The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis were performed on the data extracted from the survey in order to better understand the relationship of the variables in this study, and to test if any of the independent variables were significant predictors of vitamin D intake through supplementation and sunlight exposure. The results of this analysis showed that knowledge regarding the reduction in risk of breast cancer from sunlight exposure and through vitamin D supplementation was not related to changes in behavior involving increases in sunlight exposure and vitamin D intake through supplementation. Further, the results showed that those participants with higher levels of self-efficacy and response-efficacy regarding sunlight exposure and vitamin D supplementation had an increased amounts of vitamin D intake through supplementation on a daily basis. The results of this study can be used to help medical professionals understand the complexity involved in how their clients may or may not take action to reduce the potential for reducing the risk of breast cancer.

The use of human immunodeficiency virus (HIV) counselling and testing (HCT) is a necessary component of implementing HIV prevention and control programs in Nigeria. Knowledge, acceptance, and use of HCT remain low in Nigeria, especially among young people ages 15 to 24 years. The purpose of this study was to ascertain how sociodemographic factors (i.e., gender, place of residence, level of education, geopolitical zone, and socioeconomic status [SES]); cognitive factors (i.e., HCT awareness, knowledge of HIV prevention, and knowledge of HIV transmission); and knowledge of sexual risk behaviors affected HCT uptake among young people in Nigeria using data from the 2013 National HIV/AIDS and Reproductive Health Survey Plus. The study was guided by the social cognitive theory. The sample was composed of 10,091 young people ages 15 to 24 years from all geopolitical zones, SES, and educational backgrounds in Nigeria. Multiple regressions and multivariate comparisons revealed a significant relationship between HCT awareness and HCT uptake (p < .001) and between knowledge of HIV prevention and HCT uptake (p < .001). Sociodemographic variables of gender, place of residence, level of education, geopolitical zone, and SES were also significantly associated with HCT uptake. The sexual risk behavior variables tested were not significantly associated with HCT uptake among young people in Nigeria. The implications for positive social change include providing public health professionals with data to plan and implement HCT awareness and knowledge programs for young people in Nigeria that could increase HCT uptake and reduce the incidence of HIV/AIDS.

<p> Recent years have seen Ghana pursuing extensive reforms of its healthcare delivery system. The delivery of immunization and other outreach services to the people of Bibiani-Anhwianso-Bekwai (BAB) district in Ghana despite the tremendous efforts by the district directorate to extend services to more people has recently been stalled. Faulty case management techniques used by case managers managing the immunization delivery services may be cited for the slow pace at which this process is moving. CDCynergy, a theoretical framework and model developed by the Centers for Disease Control and Prevention (CDC) was used to examine the case management techniques used in the health services departments in and around the Bibiani-Anhwianso-Bekwai (BAB) district in Ghana to deliver immunization and outreach services to the target community. Using a community-based research approach, 27 community health nurse case managers took part in a semi structured interviews to select participants of the focus group deliberations. The focus group members were all community health nurse case managers involved in managing immunization and immunization related outreach programs. The researcher moderated a focus group discussion with nine community health nurse case managers stationed at the BAB district. Additionally, a district vice chair, a director of health services in the region, primary healthcare providers (PCPs) from health centers in the BAB district, and a nurse from one of the Community Health Post (CHPS) compounds in the Bibiani-Anhwianso-Bekwai (BAB) District participated in separate semi structured interviews. The findings identified the following: (a) majority of the community nurse case managers understand that offering immunization and outreach services to the target population constitutes an important part of their job description, (b) improving the case management techniques used by the outreach and the immunization case managers in the BAB district could improve the context of their service delivery, (c) improving the time management component of the case management techniques could tremendously improve the delivery of immunization and outreach services, and (d) developing a training manual to provide case management guidance and tools to the community health case managers, in order to improve their case management skills. Even though the community healthcare posts (CHPS) serve as a model for bringing immunization and outreach services closer to target populations, the idea of community healthcare worker (CHEW) delivery of more services to hard-to-reach communities is a definite public health measure of improving collaboration between healthcare workers, community residents, community leaders, public health administrators, and local politicians. This measure can positively impact the delivery of immunization and outreach services.</p>

<p> The purpose of this study was to compare the level of basic nutrition knowledge between future nutrition professionals, health professionals, and non-health professionals. Specifically, this study assessed and compared basic nutrition knowledge of nutrition, health-related, and non-health related undergraduate majors enrolled in an introductory nutrition course.</p><p> Participants for this study were recruited through convenience sampling from an introductory undergraduate nutrition class. An online basic nutrition knowledge exam was used to measure nutrition knowledge. Independent one-way ANOVA demonstrated there was no statistically significant difference in basic nutrition knowledge between nutrition, health-related, and non-health related undergraduate majors. Post-hoc analysis revealed there was no significant difference of basic nutrition knowledge between health-related majors and non-health related majors, and there was a significant difference in basic nutrition knowledge between nutrition majors and health-related majors as well as between nutrition majors and non-health related majors. Thus, the results demonstrate there was a statistically significant difference in basic nutrition knowledge between nutrition students, and either health-related, and non-health related undergraduate majors.</p>

