Mexican Americans, the largest Hispanic subgroup in the United States, tend to underuse mental health services. Grounded in Andersen's behavioral model of health services use, the purpose of this nonexperimental study was to examine the likelihood of birth country, education, income, and insurance predicting which respondents would report seeking mental health services to treat depression. The Mini International Neuropsychiatric Interview was used to diagnose depression in 203 Mexican Americans whose data was archived from the primary study. This archived data was analyzed within this study. The results of the 2 x 2 chi-square tests of independence indicated a significant association between a person's birth country and the likelihood that a person will seek mental health treatment, with U.S.-born participants more likely to seek mental health treatment than foreign-born participants. There were no significant bivariate associations found between education, income, or insurance and seeking mental health treatment. The full model containing the 4 independent variables was statistically significant per the results of the binary logistic regression analysis. This finding indicates that the model reliably distinguished between respondents who reported seeking and not seeking mental health treatment. The results of the binary logistic regression analysis indicated education was the only independent variable that made a uniquely significant contribution to the model, with participants with 12 years or more of education more likely to seek mental health treatment. The implications for positive social change include the potential to provide communities and health care providers knowledge of the factors that influence whether Mexican Americans with depression access mental health.

Reproduction health means ability to become pregnant, bear the full term and give birth to a healthy child. Every woman is responsible for her care for reproduction health. Health is also closely connected with love for family. Family is very important for Romani people as it is a source of power and deep roots and satisfies life necessities of its members. The thesis titled Romani Women and Reproduction Health deals mainly with the issues of reproduction health of Romani women which includes family planning of Romani women, pregnant Romani women, abortion, childbirth, contraception and also climacteric and preventive screening mammography. The issues connected with reproduction health are quite serious as preventive medical examinations are essential for subsequent treatment when a disease is diagnosed. The aim of the thesis was to find out whether or not there is any education in the area of family planning of Romani women; whether or not Romani women plan their parenthood; whether or not family planning is affected by the traditional Romani family pattern; at what age they give their first birth; whether or not Romani women undergo preventive gynaecological examinations; whether or not Romani women are informed about vaccination against uterine suppository cancer; and whether or not Romani women use hormonal substitution therapy during their climacteric. The hypotheses below were defined for these aims. The aim of the first hypothesis was to verify that there is no education in the area of family planning of Romani women. The hypothesis was verified by a questionnaire and its subsequent statistical evaluation. The aim of the second hypothesis was to verify that Romani women plan their pregnancy but this hypothesis was not verified. The aim of the third hypothesis was to verify that family planning of Romani women is affected by the traditional Romani family pattern which was not verified. The aim of the fourth hypothesis was to verify that Romani women give their first birth at the age of 17 or so. This hypothesis was verified by a questionnaire and its subsequent statistical evaluation. The aim of the fifth hypothesis was to verify that Romani women undergo preventive gynaecological examinations. This hypothesis was verified. The aim of the sixth hypothesis was to verify that Romani women are not informed about vaccination against uterine suppository cancer. This hypothesis was not verified. The aim of the seventh hypothesis was to verify that Romani women do not use hormonal replacement therapy during their climacteric. This hypothesis was verified. There were four research questions defined for a qualitative check. The first question concerned the fact how the lower socioeconomic status of Romani families affects the number of children being born. The second research question concerned the most frequent gynaecological diseases occurring of Romani women. The third question concerned the issues connected with pregnancy of Romani women. The fourth question concerned the fact whether or not Romani women let their daughters be vaccinated against uterine suppository cancer. The results of the research questions show that the informants did not have problems to become pregnant; when they had health problems during pregnancy they went to hospital to avoid complications; their lower socioeconomic status does not have any impact on the number of children in Romani families; five informants out of nine did not have any gynaecological problems; all Romani informants are informed about vaccination against uterine suppository cancer; and only three women out of nine would not let their daughters be vaccinated. A combination of quantitative and qualitative checks was used for the practical part of the thesis. A non-standardized interview and a questionnaire were used as the data collection technique. The research group consisted of Romani women of all age categories from České Budějovice.

