The present study investigated why communities differing in culture and resources are willing and able to implement gun confiscation as part of a protective order. Specifically, this study explored whether the perceived risk of intimate partner homicide and gun violence, benefits to engaging in gun confiscation, barriers to gun confiscation, community norms about guns, and community readiness to implement gun confiscation: (a) differ in urban and rural communities, (b) are perceived differently by victim service and justice system key professionals within urban and rural communities, and (c) are related to if a community is able and willing to consistently implement procedures that mandate gun confiscation of abusers as part of a protective order. Interviews, guided by an adapted guiding conceptual framework, were conducted with key professionals (N = 133) who work both in victim services and the justice system from a targeted urban community and four Appalachian communities in Kentucky. First, implementing gun confiscation procedures to disarm abusers in rural communities does not seem likely or feasible compared to the urban community given the lower perceived risk-benefit of gun confiscation, importance of gun culture, and limited resources in the selected rural communities. Second, urban justice system professionals, in comparison to urban victim service professionals, reported fewer barriers to enforcing the gun confiscation policy and were more likely to downplay law enforcement limitations in the community and attribute the ineffectiveness of the gun confiscation policy to reasons outside their control. Third, the perceived risk of intimate partner gun violence was associated with consistently implementing in gun confiscation at the emergency protective order (short-term) level, and the perceived community approval of the policy was associated with engaging in consistent gun confiscation at the domestic violence order (longer-term) level. Fourth, both urban and rural professionals pointed out potential unintended negative consequences to implementing the gun confiscation policy, such as violation of second amendment rights and increased danger for victims who seek protective orders. The results have implications for developing more effective strategies for increasing a community’s ability and motivation to enforce gun policy that keep guns out of the hands of dangerous abusers.

Each year more than 44,000 women are diagnosed with breast cancer and more than 12,000 of these die from the disease. These mortality rates are relatively high compared to the rest of Europe (Berrino et al., 2007; Mayor, 2003), which in part is due to the advanced stage of the disease at first presentation (McCready et al., 2005; Sant et al., 2003). Regular breast self-examination (BSE) can facilitate early detection (Cancer Research UK, 2008), yet it is not widespread. Identifying the motivational and contextual factors is likely to lead to the development of effective interventions as part of being ‘breast-aware’. This is particularly important given that mammography screening may not be effective (Crossing & Mansezewicz, 2003) or recommended for younger women (Cancer Research UK, 2008) and that BSE may be beneficial in offering women the opportunity to create a positive relationship with their body. This study considered the utility of a proposed Extended Health Belief Model (E-HBM) as a framework for understanding women’s knowledge, beliefs and behaviour. It sought to develop a new way to provide guidance and to encourage BSE by investigating the effect of autobiographical accounts of breast-cancer patients and a multimedia BSE support programme comparing video-enhanced or static guided instructions. The study adopted a 2x2 mixed methods design and 60 white British women aged between 19 and 67 participated. Analysis of Covariance revealed an interaction effect of autobiographical accounts and BSE support on BSE frequency and proficiency and regression analyses examined the utility of the E-HBM, with confidence being the main predictor. Moreover, thematic analysis elicited five themes; Previous Experience, BSE Irregularity, Perceived Susceptibility, Coping Style and The Usability of the 5 Step Model of BSE. The study concludes that the 5-step technique encourages BSE through creating a more pleasant experience, as women form an improved relationship with their breasts. Both the video-enhanced and static BSE supports are effective in terms of encouraging BSE and the effect of autobiographical accounts appears to be dependent on the type support. The practical implications and direction for future BSE interventions are discussed.

This thesis examines current practices of music and prayers in the context of Jam ritual among the Ahl-e Haqq, a vernacular religion group in Iranian Kurdistan. I examine the construction and sacralization of the sacred instrument of the Ahl-e Haqq, tanbūr. I also explore the sacred prayer, kalām, and the association of prayer and music. Through the ethnographic method, participant observations, and interviewing religious figures and master musicians during the fieldwork in Sahneh, Iran, I investigate the relation of the Ahl-e Haqq prayers and music, and their effect on healing during their sacred ritual performance. Drawing primarily on scholarship from David Hufford and Bonnie Blair O’Connor, I theorize to show the distinction between healing and cure. Also using Leonard Primiano’s concept of vernacular religion, my aim is to show how the Ahl-e Haqq define their vernacular health belief system. This thesis examines the effect of music and prayers on healing in particular contexts and how it influences the daily wellbeing.

In recent years, many health care organizations have begun to take advantage of computerized information systems to facilitate more effective and efficient management and processing of information. However, commensurate with the vastly innovative enhancements that computer technology has contributed to traditional paper-based health care information systems, are security vulnerabilities that have potentially devastating effects on these systems. To ensure the confidentiality, integrity, and availability of information and to ensure compliance with the Security Rule of the Health Insurance Portability and Accountability Act (HIPAA), health care organizations have implemented a number of security controls. Although the objectives of these controls are understood and acknowledged by users of computerized patient care information management systems, the controls are sometimes circumvented or ignored. The purpose of this study was the development of an instrument that measures key determinants of healthcare professionals' prudent access control behavior. The study examined healthcare professionals' prudent access control behavior using a model that integrates the Theory of Planned Behavior (TPB) and the Health Belief Model (HBM). Two additional variables - information security awareness and perceived information security responsibility were incorporated into the model. Rather than focusing on a single behavior or a few specific behaviors, a category of behaviors was proposed. Results of the study indicate that the HBM and TPB constructs as well as the two additional constructs included in the model are indeed key determinants of healthcare professionals' intention to engage in prudent access control behavior that mitigate security threats. Additionally, results of the study provide support for the partial mediating effects of perceived benefits and perceived responsibility for information security on attitude, information security awareness, subjective norm, perceived behavioral control, and perceived severity. The study contributes to the IS knowledge domain by providing theoretically grounded explanations for a subset of prudent information security behaviors of healthcare professionals.

