Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving daily physical activity. Thirty-seven nurses were recruited to use a pedometer application for 24 hours on a (12-hour) workday to track their steps for 3 consecutive days, as well as complete a final survey. A repeated measures ANOVA, with a Greenhouse-Geisser correction, determined that there was no statistical difference in the number of steps over the 3 time periods. Seventy-eight percent of the participants indicated that the project increased their awareness of physical activity. Extended research is needed to add a stronger support for the affect of wearing a pedometer and the benefits of increased awareness on health promotion. Pender's health promotion model suggests adding motivating factors such as competition. Fitness trackers now have this function and could play a large role in improving physical activity awareness and the battle of obesity for nurses and the general population. The results of this study may promote positive social change by making nurses more aware of the importance of their health and physical activity, given their long work days.

Most people have had an episode of foodborne illness at one time or another; however, the majority of those stricken with foodborne illness fails to associate ill health with something consumed within the past 72 hours. The World Health Organization (WHO) estimates that foodborne diseases affect 30% of the population in developed countries, and that in developing countries, about 2 million people die yearly due to foodborne illness. Previous researchers have indicated that food handlers with poor personal hygiene are potential sources of infection. Although public health agencies in many countries already regularly inspect food facilities to control potential foodborne illnesses to some extent, the question of the most appropriate and effective means of achieving the goal of food safety remains unanswered. Therefore, the purpose of this study was to determine whether a color-coded placard grading system is an effective tool for achieving this goal while simultaneously educating the public about food safety. This study involved 1,410 randomly selected food service establishments, consisting of traditional restaurants, take-out restaurants, grocery stores, public school cafeterias, and institutional food facilities located in Alameda County, California. Inspection data were analyzed for the first 12 months of placard grading and compared to the following 12 months during the placard grading period. Statistical analysis results did not show significant differences in the CDC major violations and in confirmed foodborne illnesses between the 2 years. However, it is expected that the new program will provide improved food handling practices in the future. Improvement in food handling practices will contribute to social change by reducing the number of foodborne illnesses, promoting better health for the community, and educating the public about food safety.

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was used to check for multicollinearity. There was not a statistically significant difference between those who were depressed (Mdn = 32.76, IQR = 7.8) and those who were not depressed (Mdn = 33.27, IQR = 5.0) in terms of BMI (U = 774.0, p = 0.47). When depression, BMI, an interaction term for depression*BMI, and other predictor variables were entered into the regression model, these variables did not account for a significant increase in shared variance in HBA1C (Î?R2 = 0.17, F (14, 74) = 0.17, p = 0.37). Social change implications generated from this study include better resource utilization, improved quality of care, increased veteran satisfaction and improved veteran experience across the healthcare system. The findings from the study can be used to expand access to specialized services for chronically ill veterans, coordinate resources, better outcomes and facilitate seamless care coordination between mental health and primary care providers

Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs and through document review. The document reviewed were reports of coordination efforts, and outcome evaluation reports. Data were managed using NVivo, while coding and themes were adopted for data analysis. Findings revealed the partial coordination efforts in the health system development. Coordination efforts should be at both national and state level to ensure adequate implementation of the health program. Most participants reported a need for the government of the recipient country to strengthen their commitment and own coordination process for development partners to adhere to the guidelines of the coordination platforms. These results could have implications for positive change by identifying the bases to achieve sustainable effectiveness of health aid in Nigeria through development of Country Coordination Mechanism for all health programs to provide guideline of harmonizing activities of development partners.

Childhood obesity rates among Mexican Americans have risen along with the concerns of public health professionals. The purpose of this cross-sectional study, based on social cognitive theory, was to investigate the relationships among parental self-efficacy, parental feeding practices and styles, and childhood obesity, as measured by the parental perception of child weight, among Mexican Americans in Texas. Mothers and fathers (n=83; 33 males, 64 females), with at least 1 child between 8 and10 years, formed the sample. Relationships were assessed using the Tool to Measure Parenting Self-Efficacy questionnaire, the Parental Feeding Practices Questionnaire for Mexican American parents, the Parenting Dimensions Inventory – Short Version, and a figure rating scale of child’s weight. Data were collected through SurveyMonkey and analyzed by gender using linear regression. Feeding styles of reasoning [β = -.065, 95% C.I. (-.124, -.007), p < .05] and greater parental control [β = -.158, 95% C.I. (-.294, -.023), p < .05] decreased parents’ perceptions of their male child’s weight; feeding styles of letting situations go [β = .049, 95% C.I. (.005, .093), p < .05] increased parents’ perceptions of their male child’s weight. Feeding practice of the use of food to control behavior [β= .029, 95% C.I. (.009, .049), p < .05] and restriction of food [β= .041, 95% C.I. (.016, .065), p < .05] increased parents’ perception of their male child’s weight. There were no significant results for female children or parental self-efficacy. This study has implications for positive social change: changes in feeding practices and styles for Mexican American parents could improve the effectiveness of obesity interventions for PH staff and thus decrease morbidity and mortality among Mexican American children, especially boys in Texas.

