Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black and White women has yet to be formally studied. Purpose: The goals of the present research were to (1) assess differences in Pap screening rates and (2) rates of adherence to recommended follow-up care after abnormal Pap results between Black and White women, (3) evaluate how specific factors of the Health Belief Model (HBM) influence the decision-making process for obtaining Pap screening and (4) receiving recommended follow-up Pap care, and (5) evaluate the role of ethnic centrality as a factor in health decision-making. Results: Results indicated that HBM facets functioned similarly in predicting engagement in Pap screening and follow-up care, although there were differences in the influence of different facets by race. Ethnic centrality showed little applicable influence on adherence to follow-up care among Black women. An exploratory analysis revealed that doctor recommendation was the most influential factor predicting follow-up care use for both racial groups. Conclusion: The present study offers support for increased education and training on provider recommendation of appropriate follow-up care, as well as effective provider communication of results and services using messaging that appeals to the values and concerns of patients.

In recent history, four influenza pandemics have occurred causing worldwide suffering. It is only a matter of time when a fifth pandemic will emerge. The willingness of the public to perform recommended precautionary actions is central for successful outbreak management, where the most important measure is vaccination. Trust in the health care system as well as personal perceptions of the threat of a pandemic can influence the publics willingness to perform precautionary actions. Aims: This study seeks to analyze how the public in two socioeconomically different areas of Stockholm perceive the threat of a possible future epidemic, their level of trust in the health system and what precautionary actions they are willing to perform. Methods: questioners with respondents from two socioeconomically different areas in Stockholm (Tensta and Danderyd) were gathered and have been statistically analyzed and interpreted using the health belief model and theories about trust. Results: The study showed that a higher level of perceived benefits of precautionary actions and a higher level of worriedness to get seriously ill if infected during an influenza epidemic were correlated with a higher level of willingness to follow precautionary actions. A significant association between unwillingness to vaccinate and perceived barriers to vaccination (that it can be harmful to the health) was also found. Trust in the health system was significantly lower in Tensta compared to Danderyd and higher trust in the health system was found to lead to higher perceived benefits of precautionary actions. Additionally, respondents with higher trust in information from the health care were generally more willing to vaccinate. Finally, no demographic determinants except age was shown to influence perceptions about precautionary actions and threat. Conclutions: Willingness to perform precautionary actions were influenced by worriedness, perceived benefits, perceived barriers, age and trust in the health care. Efforts might thus be needed to increase the trust in the health system in socioeconomically weak areas, as well as to increase the trust in influenza vaccination in general.

Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD through the development and implementation of patient education material that would increase PR awareness, increase patient motivation, and promote participation. The ACE star model was used to guide the project development, and the theoretical framework of the health belief model was used to enhance patients' perceptions and desires to participate in a PR program. Evaluation of the pretests and posttests revealed significant improvement in various variables, reduction of dyspnea, improved exercise tolerance, and increased knowledge. The evaluation of health-related quality of life using the short form 36 showed significant improvement in some subscales namely: general health, role emotional, with slight significance in bodily pain. There were no readmissions among the participants. The implementation of comprehensive PR has implications for positive social change because it helps patients with COPD to be more knowledgeable about their disease and allows for more independence and a higher quality of life.

Since 1999, Methicillin-resistant Staphylococcus aureus (MRSA) outbreaks have occurred in many correctional facilities. Even after the Federal Bureau of Prisons developed clinical practice guidelines on the management of MRSA within correctional facilities, the prevalence of MRSA decreased only insignificantly. Other researchers suggested infection control compliance was equally as important as developing clinical practice guidelines in reducing the incidence of MRSA. Several studies identified the healthcare professionals' nonadherence and inconsistencies to clinical practice guidelines as contributors to MRSA transmission. Accordingly, this project was designed to develop evidence-based recommendations for improving nurse professionals' adherence to MRSA practice guidelines in correctional settings. Using the health belief model as the theoretical framework, this project examined the nurse professionals' perceptions as well as their level of knowledge regarding MRSA by using an original instrument, Knowledge and Health Beliefs Regarding MRSA Questionnaire. The study employed a quantitative design with a purposeful sample of 36 participants using social media. Through descriptive statistical analysis, it was determined that MRSA training and education were the greatest barriers among the nurse professionals in taking MRSA preventive action (64%, n = 23). Based on the findings, assessing the educational needs of the nurse professionals must become the priority when designing infection control programs. This study contributes to social change by recognizing the potential health impact of MRSA and cautions that if public health officials do not control MRSA within correctional settings, such behavior can affect the transmission of MRSA both nationally and globally.

This study applied the constructs of the health belief model (HBM) to assess women's knowledge and attitudes (i.e., perceived susceptibility, perceived severity, perceived benefits and perceived barriers) regarding cervical cancer, HPV, and the HPV vaccine and determine whether they predict women's intentions to receive the HPV vaccine. Women aged 18 to 26 years were surveyed from a convenience sample, and were primarily well-educated White women. Using Polytomous Universal Model (PLUM) ordinal regression, it was determined that the constructs of this model could not predict women's intentions of receiving the HPV vaccine.

