Children’s health outcomes are affected by multiple variables, including biological, environmental, psychological and social factors. Many determinants are decided after birth depending on the surrounding physical, psychological and social environment that the child enters. Elements such as socioeconomic status, marital status, race, education level and access to healthcare greatly affect a mother’s health literacy, and, thus, her ability to adequately care for her child(ren). This project examines the impact of maternal health literacy training on the knowledge of mothers, who have been homeless. Ninety-one women completed a six-hour maternal health literacy training. A pre-posttest design was used to measure maternal knowledge change as the result of the training. The same measure was used at both time points, and the measure was designed in a multiple-choice format. Outcomes indicate that the maternal health literacy training positively impacted reported maternal child health knowledge. Additionally, a follow-up survey was given to 11% of the total sample, to examine the sustainability of the knowledge gains 2-4 months post-training. Findings indicate that the women who took the follow-up survey retained a considerable amount of health literacy knowledge. This is a first step into research examining how maternal health literacy training improves short and long term knowledge in a high risk sample of mothers. The positive outcomes suggest that this program could be beneficial to agencies across the country serving maternal needs in similar circumstances. Recommendations for further research are discussed.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013. / Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.

Thesis (Ph.D.) -- University of Western Sydney, 2005. / "A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy, College of Social and Health Sciences, University of Western Sydney, 2005." Includes bibliographical references and appendices.

The purpose of the project was to increase awareness about alpha-1 antitrypsin deficiency (AATD) in chronic obstructive pulmonary disease (COPD), particularly among those with a familial history of genetic factor AATD; an additional goal was to understand its relationship to COPD. COPD is the third leading cause of death in the United States, with more than half of COPD patients experiencing significant disabilities. Major causes for COPD include smoking, air pollution, secondary smoke, upper respiratory infections, hereditary factors, occupational factors, environmental factors, and socioeconomic factors. Genetic factors, however, also play a significant role in early onset COPD and in those who smoke and have the genetic factor related to COPD (AATD), symptoms are more severe and exacerbations more frequent. Undiagnosed AATD can result in under treatment and lack of planning for preventing COPD onset and exacerbation in these patients. COPD clients of a local pharmacy (n =31) were invited to complete a Likert survey and given materials on COPD exacerbation prevention and information on AATD. Results indicated that 38.7% of respondents had early onset symptoms, positive family history, and no improvement in symptoms with smoking cessation. The results support that targeting those family members with COPD and providing information on genetic factors for this condition could decrease the frequency and severity of exacerbations. This is in keeping with the health belief model that guided this study in that a perceived risk for harm has the potential to improve the use of preventative health measures in individuals.

Globally the diabetes epidemic is a major health challenge. Associated with the diagnosis of diabetes is the morbidity and premature mortality stemming from the complications of the disease. It was identified that approximately 50% of clients who attended a diabetes centre in an outer western metropolitan region of Sydney were not completing diabetes education. A strategy employed to overcome this was the introduction of a 2 ½ hour group diabetes education program called the Ongoing Education System (OES), for persons with Type 2 diabetes, that enabled completion of education at this one session. However, debate occurred among health professionals at the Wentworth Diabetes Service (WDS) as to the effectiveness of the OES as compared to the traditional individual education sessions. (one-on-one education). The purpose of this study was to compare the outcomes of two modes of diabetes education for completing education for clients with Type 2 diabetes , namely individual education (Treatment A) and the OES group education (Treatment B). The findings overall revealed no difference in the outcomes of participants who received individual education and those who received the OES at completion of education as well as at 6 and 12 month post education. A secondary finding of this study was the significant influence gender and age exerted on the outcomes of the education programs. One significant implication from the findings for both the person diagnosed with Type 2 diabetes and the health care organisation is that the OES provides a cost effective alternative to individual education that encourages clients to complete diabetes education thereby enabling the person to achieve an optimal quality of life. In addition this study provides research evidence for the benefit of current practice in diabetes education. / Doctor of Philosophy (PhD)

Thesis (M.P.A.)--Kutztown University, 1996. / Source: Masters Abstracts International, Volume: 45-06, page: 2937. Abstract precedes thesis as [3] preliminary leaves. Typescript. Includes bibliographical references (leaves [3]).

