Hispanic and African American women are infected with sexually transmitted diseases more often than are Caucasian women. This racial disparity is also seen in the incidence of human papillomavirus (HPV) and cervical cancer. The medical connection between HPV and cervical cancer is often unknown or misunderstood among women. This study addressed the beliefs and subsequent health decisions of minority parents regarding whether to get their daughters vaccinated against HPV. The theoretical framework for this study was Rosenstock's health belief model (HBM). The specific study design used was Husserl and Heidegher's theory on Phenomenology. This qualitative study utilized focus groups containing mothers of young girls ages 9 to 12 years, who were recruited from local churches in San Antonio, TX. Twenty-seven mothers, African American (9), Hispanic (7), and Caucasian (11), participated in one of two focus groups for each racial group. Each focus group session was audiotaped and NVivo for Mac was used to perform a content analysis and to identify the themes present. Minority parents held stronger cultural and spiritual beliefs against vaccinating their daughters for a sexually transmitted disease more so than believing that their daughters were at risk for being exposed to STDs such as HPV. These beliefs presented as barriers to initiating the desired HPV prevention and screening practices. Gaps in the current knowledge of all parents exist and must be thoroughly addressed for all racial/ ethnic groups. Future educational programs need to not only address the gaps in knowledge but also shape and package public health messages with sensitivity to cultural and spiritual concerns.

Health disparities have mostly affected African Americans who are poor, uninsured, under insured and unemployed. This population of African Americans seek spiritual solace and social counseling from their pastors, and church-based health promotion (CBHP) offers the opportunity to reach millions of the U. S. Black population. The lack of studies on female African American pastors implementing congregational health promotion activities influenced this study. This qualitative study helped in understanding the experiences, perspectives, and influences of 13 female African American Christian pastors on health-related issues within their congregation. Feminist theory and CBHP model guided this qualitative case study. Open-ended interview questions, field notes, and audio recordings were used to collect data. Data analysis was done using constant comparison method. Open coding and categorizing were done to develop the final themes and subthemes for the study. This research study has the potential for other researchers to replicate this study elsewhere in the United States. Potential positive social change may lead to increase in young female pastors in the churches. Possible social change benefits also include the increase of African American female pastors implementing CBHP activities in their own churches, change in congregation's health behaviors and habits, and improved health status.

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also known as the readiness to change model. This study was conducted using secondary data from the Rhode Island Department of Health PRAMS data set. The research questions determined if African American women received preconception care education at the same rate as White women, if African American women had a higher rate of infant mortality than other races, and if African American women had a higher rate of unintended pregnancies than White women in the state of Rhode Island. Independent t tests and chi square tests were used to answer the research questions. The results indicated a difference between the infant mortality rates for African American women compared to other races as well as a difference between African American women compared to White women with regard to unintentional pregnancies in Rhode Island. However, there was no difference in African American women compared to White women receiving preconception education in the state of Rhode Island. The implications for positive social change include micro- and macro-level changes in support of how planning for a pregnancy in advance can reduce poor birth outcomes.

Only three states have enacted informed consent laws aimed at providing more information concerning any alternative treatments for women who undergo hysterectomy. This study attempted to fill the research gap regarding consent laws and perceptions of women who underwent hysterectomy in a state with no informed consent laws. Supported by the health belief model (HBM), the research questions focused on the perceptions of women and their lived experiences. The purpose of this qualitative study was to examine the beliefs and attitudes of women in a state with no informed consent laws. Interviews were the main data collection technique. The participants were 10 women who underwent a hysterectomy and were between 20 and 40 years of age at the time of the research. The interview data were analyzed using thematic analysis. The findings demonstrated that the women who underwent hysterectomies in the absence of comprehensive informed consent law could be subjected to the procedure without sufficient information. Participants negatively described their physiological, psychological, and emotional consequences of undergoing hysterectomies without sufficient information; many of them reported feeling deceived by their doctors. Overall, the women expressed the belief that care providers should be required to offer all the pertinent information about hysterectomies and alternative treatments prior to the procedure. The results of this research can be used to advocate for the introduction of comprehensive informed consent laws, promoting the positive social change that would benefit the women of the U.S.

