With regard to infectious diseases, the most economical, direct, and efficient way to prevent them is timely inoculation and a comprehensive policy of vaccination. Such steps not only reduce the overall mortality rate, but also lessen a patient¡¦s susceptibility to serious complications once infected, and therefore their length of hospital stay. It is the foundation of disease prevention in all countries, and should be the primary focus of every public health department. This survey is based on a health belief model and a self-constructed questionnaire. Its sample base are parents whose children have visited one of two local hospitals, each of which is in a different administrative region. A total of 350 questionnaires were distributed. Recoveries were 270, of which 237 were useable. The effective response rate, therefore, is 67.7%. The useable recoveries were analyzed by SPSS, 17th edition, and verified and assumed by mean, standard deviation, t-test, one-way ANOVA, Pearson correlation analysis and Logistic regression analysis. The most influential factors on parents¡¦ decision whether or not to accept streptococcus pneumoniae vaccination (SPV) were as follows: 1.The greater the understanding of SPV and its policy, the greater the number of vaccinations 2.The perceived importance of good health 3. Age variability 4. The interrelationship between the perception and the policy of vaccination, the benefits of - and barriers to ¡V action, and the virulence and severity of the disease The results of this research suggest the public perception of SPV is the most important factor governing its efficacy. It is recommended, therefore, that public health departments campaign for SPV in a variety of different ways,( e.g. in newspapers and magazines, on TV, at pediatric clinics, at health centers, etc.) in order to establish a free and open flow of information to the public at large. It is in the hope of reducing the current mortality rate, length and cost of hospital stay and the serious complications arising from infection, that we offer the following data as reference for future planning.

Methicillin Resistant Staphylococcus aureus (MRSA) is the most commonly isolated multi-drug resistant organism in the hospital setting. MRSA can result in death among people who have no identified risk factors for infection. One-third of MRSA infections are cross-transmitted as Healthcare-Associated Infections (HAIs). It is well known that the single most effective means for decreasing the risk of HAIs is hand hygiene (HH), yet poor performance among registered nurses persists. The theoretical framework used to guide the study was the Health Belief Model (HBM). The purposes of the study were to: explore the RNs’ self-reported HH performance rate; explore the RNs’ knowledge related to MRSA; identify relationships between MRSA knowledge and HBM constructs; explore the RNs’ barriers to HH performance; identify relationships between barriers and self-reported HH performance; explore relationships among HH behaviors and constructs in the HBM; explore predictors of ‘overall HH’ performance; and identify if certain demographic characteristics are related to MRSA knowledge, self-reported HH, and HBM constructs. A cross sectional descriptive study was conducted with a sample of RNs who were randomly selected. The questionnaire mailing, which included the survey, consent, and the return-stamped envelope were distributed to 684 RNs. Completed surveys (n=120) from RNs who met the sample inclusion criteria were returned within four weeks. Self-reported HH were highest during times of increased perceived susceptibility for infection. In addition, nurses were more likely to overcome barriers to HH during ‘moments’ associated with the highest perceived susceptibility. Although MRSA knowledge did not correlate with ‘overall HH’ performance, there was a significant relationship identified with self-efficacy (r=.27, p<.01), which may influence HH behaviors. The most commonly identified barriers to HH performance were system factors (e.g. ‘a high workload’). Self-efficacy and barriers represented 26% of the variability in the regression model when applying significant correlations among HBM constructs and ‘overall HH.’ The phenomenon of the RN’s HH decision making is not completely understood. More research is needed to explain predictors for HH among registered nurses. This understanding will allow researchers to plan interventions aimed at increasing knowledge and understanding about perceived susceptibility, which may in turn improve self-efficacy behaviors for HH, which could decrease HAI rates. / text

Cardiovascular disease (CVD) including coronary artery disease and stroke is a significant health problem in Japan regardless of well established health care and insurance system and various public campaigns and exhibitions in the contemporary Japanese society. Higher and increasing prevalence and incidence of well-known risk factor of CVD may contribute to increasing mortality and morbidity of CVD in the future. However, limited knowledge was available for understanding perceptions of risk for CVD among Japanese adults. This grounded theory study aimed to explore social psychological process in perception of risk for CVD among Japanese adults.There were a total of 26 individuals participated in this study. Participants consisted of 19 Japanese adults with at least one CVD risk factor and 7 Japanese health care providers residing or working in which a consistently high mortality rate of CVD in both men and women.The theory grounded from the data was a process to avoid serious physical, emotional, social, and financial suffering as a consequence of developing CVD or of leaving it untreated and a process to maintain a good relationship with risk for CVD among Japanese adults with CVD risk factors. This grounded theory was consisted of the central concept of perceived risk for CVD, which defined as fear, threats, sorrow, worries, and/or anxiety for possible adverse impacts on their life living with their family and suffering for loss of independence and quality of life consequent upon CVD. This central concept was followed by actions to avoid these adverse and excruciating consequences of CVD including changing behavior, taking measures to manage CVD risk, and continually evaluating their condition. Factors contributed to perception of risk for CVD among Japanese adults were seriousness and severity of consequences of CVD, susceptibility, proneness, and possibility to develop CVD, and Japanese specific contextual factors.This study may contribute to appropriately addressing perception of risk for CVD and behavior change among Japanese adults with risk factors for CVD within the unique social, cultural context of Japan. The results of this study could apply to better nursing practice for CVD risk management and health promotion in Japan.