Walden University College of Health Sciences This is to certify that the doctoral study by Maureen Barta has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Cheryl Holly, Committee Chairperson, Health Services Faculty Dr. Eric Anderson, Committee Member, Health Services Faculty Dr. Vincent Hall, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 â?? Increasing Knowledge About Alpha-1 Antitrypsin Deficiency in the Chronic Obstructive Pulmonary Disease Population by Maureen Ann Wentink Barta MSN, Pacific Lutheran University, 1996 BSN, Pacific Lutheran University, 1992 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2015 â?? The purpose of the project was to increase awareness about alpha-1 antitrypsin deficiency (AATD) in chronic obstructive pulmonary disease (COPD), particularly among those with a familial history of genetic factor AATD; an additional goal was to understand its relationship to COPD. COPD is the third leading cause of death in the United States, with more than half of COPD patients experiencing significant disabilities. Major causes for COPD include smoking, air pollution, secondary smoke, upper respiratory infections, hereditary factors, occupational factors, environmental factors, and socioeconomic factors. Genetic factors, however, also play a significant role in early onset COPD and in those who smoke and have the genetic factor related to COPD (AATD), symptoms are more severe and exacerbations more frequent. Undiagnosed AATD can result in under treatment and lack of planning for preventing COPD onset and exacerbation in these patients. COPD clients of a local pharmacy (n =31) were invited to complete a Likert survey and given materials on COPD exacerbation prevention and information on AATD. Results indicated that 38.7% of respondents had early onset symptoms, positive family history, and no improvement in symptoms with smoking cessation. The results support that targeting those family members with COPD and providing information on genetic factors for this condition could decrease the frequency and severity of exacerbations. This is in keeping with the health belief model that guided this study in that a perceived risk for harm has the potential to improve the use of preventative health measures in individuals.

<p>  </p> <p>Maternal and infant health continues to be a compelling and urgent topic in the United States with prenatal care at its forefront for prevention of adverse outcomes. This study explored differences in adverse infant birth outcomes (i.e., preterm birth, low birthweight, and NICU stays) and postpartum maternal wellbeing outcomes (i.e., social support, depression, and confidence) related to the sociodemographic and baseline factors of mothers and their prenatal care experiences. </p> <p>Data was analyzed from the publicly available <em>Listening to Mothers III </em>dataset. Comprised of 2400 online-survey participants who gave birth to singleton infants in U.S. hospitals between 2011 and 2012. Structural equation modeling was employed with FIML to account for missing data. The model examined mediators of prenatal care (i.e., responsive provider behavior, week of first visit, duration of visits, group prenatal care; GPC) between maternal predictors and outcomes.</p> <p>Of infants in the sample, 8% were born preterm, 8% were born low birthweight, and 18% were admitted into the NICU. Depression and smoking during pregnancy, as well as participating in GPC, resulted in 15%, 20% and 18% greater proportions of infant NICU stays, respectively. For postpartum maternal wellbeing, participating in GPC increased the proportion of maternal confidence by 18%. Mothers who received responsive provider behavior had higher rates of social support (<em>b </em>= 0.28, <em>p </em>< .001), reported less depression (<em>b </em>= -0.19, <em>p </em>< .001), and felt more confident (<em>b </em>= 0.07, <em>p </em>= .02). </p> <p>Findings from this study suggest that the most impactful actions for prenatal care providers to take would be to provide increased support to mothers who identify as needing treatment for depression or smoking during pregnancy to best improve infant health through fewer admissions into the NICU, and to continue to bolster the responsiveness in which providers interact with patients to improve overall postpartum maternal wellbeing. </p>

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013. / Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.

<p>This research is based on Construal Level Theory (CLT) and explores the impact of inducing high-level vs low-level construals through various message content on health behavior intentions in the context of medication taking in depression and anxiety. In addition to the direct effects on intentions, the research also explored the mediating roles of perceived psychological distance and risk perception on these intentions and the moderating effects of age and mental health stigma.</p><p>Previous work in CLT suggests that concrete low-level construals, or mental representations, are likely to dominate thinking near decision times, but those who remain focused on more abstract high-level construals are more likely to follow through with good intentions and that a person can be induced to focus on these abstract benefits and goals through messaging. However, evidence that a person’s construal level mindset can be maintained over time to support ongoing intended behavior in the face of daily cognitive demands is lacking.</p><p>Messages were sent via secure text service to a mobile device twice weekly for 4-weeks. Results of within and between-subjects analysis showed that low-level construal messages have the greatest direct effect on behavioral intentions (BI) (<i>Wilks’ λ F</i>=11.591, <i>p</i><.001, <i>η</i>^<em>2</em>=.056) and actual medication taking behavior (<i>Wilks’ λ</i> <i>F</i>=2.979, <i>p</i>=.051, <i>η</i>^<em>2</em>=.271) as compared to controls. Significant changes were also seen in perceived social distance to a future risk (SD) (<i>Wilks’ λ F</i>=61.654, <i>p</i><.001, <i>η</i>^<em>2</em>=.240) and overall risk perception (RP) (<i>Wilks’ λ</i> <i>F</i>=3.393, <i>p</i>=.019, <i>η</i>^<em>2</em>=.058) over the 4-week study vs controls, but no mediation effect was detected between messaging, SD, or RP and BI. Finally, mental health stigma (MHS) was seen to moderate the direct effect of the messaging on BI (<i>F</i>=2.701, <i>p</i>=.048, <i>R</i>^<em>2</em><i>chng</i>=.043).</p><p>Results suggest text messages delivered over time can positively impact treatment adherence intention, behavior, and health attitudes in patients with depression and anxiety. In addition, the construal level focus of the messages is likely to impact those outcomes differentially in various patient groups.</p>