Violence is considered a public health problem in the United States, yet little is known about the benefit of using a combined epidemiology and criminology (EpiCrim) approach to focus on urban youth gun violence. The purpose of this general qualitative study was to determine in what ways Akers and Lanier's EpiCrim approach in tandem with Benet's polarities of democracy approach is explanatory of gun homicides by youth in U.S. urban areas and if the Youth Risk Behavior Surveillance System adequately addresses gun abatement measures. Data were collected through semi structured interviews of 16 criminal justice practitioners and medical professionals with experience relative to juvenile justice policies pertaining to gun violence. Interview data were inductively coded, then subjected to a thematic analysis procedure. The findings indicate that EpiCrim provides a platform to focus research efforts on complex issues that are drivers for behavioral risk factors associated with youth gun violence in urban areas. Participants perceive a necessity for legislative revisions supporting gun violence research and the reduction of privacy issues that pose barriers to EpiCrim research. EpiCrim research can provide data that help identify the root cause of youth gun violence in urban areas, and the Youth Risk Behavior Surveillance System does not fully address gun abatement measures. The positive social change implications stemming from this study include recommendations to local, state, and federal legislatures to explore legislative action to incorporate EpiCrim strategies as a method to reduce gun violence among youth in urban communities.

The HIV/AIDS pandemic is currently one of the most pressing world-wide concerns regarding the health and well-being of our global population. Due to the lack of a cure, recent efforts have focused on prevention measures for the disease. HIV prevention, particularly with the youth population, has spawned creative programs, such as the use of sport as an educational tool to equip youth with the skills to avoid contracting HIV. Due to the potent effect sport-for-development efforts exhibit on both individual and cultural level change, it can be assumed that HIV prevention sport-for-development programs are worth maintaining. Within the use of sport-for-development programs comes the problem under investigation: the need to establish a uniform method from which to evaluate HIV sport-for-development program effectiveness- specifically in regards to cultural relevance, level of community ownership, and sustainability through partnership resources. In order to address this problem, this analysis used qualitative content analysis to examine the promotional documents of three best practice football-for-development organizations- Grassroot Soccer, Mathare Youth Sports Association, and WhizzKids United. The purpose was to determine whether the Community Organization Health Model (COHM) was reflected in the values promoted through each organization’s electronic promotional material. The content analysis showed a strong qualitative presence of all six of the COHM tenets in the promotional documents, as well as a meaningful theme of expanding partnerships to enhance sustainability. These findings indicate that the tenets of the COHM are valued by best practice football-for-development organizations, which presents the opportunity for this model to be used in creating an evaluation procedure able to bridge cultural differences in programs. Keywords: HIV prevention, football, sport-for-development, evaluation

Prevalence of mental health concerns among young adults is high and continues to increase. As a specific subset of young adults, NCAA student-athletes seem to experience these concerns at a similar or greater prevalence than their non-athlete, age-matched peers. Despite the number of college student-athletes who are experiencing mental health concerns, understanding how mental health impacts sport performance has not been robustly studied and has not included the diversity of identities present in the athlete population. Thus, I explored the beliefs of 266 college student-athletes who represented diverse identities and sports regarding how mental health impacts sport performance. Responses were collected using an on-line survey and analyzed using both quantitative and qualitative methods. Overall, as well as by gender, race/ethnicity, and sport type, 96.4% to 100.0% of participants believed that mental health impacts sport performance. From thematic analysis emerged three themes and various subthemes: (a) cognitive disruptions (concentration, confidence, self-talk, motivation, mindset, and decision-making), (b) the stress of being a student-athlete (life impact sport, team factors, sport impacts mental health), and (c) a mind-body connection (mind correlates with body, and mental health symptoms impact sport performance). Post-hoc cluster analysis by demographic and sport-type variables did not reveal clustering; these variables were represented consistently across subthemes. The universality of endorsement and consistent spread of identities across subthemes represent novel findings from which further exploration of the mental health-sport performance connection is warranted.

