Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type of learning style, in the amount of changed performance between pretest and posttest. A sample of 80 adults in an urban community was recruited through organizations serving low-income individuals. The participants were assessed for baseline health literacy level, followed by identification of learning style, educational intervention, and posttest assessment, which led to determination by t test that changes between pretest and posttest scores were statistically significant between the control group and the study groups. This finding suggests that health education should be delivered to patients according to individual learning style in order for patients to comprehend and retain information provided. Social change implications include healthcare professionals appropriately addressing health literacy so that patients may participate more actively in their personal healthcare decisions to improve healthcare quality outcomes, decrease long-term costs of delivering healthcare services, and improve the general health of the community.

HIV infection persists in Swaziland with the highest prevalence of the disease globally – 1 in 4 Swazis aged 15-49 are HIV-positive. Women have a higher rate of infection than men (31.1% of women are HIV-positive, whereas 19.7% of men are HIV-positive). The difference in prevalence between the sexes raises some concerns, particularly due to the possibility of vertical transmission from mothers to infants because the average number of children ever born per woman is 2.28 for all women and 3.58 children for married women. This research aimed to determine if there was a significant difference regarding the knowledge and personal beliefs about HIV transmission between men and women. Obtaining correct knowledge regarding the transmission of HIV and where to get tested for HIV is vital to preventing further transmission of the disease. The Demographic and Health Surveys Program (DHS) gathered data in 2006-2007 to determine the baseline knowledge of individuals about the transmission of HIV. Comparisons of data collected from Swazi men (n = 4,156) and women (n = 4,987) concerning their knowledge and beliefs about HIV were made in order to obtain descriptive statistics, including chi-square to determine the presence or absence of significance (p-values) and percent differences between the sexes. Statistical Package for the Social Sciences (SPSS) software was utilized to perform all statistical analyses using both the chi-square and percent difference functions. Data was weighted accordingly prior to analyses being run in SPSS. Questions regarding the individuals’ personal beliefs about the transmission of HIV were included on surveys for both sexes, specifically addressing the following: 1) the outward appearance of those who are HIV-positive (96.1% of women and 95.7% of men believed healthy-looking individuals can be infected with HIV; p = 0.336, % difference = 0.3999, χ2 = 0.926), 2) the role (or lack thereof) of mosquitoes in transmitting HIV (65.7% of women and 66.1% of men believed mosquitoes cannot transmit HIV; p = 0.688, % difference = 0.3999, χ2 = 0.161), 3) supernatural involvement in the transmission of HIV (92.3% of women and 91.7% of men believed supernatural means do not contribute to the spread of HIV; p = 0.292, % difference = 0.5999, χ2 = 1.112), 4) and the ability of HIV to be spread via food intake (82.2% of women and 82.3% of men believe they cannot becoming infected with HIV by sharing food with an HIV-positive individual; p = 0.901, % difference = 0.0999, χ2 = 0.016). Despite no statistically significant differences between the beliefs about HIV transmission held by both men and women, the data indicated only 51.9% of women and 51.4% of men possess comprehensively correct knowledge about the transmission of HIV. Furthermore, although 91.8% of women knew where to get tested for HIV, only 78.1% of men knew where to get tested for HIV. However, an encouraging 73.8% of women and 71.8% of men between the ages of 18 and 19 stated they believed adolescents between the ages of 12 and 14 should be taught proper condom use to prevent HIV infection. Comprehensive adolescent and adult sex education programs are indicated to ensure all adolescents and sexually active men and women possess correct knowledge about the transmission of HIV and where to seek assistance for HIV testing and treatment.

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief model (HBM) was used to interpret the results. The HBM is a social cognition framework that takes into account different perceptions, namely, perceived susceptibility of acquiring a health condition, perceived severity of the condition and its consequences, perceived barriers to engaging in the recommended behavior, perceived benefits of engaging in the recommended behavior, and perceived costs of engaging in the recommended behavior. Multiple linear regression was used to analyze the data. The results, which were based upon a cross-sectional survey of 124 participants, showed that the participants' awareness of adverse events associated with NSAIDs use was not associated with sociodemographic variables, rates of consumption, or patient-physician communication. The findings will give the key stakeholders more insight into the issue of preventable adverse events that might lead to the establishment of more safety programs and informatics structural systems to monitor the consumption of OTC NSAIDs and improve lines of communication to protect the elderly population.

Secondary school students in Nigeria face challenges regarding their oral health. Few researchers have investigated oral health knowledge, attitudes, and behaviors in Nigerian populations. The purpose of this study was to assess the level of oral health knowledge, behaviors, and practices among secondary school students in Enugu State, Nigeria, in relation to their oral health status. The theoretical framework of this study was based on the health belief model. A cross-sectional study was conducted to collect data from 12 secondary schools in Enugu State, using a close-ended questionnaire as well as oral examination (dental caries and periodontal diseases) of the students who attended junior secondary (JSS) I, II, and III classes. A total stratified sample of 671 students was included in the study. Bivariate nonparametric tests and logistic regression were used to analyze the data. According to the results of the study, the levels of dental caries and periodontal diseases were relatively low. However, only one fourth of the students had received professional fluoridation, and almost 50% of the participants had never visited a dentist. Students from a missionary school had lower levels of periodontal diseases than those from public schools, with an odds ratio of 0.612 (95% CI [0.402, 0.934]). Students from JSS III class tended to have a lower level of periodontal diseases than those of JSS I class (OR: 0.567, 95% CI [0.363, 0.886]). The social change implications of this study can be the development and incorporation of oral health promotion programs into the school curriculum. These programs may increase the adoption of preventive oral health strategies by students, such as regular dental attendance, to maintain their good oral health for a life time.

