managers. The model did not support a significant relationship between peer support and burnout. The social change implications include advancing the understanding of the stressful nature of deployments and stress from the psychological demands of the job that often leads to burnout. This study can be a resource to create and implement training programs for burnout prevention, and as a tool illustrating how to care for and support colleagues while also assisting disaster survivors.

The lack of knowledge of pharmacogenetic testing for cardiovascular disease (CVD), coupled with their increased risk for CVD, may impair nurses' cognitions and attitudes toward pharmacogenetic testing for CVD. The purpose of this quantitative cross-sectional correlational study, conducted with 230 RNs without CVD who worked in acute-care settings in Georgia, was to determine if their years of education, years of experience, and gender significantly influenced their perceived risk for CVD (Questions 1-3) and their perceived knowledge of pharmacogenetic testing for CVD (Questions 4-6), and if their perceived risk for CVD significantly influenced their acceptance of pharmacogenetic testing for CVD (Question 7). Various regression analyses (hierarchical multiple linear regression, multiple linear regression, hierarchical, linear regression) were conducted for hypothesis testing. Results showed that: (a) gender significantly predicted perceived risk for CVD, in that male nurses perceived themselves to be more at risk for CVD than did female nurses; (b) years of education was a significant predictor of knowledge of pharmacogenetic testing for CVD, in that as nurses' education level increased, so did their knowledge; and (c) knowledge of pharmacogenetic testing for CVD, but not perceived risk for CVD, significantly predicted acceptance of pharmacogenetic testing for CVD. This study may act as a catalyst to promote empirical work and inform practice in nurses' CVD health and their knowledge and acceptance of pharmacogenetic testing for CVD.

The purpose of this phenomenological qualitative study was to examine the etiology of water quality perceptions and beverage preferences of Black children and adolescents, which addressed a current gap in the literature on this topic. This study was guided by Festinger's social comparison theory, which supports the notion that children and adolescents' perceptions and preferences are influenced by their social network and those with whom they have a close association. In this study, children and adolescents' water quality perceptions were examined as well as the development and factors affecting those perceptions. Whether social factors such as peer or parental influence have an impact on children and adolescents' beverage consumption were also investigated. The study participants (n = 20) were recruited from two cities in a Midwestern state for semi-structured interviews from which information was coded into themes. Participants who met the inclusion criteria were Black youths between the ages of 9 to 18 years. The data were analyzed using latent content analysis with open and axial coding.The key findings in this study indicated that Black youths had negative perceptions of tap water quality and positive perceptions of bottled water, and stronger preferences for sugar-sweetened beverages than for water. These perceptions and preferences emanated from their parents and were also influenced by their peers, tastes, and the social environment. This study's implications suggest the need for improved health literacy through programs that educate participants in making informed decisions to impact the quality of health; this will also increase the overall health of society in terms of productivity and economic growth.

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from 10 women, ages 18 to 59 who had undergone FGM/C. Participants were voluntarily recruited using purposeful snowball sampling techniques. Data were analyzed through inductive coding techniques to extract and compare recurrent themes and patterns. Four major themes emerged: (a) traditional beliefs; (b) pain, happy, and approval; (c) pain, distress, and disapproval; and (e) ignorance of the law. Results indicated that ethnocultural beliefs, religion, and customs had a strong influence on the decision to undergo FGM/C. Women who viewed themselves as heroes of the practice strongly supported the continuation of FGM/C. The women who viewed themselves as victims of FGM/C disapproved the practice as an instrument to instill fear and control. The potential for social change could improve the knowledge of public health professionals, international organizations, federal, state, and local governments to influence policies on decreasing FGM/C without undermining the culture of communities regardless of any personal belief that sees FGM/C as detrimental to women.