Bakgrund: Kärnfamiljen ses generellt som den gyllene normen för familjebildning men verkligheten visar att familjer ledda av en ensamstående förälder, främst då mammor, är en familjeform som stadigt ökar. Samtidigt visar forskningen att ensamma mammor är en utsatt grupp i samhället med mer generella hälsoproblem. Statistiken lyfter fram att det är negativt för kvinnors hälsa att vara ensamstående mamma. En mer sammansatt bild av mammornas upplevelse av sin vardag kan vara en viktig förutsättning för distriktsköterskan vid mötet med dessa kvinnor. Syfte: Syftet med denna litteraturgranskning var att identifiera upplevelser av vardagslivets utmaningar som ensamstående mamma. Metod: Litteraturstudie som inkluderade 12 studier med kvalitativ ansats. Analys av data genomfördes utifrån Evans tolkande datasyntes. Resultat: För den ensamstående mamman utgjorde vardagens alla krav en stress. Det som främst stressade var hennes ekonomiska situation och att allt ansvar låg enbart på henne, att det inte fanns någon att dela kraven och intrycken med. Detta gav en känsla av trötthet och utmattning som gav mammorna en känsla av ohälsa både fysiskt och psykiskt. Den främsta faktorn till välbefinnande hos mammorna var i interaktion till andra, sitt sociala nätverk. I de granskade studierna framkom en stolthet över sin förmåga och själva moderskapet lyftes fram som en givande och stärkande roll. Slutsats: Granskningen visade på vikten av ett socialt sammanhang, att ha ett socialt nätverk oavsett storlek. Det gav stora positiva effekter på mammornas välbefinnande. / Background: The ”Cosby-family” is viewed as a standard for family formation, but reality shows that families led by a single parent, especially mothers, are a family form that is steadily increasing in societys. At the same time, the research shows that it is a vulnerable group in society with more general health problems. The statistics emphasize that being a single mother is negative for women's health. A more complex picture of the single mothers' experience of their everyday life can be an important prerequisite for the district nurse in the meeting with these women. Aim: The purpose of this literature review was to identify the experiences of everyday life's challenges as a single mother. Method: A literature study that included 12 studies with a qualitative approach.  The analysis of data was carried out based on Evans interpretive data synthesis. Results: For the single mother, the everyday demands were a stressfactor. What mainly stressed her was her financial situation and that all the responsibility lay solely on her, that there was no one to share the demands and feelings with. This gave a feeling of fatigue and exhaustion that gave the mothers a sense of ill-health both physically and mentally. The main factor of well-being of the selected group was when they interacted with others, their social network. In the examined studies, a sense of pride came out for their accomplishments and the motherhood itself was highlighted as a rewarding and strengthening role. Conclusion: The review showed the importance of a social context, to have a social network regardless of it´s size. It had great positive effects on the mother's wellbeing.

Syftet för föreliggande studie var att undersöka olika sätt att organisera primärvårdens om- händertagande av patienter med psykisk ohälsa och hur det påverkar patienters nöjdhet med vården. Studiens frågeställningar syftade att undersöka 1) skillnader i nöjdhet mellan patienter som erbjuds sedvanlig Integrerad Beteendehälsa (IBH) med Brief Interventions (BI) och de som får utökad bedömning med vägledd självhjälp 2) om patienters vardagliga funktion förbättras och om förbättringen har ett samband med deras upplevelse av nöjdhet 3) hur vanligt negativa upplevelser är inom behandlingsmetoderna. Av 41 randomiserade primärvårdspatienter kunde 30 analyseras utifrån deras upplevda nöjdhet inom vården. Båda grupperna var i genomsnitt nöjda med vården och skattade besöken som hjälpsamma. Patienter som efter utökad bedömning fick vägledd självhjälp skattade tidigt i behandlingen högre grad av nöjdhet och den skillnaden kvarstod. Det fanns en signifikant förändring av vardaglig funktion till det bättre för patientgruppen som helhet, men förändringen korrelerade inte signifikant med nöjdhet. Det fanns en tydlig skillnad i antal rapporterade negativa upplevelser. 14 negativa upplevelser rapporterades av patienter som fått Brief Interventions, medan en negativ upplevelse rapporterades av patienterna som fått vägledd självhjälp. Slutsatser från föreliggande studie bekräftar tidigare forskning kring att nöjdhet går att uppfylla med kortare behandlingsinterventioner samt strukturerade behandlingar. / The purpose of the present study was to examine different ways of organizing primary care for patients with general mental disorders, and how the treatment affects the patient’s satisfaction with the care. The study aimed to examine 1) if there is a difference in patient satisfaction between patients offered brief interventions within the primary care behavior health model, and patients offered an extended assessment with guided self help 2) if the patients everyday function improves and correlates with their experience of satisfaction 3) how common adverse events are within the two treatment methods. Out of 41randomized primary care patients, 30 could be analyzed based on their perceived satisfaction in health care. The result showed that both treatment groups were overall satisfied with the care and estimated the care visits as helpful. Patients who received guided self-help estimated a higher degree of satisfaction earlier in the treatment, and the level of satisfaction remained high throughout the treatment. Regarding the patient group as a whole, there was a significant change in everyday function; the patients improved their everyday function although it did not correlate with satisfaction. There was a significant difference in the number of adverse events between the two treatment groups. 14 adverse events were reported from patients who received Brief Interventions and 1 adverse event was reported from a patient who received guided self-help. Conclusions from the present study confirm findings from previous research that it is possible to achieve patient satisfaction with brief treatment interventions and structured treatment plans.