In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender identity; and experience with health care providers and the three dependent breast cancer screening compliance variables: breast self-examination (BSE), clinical breast examination (CBE), and mammography screening. Statistically significant associations between dependent and independent variables at the .05 level were further analyzed with logistic regression. Results of the ten regression models found that BSE was predicted by socioeconomic characteristics and participation in wellness activities. Compliance with CBE guidelines was predicted by sociodemographic characteristics, wellness activities, sexual orientation/gender identity and provider experience. Sociodemographic variables and provider experience also predicted mammography screening. Overall compliance was predicted by sociodemographic characteristics, namely insurance status. The social change implications of this research are an improved understanding of African American lesbian and bisexual women's screening behavior and guidance toward interventions that can improve and breast cancer screening compliance with guidelines.

Nursing schools struggle to prepare enough nurses to meet the health care needs of a diverse and aging population in the United States. Many students do not complete their degrees, contributing to the problem. The purpose of this qualitative study was to explore and describe how successful Latina students experience and respond to the academic challenges of prerequisite nursing courses. The nursing shortage; healthcare needs of Hispanic patients; student outcomes; self-efficacy, achievement goal orientation, and academic help-seeking; and Hispanic cultural values framed the study. Using semistructured private interviews, the researcher explored the lived experiences of 6 successful Latina students when they encountered challenges in prerequisite nursing courses. Seven superordinate themes emerged following interpretative phenomenological analysis of the data: (a) facing academic challenges, (b) recognizing emotional response, (c) seeking help, (d) transcending academic challenges, (e) owning knowledge, (f) persevering, and (g) living out values and beliefs. The hermeneutic approach allowed participants to describe the transition from avoiding to reaching out for help. Conclusions and recommendations include the need for faculty to recognize and respond to the importance of family, relationships, values, and beliefs to academic success in Latina students. Implications for social change include enhanced faculty ability to support the academic endeavors of this population. Improved graduation rates in Latina nursing students will help to address the nursing shortage and the need for a health care workforce that mirrors the population of the United States.

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature of knowledge transfer, research questions examined the characteristics of an effective knowledge sharing network, associated knowledge sharing similarities and dissimilarities, and perceived knowledge sharing enablers and inhibiters. Social network and thematic analysis were used to collect, map, and analyze perceived informal knowledge transfer practices. Findings indicated that face-to-face communication, visual and verbal cues, and individuals who had a few powerful neighboring connections were influential knowledge resources. The social implications from these findings will act as a catalyst to shift prevalent cultural knowledge management practices thereby positively affecting workload and resource management. Employees will more clearly understand their knowledge management roles and how their actions affect service delivery to citizens. Acting as a knowledge transfer model, the ministry could positively influence the government's Public Service Agency, other ministries, health authorities, and private sector organizations to adopt effective knowledge transfer practices to improve managerial and managerial/staff communication and trust.

Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included that (a) healthcare is focused on children and pregnant women; (b) healthcare is largely ineffective because of insufficient funding, misguided leadership, poor system infrastructure, and facility neglect; (c) residents lack knowledge of and confidence in available primary healthcare services; (d) residents regularly use traditional healers even though these healers are not recognized by local government administrators; and (e) residents can be valuable participants in community-based research. The potential for positive social change includes improved communication between local government, residents, and traditional healers, and improved access to healthcare for residents.

The Centers for Disease Control and Prevention predicted that the incidence of HIV/AIDS among the American population aged 50 years and over would account for 50% of all HIV/AIDS cases in the United States by 2015. Yet there is little research available about the reason for the high prevalence or the availability of interventions available for this population. The purpose of this study was to explore factors related to HIV/AIDS awareness in a group of older recipients of health care and their health care providers. This study was intended to help fill the information gaps in this area by using a conceptual framework based on systems theory and social network theory. A mixed-method design was used to collect data; semi-structured interviews were conducted with a sample of 17 health care providers and analyzed using thematic content analysis. Structured exploratory surveys were distributed to a sample of 99 HIV/AIDS-positive adults, aged 50 and over, to understand common factors likely to have contributed to their infection and the results were compared to common factors already identified in the general population in the literature. Results of this study indicate possible communication barriers that exist between care providers and their older clients when discussing topics related to behavioral factors contributing to HIV/AIDS. This study contributes to social change by adding support to the importance of education programs and awareness campaigns about factors related to HIV/AIDS to curtail the spread of this disease among older adults.

Research confirms inactivity increases in adolescence and that unfit youth are at risk of acquiring cardiovascular diseases, diabetes, obesity, or other significant physical disorders later in life. Thus, the purpose of this phenomenological study was to describe the experience of chronically inactive children who were exposed to an exercise intervention program. The specific focus of the research was to better understand the essential educational needs of the participants and the effective elements of the program, Moving for Fun (MFF), a 7-week after-school fitness intervention program designed to modify chronic inactivity. Open-ended interviews and 3 observations were conducted with 8 middle school students (4 males and 4 females) identified as scoring low on a standardized assessment protocol of health-related physical fitness. Interview data were transcribed and coded using a combination of open and a priori coding to extract significant statements that were analyzed into clusters of meaning that described key elements of the students' experience. Video-taped observations were analyzed to use behaviors during MFF activities as a means of checking interpretations of the interview data. Interpretation of the final structural analysis suggested that students did not have a good understanding health-related fitness or how it is achieved; however they enjoyed participating in inclusive physical activity, and were planning to add more physical activity to their lives. Recommendations include an examination of physical activity programming and an increase in programs that serve participants with varied needs. Developing more student-centered programs that teach or include fitness education can decrease the number of students lacking physical fitness and increase the population of those who carry fitness activities and better health with them into the future.