Magister Public Health - MPH / The study aimed to describe the knowledge and awareness of HPV infection and vaccine of female university students and to determine the predictors of vaccine acceptability. The study found that 70% of the participants were sexually active. Awareness and knowledge on HPV/vaccine were poor; with only 22% being aware of HPV and that a HPV vaccine was available in South Africa. A greater proportion (80%) reported willingness to be vaccinated. Being aware of the existence of a pap smear, higher knowledge about HPV, higher perceived vaccine effectiveness and higher perceived severity of HPV infection were significantly associated with increased willingness to be vaccinated. / South Africa

In Lebanon, estimates of Complementary and Alternative Medicine (CAM) use among college students are not available. CAM practices are not well regulated and some products contain unsafe substances. The purpose of this study was to estimate the prevalence and predictors of CAM use among Lebanese college students using the health belief model. A quantitative cross sectional research design was used. An online survey was administered to 126 Lebanese college students with the aim of determining the most important predictors of CAM use. A majority (89%) of surveyed students reported the use of CAM in the last 12 months. Based on the findings of a multiple logistic regression analysis, perceived susceptibility (OR = 1.781), perceived barriers (OR =.809), and cues to action (OR = 1.650), 95% CIs [1.185, 2.678], [.658, .995], [1.049, 1.821], respectively, significantly predicted CAM use. Results indicate that people who perceive themselves more susceptible to diseases, who do not perceive barriers to CAM use, and who follow more cues to action are more likely to use CAM than others. These factors provide pathways for facilitating positive social change by developing stricter governmental policies to ensure consumer safety and to promote high quality products, and by driving the development of public awareness interventions about CAM use and related health risks.

Diabetes is a growing health concern among those in rural locations. Rural residents smoke more, exercise less, have less nutritious diets and are more likely to be obese than urban residents. Evidence-based diabetes prevention programs targeting behavior change are available to this population yet participation remains low. This study examined the self-reported barriers and health beliefs of those who declined participation in a diabetes prevention program (DPP). Of 269 clients identified to be at risk for developing Type II Diabetes (T2D), only 85 answered the phone and 33 were interviewed to discuss their health beliefs and reasons for not participating in a diabetes prevention program. Almost half of the participants who expressed their lack of desire to participate in the DPP cited a low level of interest and not seeing any personal benefit as their primary reasons. Participants were closed off when asked what it would take to get them to participate in the program with 63% citing “nothing” as the most common answer when questioned as to what would encourage their participation. In order to limit barriers to participation in prevention-based programs for rural populations special attention needs to address improving general interest and knowledge about the efficacy of a DPP.

Type 2 diabetes mellitus (T2DM) is a disease that affects the body's ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief model. Participants selected for this study were at least 18 years of age, self-identified as AA, self-reported a family history of T2DM, and were not diagnosed with the disease themselves. Transcriptions of 20 face-to-face interviews were stored and organized via a qualitative research software NVivo Version 12 for Mac and later analyzed for data outcome. Participants demonstrated a strong awareness of T2DM with an accurate definition of T2DM and explanation of signs, symptoms, and prevention. Participants recognized family history as a risk factor in only 55% of the responses. However, family history played a major role in prevention in the lives of the participants. The participants reflected on personal barriers to health behavior changes and were encouraged to incorporate better life choices in their own lives. This research offers communities, healthcare providers, and stakeholders a better understanding of the importance of family history as a risk factor to T2DM as programs are developed to mitigate health disparities in the AA community.

Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were obtained for this project. The purpose of this project was to explore barriers to SMBG and to use a literature search to identify strategies for improving compliance with SMBG. The health belief model was the framework used to guide the project. Secondary data obtained from the QIP (n = 19) were analyzed and coded. Results indicated that patients' financial concerns, social support, emotional needs, and lack of diabetes education were the main barriers to daily SMBG. Recommendations to the providers were to consider each barrier before ordering the use and frequency of SMBG and to consider an appropriate strategy for promoting SMBG adherence. Addressing low compliance with SMBG may promote positive social change through improved T2DM management, self-care, adherence to daily SMBG and treatment, and improved patient quality of life.

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would increase provider perception of preparedness on recommending Gardasil 9 immunization in adolescents. Convenience sampling was utilized to recruit participants. There were 9 out of 25 providers that attended the educational in service with 8 completing the continuing education evaluation tool. Participants included providers who are affiliated and hold privileges with the health care system. Survey Monkey was used to analyze the participant evaluations. All the participants found the educational information relevant to increasing their perception of preparedness on recommending Gardasil 9 immunization in adolescents. The findings suggest that providers would benefit from training on recommending HPV immunization in adolescents. Continued training would help enhance timely immunization rates that could decrease cancer rates and reduce associated healthcare cost, in turn promoting population health and positive social change.