Many men who have sex with men (MSM) engage in alcohol and drug use. Drug use, particularly methamphetamines, amyl nitrates (poppers), and drugs used to treat erectile dysfunction among MSM may also contribute to risks such as unprotected sex, which leads to the possibility of contracting syphilis, Human immunodeficiency virus (HIV), and other Sexually Transmitted Infections (STIs). In the Metro Atlanta Area (Fulton and Dekalb Counties), primary and secondary syphilis rates among MSM are still rising and rank highest among the other counties in the area. Guided by the risk and protective factor theory, the purpose of this study was to determine if club drug use was a contributing factor in high-risk sexual behavior among MSM with syphilis. Data were collected from the State Electronic Notifiable Disease Surveillance System with permission from the State of Georgia's Division of Public Health's STD division and was tested by using hierarchical regression analyses. The findings were inconsistent with the reported literature; there was no association between drug use and risky sexual behavior in this sample of MSM infected with syphilis. However, there was an association between prior incarceration being predictive of engaging in sex with anonymous partners and having sex while high. Implications for positive social change include evidence for the need for public health interventions that target incarcerated MSM because they exhibit the highest-risk sexual behavior due to their time served in the correctional system. Further exploration of this topic could be used to develop health information and policies to meet the needs of those affected by high-risk sexual behavior while incarcerated and upon release, ultimately reducing the spread of HIV.

Among young adults at risk for unintended pregnancies, preconception health and prenatal care programs aimed at positive birth outcomes remain unaddressed. The purpose of this phenomenological study was to explore the lived experiences of young adults in terms of their willingness to use preconception health and prenatal care as a means for increasing both positive birth outcomes and overall health. All study participants met the following criteria: (a) young adult man or woman, (b) age 18 to 25, (c) at risk for unintended pregnancies, (d) sexually active, (e) single or in cohabiting partnerships, and (f) living in the greater Los Angeles, Calif., area. The researcher conducted individual, semi structured interviews with study participants, and analyzed the resulting transcripts using a modified van Kaam analysis. Data analysis yielded 3 major themes to address the study's 3 research questions. First, participants believed that parenthood is largely learned through witnessing the practices of their parents, family members, and friends. Second, participants believed in the necessity of healthy lifestyle choices for healthy preconception and optimal prenatal care. Third, the key obstacle to perinatal care was the lack of awareness of pregnancy and available health care resources. These findings may provide a guideline for improving preconception health and prenatal care programs for young adults who are at risk of unintended pregnancies.

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, and experiences in health behavior of individuals in a community. The development of a 20 question survey was guided by 4 research questions designed to evaluate any differences in Amish parents' decision to defer recommended childhood immunizations. Multivariate analysis of variance was used to evaluate the 4 research questions based on the 84 individual surveys received. Results revealed a significant link between knowledge, beliefs, and opinions toward immunization and immunization adherence. Results also revealed that age and gender had no effect on the relationship between knowledge, beliefs, attitudes, and opinions toward immunization adherence. This study contributes to positive social change by educating parents of Amish children as to why it is important to receive timely childhood immunizations; thereby, keeping their children safe from vaccine-preventable diseases.

Caregivers' compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers' for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers' age, gender, residence (rural or urban), and their level of education as well as records from their children's immunization cards. Data obtained were tested for associations between caregiver's demographic information and their children's receipt of polio doses within specified timelines using chi-square and logistic regression analysis. Fisher's exact analysis were conducted for variables with frequencies less than 5. The only significant association recorded was between the receipt of Polio Dose A and location of caregivers' residence: Rural dwelling caregivers were less likely to receive the first dose of polio. Results showed Polio Dose D to be the dose most likely received in an untimely manner as well as most likely missed of the 4 doses. Logistic regression analysis did not show any variable to be of greater odds in predicting completion of the 4 doses or compliance with timelines of their receipt. Study's results may inspire polio program planners to develop interventions that broaden the immunization coverage for rural dwellers to include nontraditional maternity locations. Positive social change will ensue by the improvement caregivers' compliance with full polio dose receipts with timelines, maximizing immunity.

HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. The purpose of the study was to examine determinants that predicted odds of HIV screening for persons impacted by Hurricane Sandy, and how these factors differed according to demographic characteristics, geographical attributes, health-related quality of life score, access-to-care, and health insurance status. The social ecologic model provided the framework for this multilevel cross-sectional study that included New Jersey data from the Behavior Risk Factor Surveillance System. Bivariate chi-square, simple logistic regression, and adjusted multivariate and weighted logistic regression analyses were performed to estimate HIV screening odds. Findings indicated a significant odds ratio with access to care post- Hurricane Sandy and HIV screening (odds ratio = 1.74, 95% CI = 1.38-2.21). The positive social change implications may include assisting people to develop realistic plans for HIV screening, improving understanding of HIV screening determinants, and raising awareness of the risk factors related with access to medical care post-Hurricane Sandy.

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the study was the healthcare utilization model. Interviews were conducted with 10 women participants, ages between 18 and 45. The data collected through semistructured interviews were analyzed using NVivo 11 and the Colaizzi 7-step processes to identify themes and subthemes. Study findings revealed systemic challenges that affected healthcare access which need to be adequately addressed to reduce maternal and child mortality among women of child-bearing age. The study findings could foster social change by improving the development of healthcare standards, as well as illustrating methods of increasing the level of access to healthcare services among women of childbearing age.