Sudden Infant Death Syndrome (SIDS) is a serious public health issue in this country and a major contributor to infant mortality in African American populations. African Americans have one of the highest rates of SIDS, some of which is due to increased risk factors for SIDS, such as prone sleeping and bed-sharing, as well as a lack of adherence to the SIDS risk reducing recommendations. Little is understood about this lack of adherence in the African American population or how to effectively address it but some research suggests a link between parental health beliefs of SIDS and the risk reducing recommendations and the implementation of these recommendations. This study used quantitative methods to gather data about the health beliefs and perceptions of SIDS among African American women living in Service Planning Area (SPA) Six of Los Angeles County to better understand the link between beliefs about SIDS and how this relates to implementation of the safe infant sleeping recommendations, specifically bed-sharing and prone sleeping. A self-administered questionnaire was developed to collect data using the Health Belief Model and several of its concepts as a guiding framework to assist with the construction of the questionnaire. The questionnaire was distributed electronically through the survey software program, Survey Monkey and analyzed using statistical software, SPSS. Exploratory factor analysis found the questionnaire reliable and valid upon the removal of four items, including the construct of cues to action. The new 19-item questionnaire suggested that the women felt that SIDS was a big problem but didn't feel as susceptible. There was also a clear confusion about prone sleeping position. Overall, the data suggests a need for tailored educational campaigns in African American communities to increase awareness of and susceptibility to SIDS and stressing the benefits of supine sleeping position.

Introduction and Rationale: Sudden infant death syndrome (SIDS) continues to be the leading cause of death in infants 28 days to 12 months old and the third leading cause of infant mortality (CDC, 2014; Task Force on SIDS, 2011a). SIDS has no identifiable cause although many hypotheses have existed and there are many known risk factors. Nicotine use is the second most modifiable risk factor for SIDS and to date there is no national public education campaign. Formal education is needed. Written education materials, such as brochures, are an effective way to increase knowledge and awareness of a health topic. Purpose and Objective: The purpose of this DNP Project was to create an educational brochure about SIDS and nicotine as a significant modifiable risk factor. The brochure is directed towards pregnant women and women with infants less than 12 months of age. The objective was to educate and inform mothers about SIDS, nicotine and its relation to SIDS, and the importance of abstaining from nicotine during and after pregnancy. Methods: The brochure was created using the Health Belief Model (HBM) as a framework. The HBM was used to explain health behavior modifications and was used as a foundation for education interventions. The model has successfully been applied to explain other preventative health behaviors and provide health education in various contexts. Results: The brochure was evaluated by two subject matter experts who have published peer reviewed articles using the HBM. Both subject matter experts found the HBM applied to the brochure appropriately. In their opinion, the content of the brochure should have positive impact for health modification in women who use nicotine and are pregnant or have a child less than 12 months of age. Conclusions: This DNP Project demonstrated SIDS as a current significant health problem and identified maternal nicotine use as the second most modifiable risk factor. Due to lack of current public education, a brochure was created using the HBM as a framework. Subject matter experts stated the brochure was created based on the HBM and will likely a have positive health influence on the intended population.

Vaccination, one of public health’s greatest disease prevention tools, is broadening to focus on adolescents. Now that there are more vaccines targeted specifically for adolescents, it is time to give more focus to vaccine delivery in this population. This research will increase the knowledge base to support informed changes in adolescent vaccine delivery by identifying knowledge and attitudes of adolescents toward vaccination within the context of barriers and solutions. Perceived susceptibility to disease, benefits and barriers to vaccination and other constructs were collected through a survey to 1368 high school students. In this population, a scheduled adolescent healthcare visit is feasible, vaccine education can diminishes health misconceptions, and vaccination mandates are ways to reach some students.