Made available in DSpace on 2015-03-05T20:04:16Z (GMT). No. of bitstreams: 0 Previous issue date: 24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O estudo identifica características dos processos de trabalho na saúde a partir da percepção dos profissionais sobre práticas de atendimento, relações na equipe de saúde e integralidade como mecanismos de interferência no processo de transição do modelo assistencial de saúde. É um estudo exploratório de natureza qualitativa. Foi realizado em uma Unidade de Saúde da Família do município de Campo Bom/RS. O método de coleta de dados foi grupo focal. A amostra é composta por um médico, uma enfermeira, dois técnicos de enfermagem, seis agentes comunitários de saúde, uma dentista, uma auxiliar de dentista e uma agente administrativa. Os dados foram tratados por meio da análise de conteúdo temática. Identificou-se empenho dos profissionais do PSF para organizarem seus processos de trabalho de forma a implementar o modelo de saúde usuário-centrado, com destaque nas práticas de atendimento, questões relacionadas à equipe de saúde e com indícios da implementação do modelo de saúde alicerçado na integralidade. Contudo, / The study identifies the work processes characteristics in health, from the perception of professionals about attendance practices, relations in the health team, and integrality, as interference mechanisms in the process of health assistance model transition onwards. It is an exploratory study of qualitative nature in a Family Health Unit in the City of Campo Bom/RS. The data collection method was group-focused. The sample is made-up by a physician, a nurse, two nursing technicians, six community health agents, one dentist, one dentist assistant, and one administrative agent. The data were worked through theme content analysis. The engagement of the Family Health Program professionals to organize their work processes in order to implement the model of health user-centered was identified, highlighting the attendance practices, issues related to the health team, and with indications of the health model implementation based on integrality. However, a paternalist trend was identified in the health team actions, a

Our modern health care system requires technology that can deal with multidisciplinary and complex processes, operations, and situations. The EHR, by far, is one of the greatest health information technology innovations that satisfy these requirements because of its efficiency and the effectiveness of its features. This study sought to develop an in-depth understanding of how underserved patients' perspectives about their health and illness, can contribute to greater use of the EHR. It also sought to improve their health outcomes and maintain sustainable change in the lives of the underserved. A quantitative non-experimental design study was conducted over a 6-week period outside of three different internal medicine clinics, one in the Northwestern and the two others in the Southeastern regions of Washington, DC. Surveys were distributed directly to patients coming out of these health clinics, and participants sent their responses via mail. Data collection included 215 surveys out of 560, but, only 155 fit the overall study categories. A strong level of significance in the relationships between clinical outcome measures and the EHR was identified at a 95% confidence interval. There were considerable health determinants that demonstrated the essence of patients' perspectives and the need for its incorporation into health outcomes measures for the underserved populations. The study also identified sets of environmental health predictors which acted as facilitators and contributors to a holistic health management model designed to contribute to the needs of the underserved communities. The holistic health model and the individual care plan model derived from the study are applicable at the level of the underserved population. It can help achieve sustainable health outcomes that will save lives and promote better health.

Black American women have the highest screening rates for cervical cancer among all the ethnic groups in the United States. Even though evidence from the literature suggests that the number of deaths from cervical cancer in the United States could be reduced by preventive screening, this particular minority population still suffers disproportionately higher mortality from the disease than the other minority and majority populations in the United States. This study was proposed to investigate cancer screening disparities among different subpopulations of women residing in the United States during 1999, and to recommend public health interventions that could potentially increase cervical cancer screening rates, thereby decreasing differential mortality rates for cervical cancer among these subpopulations. The Preventive Health Model in conjunction with data from the 1999 Behavioral Risk Factor Surveillance System was used to identify the covariates of cervical cancer screening behavior in an ethnically diverse population of American women residing in the United States during the specified timeframe. Univariate, bivariate and multivariable logistic regression procedures were used to evaluate the association between each one of the independent variables and the dependent variable (compliance with the 1999 cervical screening guidelines of the American Cancer Society). One of the major findings of this study was that Black, White and Hispanic American women were more similar in their screening behavior than dissimilar. The study also showed that the disparity in cervical cancer screening behavior in this population is in age, rather than in ethnic origin. Black, White and Hispanic American women of child-bearing age (18-44 years) were more likely to be compliant with the 1999 cervical cancer screening guidelines of the American Cancer Society, than Black, White and Hispanic American women who were not of child-bearing age (45 to 64 years). Implications for public health intervention studies are discussed, and recommendations made for future research in this area of cervical cancer screening behavior.