Research has indicated that effective parenting programs for pregnant and parenting teens greatly improve educational and career opportunities for teen parents. Such research underscores the need for schools to use these programs in their efforts to increase high school graduation rates for this population. The aim of this case study was to assess if a school-based parenting program was successful and, if so, how elements of this program might be useful to educators who are planning similar programs. The study included an examination of archived program data, which included end-of-year reports related to the program and participants, and interviews with 12 key program administrators and teachers. Outcome evaluation theory and a logic model served as the conceptual framework. The research design had 2 parts: a quantitative secondary analysis of archived data and qualitative interviews. The program data were analyzed using descriptive statistics. The interview data were downloaded into a computer-assisted qualitative software program to organize the data, code the data, and to determine major themes. Major findings were that the program met goals and objectives due to: (a) clearly stated and specific program objectives;(b) a high level of program support from district and administrative staff; (c) a major asset of the program, its curriculum; (d) adequate resources and funding, and (e) the active participation of, and open communication between, parents/guardians of program participants, faculty, and staff. This study contributes to social change by showing educators and parents that an effective school-base parenting program can result in improved high school completion and brighter outcomes for pregnant and parenting students.

Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention behavior. The health belief model and the sociocultural theory provided the theoretical underpinnings for this qualitative study. Semistructured interviews were conducted with a purposeful sample of 12 immigrants living in a rural area of Oklahoma. Data were triangulated and analyzed to identify themes and patterns. Findings indicated participants perceived susceptibility of contracting a vaccine-preventable disease if not immunized, with the severity of the disease having the potential to cause death. Identified barriers in immunization uptake were language barrier, lack of immunization information in Spanish, and fear of deportation. Recommendations include public health outreach providing culturally, linguistic appropriate immunization information to immigrants within communities. Findings provide health psychologists and other health care professionals the ability to formulate interventions targeting immunizations in female Mexican immigrants. These interventions could promote positive social change by decreasing immigrants' and their children's risk of morbidity and mortality related to lack of immunization uptake.

Intimate partner violence (IPV) is a significant public health problem that affects approximately 2.4 million individuals in the United States each year. Race, age, gender, and household income are established correlates of criminal victimization and diverge across various victimization experiences for these individuals. The purpose of this study was to investigate relationships between IPV victimization and the demographic variables of race, age, gender, and household income using race, class, and gender theory as a framework. Logistic regression analyses on data from 3,492 adult male and 3,637 adult female IPV victims obtained from the 2013 National Crime Victimization Survey showed that race was not significantly associated with IPV, while age, gender, and household income were significantly associated. Respondents 65 years or older reported less victimization and men were 2.09 times at lower odds to experience IPV than women. Respondents in the household income category of less than $7,500 were 1.62 times at higher odds to experience IPV than were those in the $75,000 or greater income category. Positive social change could result from an increased awareness of circumstances related to IPV victimization so public health practitioners can work to reduce its incidence impacting individuals, families, and communities.

Epidemiologic surveillance indicates an increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without. The present study investigated this disparity in weight severity between both groups, with a focus on the provision of obesity management counseling by physicians. This study consisted of a retrospective medical record review that acknowledged the effect of patient-provider interactions on health behaviors and risk perceptions. An independent sample t test compared the incidence of clinician-initiated obesity management counseling received by children with SHCN to that which was received by children without SHCN. This t test revealed a statistically significant difference between the weight management frequency received by youth with SHCN (M = 1.0, SD =.46498) and the weight management frequency received by youth without SHCN (M = 2.0, SD = .74975), t(100) = 7.826, p = .000, α =.05 over a 2-year timeframe. Bivariate correlation analysis validated a correlation between weight severity among children with SHCN and the incidence of clinician-initiated obesity management counseling. The results indicated a small but significant association between weight severity and weight management frequency among children with SHCN, r(50) = .287, p = .044, α =.05. These results support the need for a transformation in the delivery of preventive health services for children with SHCN, such as providing clinician-based obesity management strategies and increasing access to validated diagnosis-specific preventive health screening tools. These results promote positive social change by informing efforts to improve health outcomes and decrease health disparities experienced by people with SHCN.

The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a review of patient satisfaction results, reduction in patient readmission rate, and emergency room consults. Two years of data from a community-based health care program were collated from a sample of 819 individuals with chronic disease between 65- and 85-years-old who had a 30-day hospital readmission after a nurse practitioner home visit and a 30- day readmission for an exacerbation of their CHF, DM II, or COPD. The secondary data were analyzed, using SPSS, to determine changes in rates of readmission. Descriptive statistics were used to represent and compare changes in rates. After implementation of the nurse practitioner home visit program, the 30-day readmission demonstrated an 81.07% reduction and the 30-day readmission for exacerbation of COPD, CHF, and DM II was reduced by 36.77%. The project findings contribute to social change by identifying how a reduction in the frequency of hospitalizations could contribute to decreased health care expenses and improved health outcomes. Home care and chronic health care organizations, as well as advanced-practice nurses working in home care settings, may use the results of the study to establish effective community interventions that reduce health care costs.