Background: Type II diabetes, which is known as non-insulin dependent diabetes, has become an epidemic worldwide. In the United States, diabetes affects 25.8 million people which represent 8.3% of the population. Out of 25.8 million, 23.22 million people have Type II diabetes. According to the National Statistics Vital Report, Type II diabetes was the number seven cause of death in the USA and it can be prevented. The primary purpose of this study was to assess the overall knowledge and health beliefs about Type II diabetes among a sample of undergraduate students; the second purpose was to assess the relationship between the overall knowledge and health belief subscale. Methods: A cross-sectional and descriptive survey design was used. An existing knowledge and health belief instruments was adapted. In the 2014 spring semester, a non- random convenience sample of over 200 undergraduate students who enrolled in Foundation of Human Health 101- class were surveyed in order to assess knowledge and health belief about Type II diabetes. The Health Belief Model provided the theoretical framework for this study. Results: Overview of the participants in this study was provided through conducting a descriptive analysis. Majority of the participant were female, aged between eighteen and twenty, and Caucasian. Data analysis revealed that the overall knowledge about Type II diabetes among participants was low. For the individual health beliefs, perceived susceptibility, perceived severity, and perceived barriers to Type II diabetes were low; however, perceived benefits to engaging in healthy behaviors was high. Having other problems more important than worrying about diet and exercise, and not knowing the appropriate exercise to perform to reduce the risk of developing Type II diabetes were the major barriers among participants. A positive, weak, statistically significant correlation was found between overall knowledge and total belief of benefits to engaging in healthy actions. At the same time, a negative, weak, statistically significant correlation was found between overall knowledge and total belief of barriers to engaging in health lifestyles. Results from multiple regression revealed that knowledge was best predicted by race/ethnicity. Family history, stress level, and level of exercise were the best predictors of perceived susceptibility, perceived benefits, and perceived barriers, respectively. Perceived severity was not predicted by any of the independent variables.

AN ABSTRACT OF THE DISSERTATION OF VICTOR NOLLEN WHITE, for the Doctor of Philosophy degree in Health Education, presented On November 14, 2014, at Southern Illinois University Carbondale. Title: THE USE OF THE EXPANDED HEALTH BELIEF MODEL (EHBM) TO EVALAUTE OSTEOPOROSIS ATTITUDES, KNOWLEDGE, BELIEFS AND SELF-EFFICACY OF NEZ PERCE TRIBAL AND NON NEZ PERCE TRIBAL MEMBERS IN NEZ PERCE COUNTY, IDAHO. Major Professor: Dr. Dhitinut Ratnapradipa According to the State of Idaho, the National Osteoporosis Foundation, and the U.S. Department of Health and Human Services, osteoporosis is a public health concern nationally among non-Native American (NNA) and Native American (NA) populations. The purpose of this research project is to obtain written survey data on osteoporosis attitudes, knowledge, beliefs, and self-efficacy among male and female members of the Nez Perce Tribe (Nimiipuu) and non-Tribal members, aged 18 and over via voluntary completion of a written survey questionnaire based on the expanded health belief model (EHBM). The study was conducted in Nez Perce County, ID. The research involved determining whether or not there is a statistically significant difference in osteoporosis attitudes, knowledge, beliefs and self-efficacy among males and females, aged 18 and over Nez Perce Tribal members as compared to Non-Tribal members in Nez Perce County, ID. Non-Nez Perce tribal members are individuals whom are 1) Native Americans who are not members of the Nez Perce Tribe and 2) all Non-Native Americans in the research study. Exercise self-efficacy and gender seem to be the most significant variables showing evidence against the null hypotheses and in favor of the research hypothesis (Null Hypothesis: H0: Native American=Non-Native American. Research Hypothesis: H1: Native American ≠ Non-Native American). Age also shows evidence against the null hypothesis and in favor of the research hypothesis, but not as strongly as exercise and gender. Seriousness of osteoporosis was the most concern to all respondents and female Native Americans perceived the greatest barrier to preventing osteoporosis was being unable to access dietary calcium on a regular basis.

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Patients diagnosed with Multidrug-resistant(MDR) and Extreme drug-resistant (XDR) tuberculosis (TB) have to be hospitalised for a period of six to twelve months, according to the MDR/XDR Policy Guidelines on the treatment of drug-resistant TB – until the patient recovers, and is no longer infectious. There are factors associated with both the patients’ and their partners’ (spouses) resistance to long-term hospitalisation. This has resulted in several acts of violence against the hospital property and members of the health-care team. However, there are a small number of partners who assist the health-care team – by ensuring compliance from the patients and providing their continued support to the patient – despite their own risk of being infected with MDR and XDR TB. This qualitative study was aimed at exploring and describing the resilience factors that have been observed amongst a small number of partners of patients with MDR and XDR TB at an in-patient treatment centre in Port Elizabeth. The research design was exploratory, descriptive and contextual in nature; and the researcher interviewed eight spouses or live-in partners of patientsfor this study, until data saturation was achieved. The data were collected through semi-structured interviews; and the data analysis was conducted, according to the eight steps proposed by Tesch model of data analysis (in Creswell, 1998).Guba’smodel of trustworthiness was used to assess the data collected during the interviews. The findings from this study will inform the health-care team on methods of how the support of the patients’ partners could be mobilised in the holistic treatment plan of MDR and XDR TB patients in an in-patient treatment centre.