High school youth in Grades 9-12 who are in public schools without comprehensive sexual health education (CSHED) are more likely to engage in high-risk sexual behaviors and have higher rates of HIV and sexually transmitted diseases than are their peers in schools with CSHED. The purpose of this correlational study was to explore the statistical relationship between the consistent implementation of CSHED, before and after the enactment of the Chicago Public Schools' (CPS) sexual health education policy, and the sexual risk behaviors of Chicago high school youth in Grades 9-12. The study was based on Antonovsky's salutogenic model of health and wellbeing. CPS students' sexual risk behaviors were analyzed using data obtained from the Youth Risk Behavior Surveillance System (YRBSS) for the years of 2007 and 2013. Logistic regression was used to estimate prevalence and odds ratios of each sexual risk behavior. The findings showed a complex pattern of and variances across the sexual risk behaviors analyzed. The prevalence of sexual behaviors among all students remained relatively stable. The prevalence estimates for students who drank alcohol or used drugs before the last sexual encounter and who were never taught about AIDS or HIV increased from 2007 to 2013. The likelihood of not using birth control pills before the last sexual intercourse encounter decreased among Black students; the likelihood that Hispanic/Latino students ever had sex, and had sex with 4 or more people in their life, decreased. The decrease of sexual risk behaviors indicates a positive influence by CSHED, while the increases indicate continuing challenges to the promotion of healthy sexual behaviors. These findings show the need for legislators and school administrators to increase support for the enactment of CSHED policy to help mitigate the sexual risk behaviors of high school youth.

African American men have the highest prostate cancer occurrence and deaths of any population, yet many are unaware of screening opportunities or prognoses if diagnosed with the disease. The focus of this study was to learn whether a web-based prostate health education decision aid would increase prostate cancer knowledge, declared intention to be screened, and the likelihood of scheduling a prostate-specific antigen (PSA) test. The transtheoretical model of behavior change served as the theoretical framework for the study to assess readiness to adopt new behaviors. A total of 128 African American men between the ages of 40--65 without a history of prostate cancer participated in the study and were divided into 2 nonequivalent groups. The control group had 48 participants, and the intervention group had 80. After reviewing the web-based intervention, participants completed a demographic questionnaire, The Prostate Knowledge Questionnaire, and an Intent-to-Screen Tool. Mean differences in knowledge change were compared while adjusting for covariates using least squares regression. There was no significant improvement in the Prostate Knowledge Change score between the experimental and control groups. Therefore, the alternate hypothesis cannot be accepted. The social change implications suggest that the web-based decision aid studied in this project may not be the best tool to increase knowledge about prostate cancer screening. Therefore, more research is needed regarding ways to reach and inform African American men about the pros and cons of prostate cancer screening to foster informed decision making.

Shaken baby syndrome (SBS) is one of the most violent forms of physical child abuse. In 2007, the State of Ohio enacted a health education mandate known as Claire's law. Claire's law requires all birthing hospitals to provide SBS education to mothers prior to their discharge. This law is the result of public demand and advocacy initiatives; however, it was not clear how the mandate was developed or whether or not the mandate and subsequent educational programs have had an impact on efforts to prevent SBS. The purpose of this qualitative case study was to explore the state of Ohio's processes involved in creating legislation to mandate SBS education. Data were collected through document reviews and interviews with SBS workgroup members (n = 5). The precede-proceed program planning model provided the conceptual framework to examine the participatory process involved in the development of the mandate from its beginning. The findings of the study showed that SBS workgroup members believed mandated education would affect SBS incidence and would ensure that mothers receive SBS education in Ohio hospitals during their birth experience. The findings also demonstrated a lack of a formal program planning methodology and no public inclusion in the development of the mandate or its required health education component. The state of Ohio has an additional means to ensure widespread education on SBS through the creation of this mandate. Statutory requirements provide opportunities for health professionals to educate the public on the effects of shaking a baby, resulting in a key implication for social change. Legislation focused on health education should be multifaceted and include varying layers of intervention.

Thesis (Ph. D.)--Curtin University of Technology, 2004. / Includes bibliographical references (p. 278-298).