Thesis (M.S.)--Boston University

Obesity, a public health issue in the United States, has been linked to numerous chronic diseases. A gap exists in the literature related to racial and cultural etiology of body satisfaction for obese women. The purpose of this qualitative phenomenological study was to describe the racial and cultural etiology of body satisfaction for obese Black women and White women residing in a rural area of the state of North Carolina. Social comparison theory provided the theoretical underpinning for this examination. The central research question was how do obese, young adult Black women and White women describe their perceptions about and experiences of the racial and cultural etiology of their body satisfaction. One-on-one interviews were used to collect data from 6 obese young adult women (3 Black women and 3 White women) between the ages of 18 and 29 years residing in a rural area of North Carolina. Braun and Clarke's 6-phase method for thematic analysis was used to analyze the data. Six themes emerged from the data analysis: (a) Black participants viewed the media through a lens of body positivity, (b) White women related media influences as confrontation with the media, (c) Black women related peer influences to include shaming and denial, (d) White women viewed peer influences as including negative comparisons and positive examples, (e) Black women related family influences to include normalizing obesity, and (f) White women related family influences as including one welcoming the outcast. The results of the study foster positive social change, as deeper understanding of racial and cultural differences regarding body satisfaction of Black women and White women could lead to positive body image and greater body satisfaction among these groups.

The lack of access to improved toilet sanitation remains a major health and environmental hazard in developing nations in the world. Despite global leadership efforts at the level of the United Nations and nongovernmental organizations around the world, diarrhea-related diseases disproportionately affect children. Evidence from the literature suggests that competent and sustained leadership is central to resolving the problem. From a historical perspective, leadership advocacy and engagement prompted the sanitary revolution in the West in the 18th and 19th century that led to the eradication of preventable infectious diseases such as cholera. Integrated leadership that made use of sanitation and water institutions at the national, state, and local levels and structured, skilled, and financial capability helped create an enabling environment for better and sustainable hygiene sanitation in the West. A qualitative approach was used to explore the role of collaborative leadership in enhancing the demand for toilet hygiene in rural Njinikom and the community's perception of the state of sanitation. One-on-one interviews were conducted with 25 adults aged 18 years and above with knowledge and exposure to poor toilet sanitation. Content analysis was used to develop themes and patterns from the data. The findings revealed barriers such as inefficient leadership and limited financial resources that impede adequate feces disposal and motivating factors for better sanitation. The results provided support for a partnership approach that is inclusive, relevant, useful, and sustainable. The implication of the study includes renewed interest in improving toilet sanitation and health and increase understanding of the importance of adequate feces disposal in preventing and eliminating associated fecal-oral diseases.

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and associations between variables. Archived data dating from 2012 to 2014 of health inspection reports on 558 food establishments were collected and analyzed using the Manitoba Health Hedgehog database. Chi Square, Pearson Correlation Coefficients, and Fisher's Exact Tests revealed the association of food safety practices, routine health inspections, and food safety certification. Results indicated no statistical difference between food safety practices and routine health inspections. Pearson's r analysis revealed a weak relation between routine inspections, internal temperature, thermometer use, and food storage/food protection noncompliance. Logistic regression analysis revealed that food safety certification was not a predictor of food safety practice compliance. This study can provide a bridge to reevaluate current health policies pertaining to food safety practices in Manitoba. This study adheres to the need for social change in establishing and creating prevention programs for food staff. Food safety programs can safeguard the food industry and protect public health from foodborne illnesses.

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) were used in combination as the theoretical foundation of this study. Data collection was done using an adapted version of the Health Information National Trends Survey (HINTS), the Condom Use Self Efficacy Scale (CUSES), and an adapted version of the Marin County (California) Health Department's Sexual Risk Survey. There were 128 eligible participants and analysis of the data showed that the internet was the primary source of both general health information (87.5%) and STD specific health information (75.8%). A multiple regression analysis showed that there was no statistically significant correlation between perceived susceptibility and health information seeking or sexual risk (p > .05). This can aid in positive social change by prompting additional research on the subject of STD prevention in young adults through the design and dissemination of tools for education that may reduce the rate of STDs or other health ailments.

Limited knowledge exists about sexual orientation and intimate partner violence among women who have sex with women. These women are at risk for adverse physical and mental health hygiene outcomes that may result from unhealthy lifestyles secondary to intimate partner violence. The purpose of this study was to examine the association between sexual orientation and intimate partner violence among women who have sex with women. The constructs of the biopsychosocial model guided the study and examination of the relationships among biological factors (sexual orientation), social contexts (support of family and friends and use of community services), and psychological influence (mental health status) on intimate partner violence among women who have sex with women. The study was a quantitative cross-sectional analysis of archived data from the 2010 National Intimate Partner and Sexual Violence Survey. Forward stepwise logistic regression indicated a statistically significant relationship between sexual orientation and intimate partner violence victimization (p < .05) Annual household income, race, family/proximal support, and support of community were significant predictors of intimate partner violence victimization. The social change implications of the study are that findings may inform design and implementation of policies, services, and interventions that target the diverse needs of female same-sex intimate partner violence victims.