<p> A personal belief exemption (PBE) has allowed parents to exempt their children from immunization when they are opposed to it based on their personal beliefs. As the number of PBE increased over the past few years, there was an increase in incidence of vaccine preventable diseases such as measles and pertussis among kindergartens. The current study examined the association between the percentages of PBEs filed by parents of kindergarten and three socio-demographic variables of schools including ethnicity, income level, and religious affiliation. The statistical findings showed that the percentages of PBE were lower among Asian Americans and Hispanics than Caucasians, higher among the religiously affiliated schools than religiously affiliated schools, and higher among south Orange County (OC) schools than north OC schools. The findings can help public health field detect which risk factors correlate the percentage of PBE and develop interventions more effectively and can help limit future outbreaks.</p>

<p> Maternal mortality, an example of poor maternal health outcomes, is widely accepted as an indicator of the overall health of a population. One of the Millennium Development Goals was reduction in maternal mortality by 3 quarters by 2015. These goals were not met in Nigeria and it is important to look at some of the reasons why. Education has been shown to have positive impact on pregnancy outcomes; however, the characteristics of pregnant women, their health literacy level, their usage of antenatal care services and how these impact pregnancy outcomes are yet to be analyzed in Lagos, Nigeria. Guided by the social cognitive theory and health belief model, the purpose of this cross-sectional quantitative study was to determine if there is a relationship between maternal health literacy, antenatal care visits, development of medical conditions during pregnancy, and pregnancy outcomes (measured by healthy or unhealthy baby) in Lagos, Nigeria. The research question for this study tested if there was a relationship between these variables. Lisa Chew&rsquo;s health literacy assessment tool was used in a sample of 130 women in Shomolu local government in Nigeria who met the inclusion criteria. Using binary logistic correlations, only problems developed during pregnancy is statistically significant with pregnancy outcomes (<i>p</i> &lt; .05). The results suggested an increase in problems developed during pregnancy most likely will increase the chance of having negative pregnancy outcomes. Results from this study could promote positive social change by helping health professionals identify the characteristics of at-risk women during antenatal education sessions. The results could also help health professionals in the development of targeted antenatal care interventions.</p>

<p> The purpose of the study was for the researcher to explore adult education techniques and tools that could be used to explore eating habits within research study groups. The participants enrolled in the research study groups brought their own way of thinking on eating habit discussions based on their unique experience in life. The researcher explored different techniques that could help improve the participants&rsquo; quality of life and other positive solutions to benefit the participants. </p><p> This research study explored the impact of learning contracts on participants with eating habit research-based study groups. The study explored the degree to which learning contracts may be a beneficial tool to positively impact eating habits. Pre and post-surveys were administered within the research groups that participated. The purpose behind the study was to learn the impact learning contracts could have on eating habits. In addition, the study explored differences, positive impacts, benefits, and outcomes for participants utilizing learning contracts on eating habits.</p><p>

<p> The number of older adults facing food insecurity is on the rise. As an attempt to reduce food insecurity at a policy level, nutrition incentive programs such as Market Match have been available within the community at participating Farmers Markets. An ecological framework was used in this study to assess the impact of Market Match on intrapersonal, interpersonal, community and policy factors that contribute to food insecurity for older adults. The aim of this study was to evaluate the overall impact of Market Match among older adults by measuring participants&rsquo; Market Match satisfaction through feasibility and accessibility. Findings from this study suggests programs such as Market Match may be beneficial in reducing food insecurity among older adults.</p><p>

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. A combination of the Orem's Theory of self-care and the Bandura's social cognitive theory (SCT) guided this study. The sample included 96 diabetic Hispanic Americans aged 18 and older residing in Fairfax County, VA. Multiple linear regression analysis showed a statistically significant relationship between diabetes knowledge, education level, health literacy, self-efficacy, and self-reported diabetes self-care behaviors. The score of the self-reported diabetes self-care behaviors was related at statistically significant levels to the score of diabetes knowledge (rs = 0.5230, p = 0.00), to the score of education level (rs = 0.2831, p = 0.01), to the score of health literacy level (rs = 0.6332, p = 0.00), and to the score of self-efficacy (rs = 0.7783, p = 0.00). The results of this research study could contribute to positive social change by providing the public health workforce in Fairfax County, VA with insights for developing culturally sensitive education programs that best fit the needs of Hispanics and fight against Type 2 diabetes.

Preventive health care is effective in reducing both infectious diseases and chronic conditions among the elderly. Despite efforts to prevent or decrease the risk of illness, unmarried men are less likely to receive selected preventive services compared to married men. The purpose of this cross-sectional survey was to describe disease prevention attitudes and behaviors of retired, unmarried, male baby boomers residing in Harlingen, Texas. Further, the study examined the effects of socioeconomic status on disease prevention attitudes and behaviors. The health belief theory framed the study. A validated questionnaire collected disease prevention attitudes, behaviors, and sociodemographic characteristics data. Data inquiry included ANOVA, multiple regression and moderation analysis. The findings did not show any differences in disease prevention attitudes and behaviors among retired, unmarried male boomers. Multiple linear regression indicated that the socioeconomic factors explained 24% of the variance in disease prevention behaviors (p = .001). Moderation analysis showed that 29% of the variability in the dependent variable could be explained by the independent variables and interaction terms. The only significant predictor was education, p= .002); none of the interaction terms were significant. Positive social change from the study is the possible increase in disease prevention behavior among the retired, unmarried male baby with a low level of education. The study results may help in developing policies that would target education barriers and raise awareness of disease prevention behavior among the retired, unmarried male baby boomers.