Low Human Immunodeficiency Virus [HIV] test uptake and multiple partnerships among men in Nigeria are contributing factors to HIV transmission. The purpose of this quantitative cross-sectional study was to examine the relationship between HIV test uptake, sociodemographic characteristics, HIV knowledge, attitude, and multiple sexual partnerships. The health belief model provided the framework for the study. Data were collected from the 2013 Nigerian National Demographic Health Survey, which surveyed 17,359 Nigerian men ages 15-49 years. Chi-square and binary logistic regression analysis showed that sociodemographic variables (age, residence, marital status, religion, wealth status, ethnicity, and educational level), HIV test uptake, HIV knowledge, and attitudes toward negotiating safer sex are significantly associated with multiple sexual partnerships. Findings showed that multiple sexual partnerships were higher among middle-aged men (25-39 years) in Nigeria and lower among Hausa Muslims. Findings showed that HIV testing is a significant predictor of multiple sexual partnerships, those that have been tested are more likely to be engaged in multiple sexual partnerships than those never tested. A well-tailored intervention that will promote follow up with men after HIV test uptake is essential to reduce the practice of multiple sexual partners among them. This may result in positive social change by presenting public health experts, donor agencies, and health teachers with valuable information about how multiple sexual partners and HIV testing can influence sexual risk behaviors among men. This may advance HIV prevention and control practices among men in Nigeria.

Approximately 35% of women in the United States experience intimate partner violence (IPV). IPV could be linked to symptoms of posttraumatic stress disorder (PTSD) that result in long-term mental health issues. Public health professionals, college counselors, and educators require information to assist in identifying college-age women who may be affected by IPV. The purpose of the study was to explore the association between the occurrence of symptoms of PTSD and IPV among college-aged women. The socioecological model was the theoretical framework for the study. A total of 199 cases were selected from National Intimate Partner & Sexual Violence Survey dataset for analysis. Data were analyzed using chi-square analysis and Welch's t test. The results of the study indicated significant association in the relationships between PTSD symptoms and IPV, which displayed p < .001, and significant association between PTSD symptoms and socioeconomic status, which displayed p = .026. The results also indicated that age (p = .313), ethnicity (p = .178), social support, and education (p = .079). have no significant relationship with PTSD symptoms and IPV among college-aged women. The potential positive social impact of this study is that findings show predictive factors that may have influenced a type of behavior as it relates to IPV, which could create and improve IPV prevention programs for college women, college educators, college counselors, local authorities, and health care workers. Providing focused attention on the education of these individuals could assist in early detection, which could reduce the potential for IPV/PTSD symptoms to occur among college-aged women.

The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis were performed on the data extracted from the survey in order to better understand the relationship of the variables in this study, and to test if any of the independent variables were significant predictors of vitamin D intake through supplementation and sunlight exposure. The results of this analysis showed that knowledge regarding the reduction in risk of breast cancer from sunlight exposure and through vitamin D supplementation was not related to changes in behavior involving increases in sunlight exposure and vitamin D intake through supplementation. Further, the results showed that those participants with higher levels of self-efficacy and response-efficacy regarding sunlight exposure and vitamin D supplementation had an increased amounts of vitamin D intake through supplementation on a daily basis. The results of this study can be used to help medical professionals understand the complexity involved in how their clients may or may not take action to reduce the potential for reducing the risk of breast cancer.

Breastfeeding is associated with numerous health and social benefits. Although support for breastfeeding is promoted globally, disparities in breastfeeding rates and support continue. African American mothers have lower breastfeeding rates than do Hispanic and Caucasian mothers. Several researchers have focused on the benefits of breastfeeding support, but no available research has explained any specific ethnic group perceptions of breastfeeding. This study explored 10 first-time African American mothers' perceptions of the breastfeeding support they received from physicians, nurses, midwives, and lactation consultants. The purposeful criterion sampling strategy was used to recruit participants, and data were collected through semistructured telephone interviews. The phenomenological research strategy, the social constructivist philosophical framework, and the breastfeeding self-efficacy theory guided the research process and helped in understanding the lived experiences of the participants. Data were analyzed thematically, revealing motivating factors for breastfeeding, experiences in getting breastfeeding support, types of breastfeeding support groups, and overall breastfeeding experiences. All participants felt it was important to breastfeed for their children's health. Their main concern was a lack of adequate professional support after they gave birth. The findings from this study can contribute to positive social change by increasing awareness related to first-time African American mothers' breastfeeding experiences and perceptions. Such awareness can assist in creating culturally sensitive programs to assist more first-time African American mothers increase their self-efficacy and promote successful breastfeeding.