In Cameroon, many disabled people (an estimated 10-20% of the population) have inadequate access to education and health care, and disabled people's organizations (DPOs) are advocating for social change. Yet, there is a scarcity of information regarding how African DPOs address HIV and AIDS. The purpose of this study was to assess how DPOs in Cameroon have responded to AIDS in the disabled population and to identify strategies to enable DPOs to manage AIDS issues. This study was guided by the complex adaptive systems theory as the theoretical framework. The research questions focused on what DPOs have done to develop their organizational capacities to address AIDS issues, and on the contextual factors that influence these organizational capacities. To answer the research questions, a qualitative, multiple case study was conducted. A purposeful sample of 25 people, primarily executive members of four community-based nongovernmental DPOs and key informants with experience in this field, participated in interviews and focus groups. Information was gathered from documents and participant observation. Data were coded using a priori and emergent codes and iteratively analyzed into themes. Evident themes were that capacities in these groups were limited by marginalization and poverty, a lack of connection between DPOs and the AIDS community, limited health education, and inadequate understandings of the complexity of AIDS. DPOs desired participation in AIDS-related efforts and continued to explore potential opportunities. These results could be used to enhance social change by improving AIDS practices and research programs, increasing organizational capacity and social inclusion of DPOs, and the development of policy at organizational and governmental levels.

Cardiovascular disease is the leading cause of death in the United States; firefighters are at a greater risk for both the disease and death. Their exposure to stress, toxic fumes and smoke, unhealthy eating habits, excessive weight, and low levels of physical activity are all contributing risk factors to this disease. The purpose of this quantitative study was to determine the effectiveness of a multi-faceted program of exercise and nutritional counseling to decrease body fat composition and increase fitness levels nine months after initial implementation among a sample of 202 firefighters. Social learning theory was the theoretical foundation for the study, as the firefighting population utilizes strong social networks which aid in the ability to observe, model, and imitate new learned healthier behaviors. Statistical analysis showed no significant difference between pre- and post-body composition. There were significant differences seen between pretest- and posttest fitness scores. The implication for positive social change lies in the fact that these study findings indicate that voluntary exercise and nutrition programs may not be adequate to address the issue of obesity among the firefighter population. Results can be used to inform better nutrition and exercise interventions for firefighters, thus helping them attain their goal of becoming a healthier workforce.

Lack of fruit and vegetable (FV) consumption is directly linked to the prevalence of obesity and chronic disease in the United States. The USDA Fresh Fruit and Vegetable Program (FFVP) offers elementary school teachers access to healthy foods as part of the public school classroom experience. The purpose of this study---which was based on self-efficacy theory and the socio-ecological model---was to examine if an association exists between selected factors: (a) daily fruit and vegetable consumption, training status in the USDA Fresh Fruit and Vegetable Program (FFVP), and an established school nutrition policy and (b) nutrition-teaching self-efficacy (NTSE) among elementary school teachers who participated in the FFVP. Using an online survey, 66 teachers out of 114 (58% response rate) completed a 26-question survey adapted from the Nutrition-Teaching Self-Efficacy Scale and the National Cancer Institute's Food Attitude and Behavior Survey. Based on the results of the chi-square test of association (p = 0.031), an association between daily FV intake and NTSE among teachers involved in the USDA FFVP was confirmed. The odds of having high NTSE are 3.45 higher in those who consume more than 3 cups of combined FV each day (p = 0.029). There were no significant associations between NTSE and FFVP training and established school nutrition policy. The social change implication of this study is that healthier, confident teachers build healthier school environments and create the impetus for increasing FV consumption in the community at large, thereby helping to reduce the risk of obesity and chronic diseases.

No description available.

<p> Individuals diagnosed with dementia make up the majority of the population in skilled nursing facilities (SNFs). Certified Nursing Assistants (CNAs) are the primary caretakers of older adults living in SNFs. The purpose of this grant project was to write a proposal for funding to provide Person-Centered Care (PCC) training to help CNAs enhance their skills to better enhance the quality of life of older adults living with dementia in SNFs. </p><p> The goal of PCC training is to help CNAs better understand the signs and symptoms of Alzheimer&rsquo;s and dementia, improve communication skills, and provide strategies to manage the behavioral and psychological symptoms of dementia. Previous research on PCC has found it to be effective in improving the quality of care of older adults who are affected by dementia and who are living in nursing homes. </p><p> Actual submission or funding of the grant was not required for the successful completion of this project.</p>

<p> Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided the theoretical framework to guide this quality improvement project. A 45-minute in-service and accompanying reference manual was given to 4 participating PCPs, along with a demographic questionnaire asking about their age, race, gender, marital status, and years in practice. Following the in-service, a 10-question self-completed questionnaire consisting of a combination of open-ended and nominal scale yes/no questions, was administered. A thematic analysis revealed 2 primary barriers for diagnosis without the FDST: lengthy screening time and trouble differentiating FMS from a patient&rsquo;s other conditions. In response to one of the yes/no questions, the participants all replied that the in-service on FDST was helpful in diagnosing FMS. Implications for social change include improved diagnosis with a diagnostic screening instrument, improved quality of health care, and cost effectiveness at the system level for chronic disease prevention and management. This project demonstrates in a localized primary care setting that the FDST may offers PCPs a reliable method to diagnose FMS.</p>