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial classes, (b) increased scheduling of 1:1 classes, (c) education of more staff to meet patients' needs, (d) automatic phone call reminders to patients, (e) increased mailing of appointments to absent patients, (f) promoting DSME classes at physicians' meetings, (g) having clinic nurses schedule the patient's first classes at the time of physician visit (h) alteration of class times to compliment patient schedules, and (i) scheduling classes around public transportation schedules. Although there were no pre- and post-attendance data provided by the facility, recommendations of the DSME project team were to continue tracking weekly patient attendance and maintain the current recommendations for increasing enrollment. This project might contribute to positive social change for patients, their families, clinic employees, and the community by improving the health and self-management of the diabetic patients.

Latinos of low socioeconomic status are disproportionately affected by diabetes Type II complicated by poor adherence to diabetes Type II medications and management programs. Self-management of diabetes Type II is a tool used to teach health education to patients with diabetes. The objective of this retrospective quantitative study was to explore if there are predictors of nonadherence to diabetes Type II medications and programs among Latinos with diabetes Type II. Data from 200 patient records from a community clinic in Fresno County California were analyzed using both bivariate and multivariate analysis. Selected sociodemographic independent variables were age, gender, income, migrant worker status, family size, and having received health education. The dependent variable was adherence to medication and management programs. Gender and health education were the only strong predictors of nonadherence to diabetes Type II medications and programs among the study sample in the bivariate analysis. The combination of gender and health education was the only strong predictor to diabetes Type II medications and programs in the multivariate analysis. Recommendations include personalized health education that incorporates a protocol for teaching patients about diet, consumption of alcoholic beverages, exercise, medication, and the effects these behaviors have on diabetes prevention and management. The implications for positive change include decreasing complications, improving quality of life, and improving patient satisfaction. The implications also include decreasing health care cost for stakeholders, including patients, and insurance payers.

Full (complete) childhood immunization against tuberculosis, poliomyelitis, diphtheria, tetanus, hepatitis B, yellow fever, measles, and the maternal retention of immunization documentation are the most cost-effective interventions against vaccine-preventable childhood diseases. The full childhood immunization rate in Nigeria has not reached the expected target level of compliance at 90%. Using the social ecological model, this study investigated the influence of maternal satisfaction with postnatal services and paternal support on full childhood immunization status; it also examined the association between maternal factors and the maternal retention of immunization documentation in Owerri, Nigeria. The hypotheses were that maternal satisfaction with postnatal services and paternal support were associated with full childhood immunization status. This study was a quantitative, cross-sectional survey design that included validated modified WHO/EPI-30 cluster immunization survey information from the cluster sample of 560 mothers of children between the ages of 12 and 23 months old. The multivariate logistic regression analysis (at the .05 level) indicated that the odds of full childhood immunization status were lower for participants who indicated no maternal satisfaction with postnatal services compared with those who indicated satisfaction with postnatal services. Public health workers and policymakers should invest more resources in maternal and child health care resources to increase maternal satisfaction with postnatal services. The study outcomes may help to evolve a system that may increase childhood immunization status and reduce vaccine-preventable diseases in Owerri, and serve as a model for other countries.

Human papillomavirus (HPV) is a preventable, sexually transmitted infection whose prevalence has been rising dramatically among men who have sex with men (MSM) in the United States since 2008. The HPV infection rate for MSM is rising even faster for MSM who are infected with the human immunodeficiency virus (HIV) and for those who have developed acquired immune deficiency syndrome (AIDS). It is not clear whether MSM in general and MSM with HIV have the knowledge necessary to prevent infection of themselves and their partners. This phenomenological study explored the knowledge, health perceptions, attitudes, and norms of the community of MSM and HIV-positive MSM relative to HPV, using private, semi-structured, detailed interviews with 37 HIV-positive MSM between 18 and 26 years of age; interviews were conducted at 3 outpatient clinics and 2 private medical practices. Interview transcripts were analyzed; these findings revealed that the study population of HIV-positive MSM had a basic understanding of HPV but knew little about the transmission of HPV or about the availability and cost of HPV vaccines. This study promotes positive social change by identifying specific opportunities to improve health education policy and programs targeting HIV-positive MSM. It also supports primary prevention efforts that have the potential to be life-saving. Through educating MSMs, the potential exists to reach more MSMs with primary prevention life-saving efforts. Study recommendations include developing inclusive education programs addressing different aspects of, and behavioral approaches to, the reduction of HPV infection risk; further exploration of a cost-benefit analysis of the HPV vaccine; and support for policy change regarding insurance coverage for male HPV vaccine in the United States.