The primary purpose of this research was to examine the adoption of computer security software in the home computer environment. The use of the Health Belief Model as a framework to design a model to examine home user adoption of computer security provided the basis for this research. The method of the investigation was a cross-sectional study using a self-reported web-based survey to test the theoretical model derived from the Health Belief Model. The survey targeted individuals who are responsible for the selection, installation, and maintenance of software on their home computers. The data collection relied on a snowball sampling technique that recruited a total of 186 participants who completed the online survey. The research model contains a total of 26 hypothesized relationships that were tested using multiple regression analysis techniques. The research model contains six main predicting variables (perceived vulnerability, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action) and four moderating variables (age, gender, education, and prior experience of attack). The model explains 30.4% of the variance in computer security usage, the dependent variable in the research model. The results demonstrate that certain constructs found in the Health Belief Model are more effective than others in motivating individuals to utilize computer security software. Specifically, the results show that perceived vulnerability (H1), perceived barriers (H4), self-efficacy (H5), and the two-way interactions of age and barriers (H8d), education and benefits (H9c), prior experience and perceived severity (H10b), and prior experience and self-efficacy (H10e) had significant effects on computer security usage. Additionally, prior experience was found to have a significant main effect on the dependent variable. Information from this research provides evidence that the Health Belief Model can be used to study the computer security usage behavior of home computer users. Further, the relationship of perceived vulnerability and computer security usage provides a way for practitioners to increase computer security usage behavior through targeted media campaigns.

Indiana University-Purdue University Indianapolis (IUPUI) / In the United States, over 30 percent of children are categorized as overweight or obese. Comorbid conditions, such as cardiovascular disease and other health complications related to obesity, are also on the rise. This public health issue is often related to disproportionate dietary intake and lack of physical activity. Efforts that promote fruits and vegetables (F/V) as preferred food choices over high fat and high sugar foods may help combat the increasing incidence of overweight and obesity. Other benefits from F/V include prebiotics or fiber that helps to create and maintain a healthy microbiota, which is now recognized as essential for long-term positive health outcomes. Many children, however, fall short in consuming the recommended daily amounts of F/V servings, and therefore, lack key nutrients such as vitamins, minerals, phytonutrients and fiber. This study is a pilot, quasi-experimental design that provides information related to the importance of eating F/V to children, ages 11-12 years, who attend a parochial school in Indianapolis, Indiana. The data from this study describe the amounts of F/V servings in home-prepared school lunches. The primary aim of this study is to determine if eight interactive multimedia lessons and activities delivered to one group of students (intervention) and a single lesson delivered to a different group of students in the same school and grade (control), affects the amount of lunch F/V servings, student knowledge, attitude, and self-efficacy/perception. This baseline data will contribute to the design and implementation of a health curriculum for middle school age students. Focus groups, adapted validated assessment tools as well as the on-site observation of F/V servings brought in lunches and consumed at lunch are compared between both groups to document any effects of the instruction. The results show that a statistically significant change in knowledge occurred within the intervention group following the implementation of this F/V education series. Favorable findings, with a positive upward trend in relative amounts of F/V, were identified and more research in this area is warranted.

Indiana University-Purdue University Indianapolis (IUPUI) / Children are at increased risk for harmful lead exposure due to their behavior and the increased percentage of lead absorption. While lead levels and the possible adverse health effects vary by age and level absorbed, the medical field agrees that lead is a persistent public health issue of the first order. Importantly, Hoosier children are at an increased risk for possible negative side effects because of the small percentage of children who are being tested; despite the AAP’s recommendation. The Health Belief Model (HBM) provided a strong and appropriate framework for guiding this formative research about parents’ perceptions of blood lead testing. This study aimed to answer two research questions based on HBM concepts and utilized both quantitative and qualitative methods to help answer them. Using snowball and convenience sampling, 14 Hoosier parents were recruited to participate in this study during the spring of 2020. Parents were recruitment from four counties across the state with known high rates of lead and/or low rates of blood lead testing among babies and small children. The findings from this study yield broad suggestions for future work within the field of communication research and specific suggestions for applied communication campaign research and clinical interventions within the state of Indiana. This study suggests we still have a long way to go as a state in addressing the dangers of lead toxicity and increasing regular testing among Hoosier children.

The purpose of this study is to explore college students' breast and testicular cancer self-examination beliefs and practices using constructs of the Health Belief Model. Over a 1.6 million Americans are diagnosed each year with cancer. With that, over 200,000 women will be diagnosed with breast cancer while nearly 8,000 men will develop testicular cancer. If cancer is diagnosed and treated in the early stages, it will greatly increase the chance of survival and quality of life. One of the easiest methods to discover cancer early is to perform self-examinations. Self-examinations are safe, quick, private, and do not require a visit to the doctor. This study will explain reasons why some college students perform breast (for women) and testicular (for men) self-examinations while others choose not to perform self-examinations. A survey of 386 (202 female and 184 male) college students was conducted at a midsize university located in the Midwest. Participants were asked to complete Champion's Health Belief Model Scale. In addition, participants were asked to complete two open-ended survey questions regarding their self-examinations beliefs and behaviors. Overall, 129 (34%) participants performed self-examinations. Of those 129, females were more likely to perform self-examinations than males. In addition, females were also more likely to be taught how to perform self-examinations. Participants were more likely to perform self-examinations if felt susceptible to developing cancer and if they felt comfortable in their ability to properly perform one. Finally, participants were also more likely to perform self-examinations if they were given a cue to action (i.e. their doctor told them to or a relative had cancer). The significance of the data will help educators and health care professionals develop health programming to address the barriers that keep college students from performing self-examinations. In particular, there needs to be tailored programming for males because they are more susceptible to developing testicular cancer during their college years than any other time in their lives. Finally, a social marketing campaign could be an easy intervention to reach the masses. A Social marketing campaign would be a beneficial way to raise awareness, educate students on cancer in college, and show the simple steps in performing self-examinations.

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