The health of the veteran population within the United States has become a matter of ever-increasing concern, and many individuals who have attained veteran status are experiencing health issues following their discharge from the military. Despite such concerns, there are often not enough resources available to assist these individuals to the degree necessary in an expedient manner. The purpose of this case study was to use social cognitive theory to understand the physical activity of veterans following their time in service. Through the use of social cognitive theory, this study explored the thoughts, perceptions, and behaviors of 11 veterans to determine how their physical fitness levels were affected following their time in the service. Data were collected by interview over the course of a 1-month period by visiting the U.S. Department of Veterans Affairs hospital a minimum of 3 days per week and a content analysis of interview transcripts led to the presented results. Results indicated that expectations of physical activity were realistic post service, and self-efficacy and self-control levels were high. Veterans indicated the beneficence of physical activity as a means of promoting overall wellbeing; however, paticipants also indicated dissatisfaction with the available options to them through the U.S. Department of Veterans Affairs. The results provided clear direction as to the steps that can be taken to work to increase the physical activity levels of veterans. Potential social change implications resulting from the study could lead to improvements in understanding of veteran health statuses.

Prior research has indicated that healthcare personnel (HCP) who work in areas where Mycobacterium tuberculosis poses an occupational hazard are at high risk of tuberculin skin test (TST) positivity and subsequent conversion to active tuberculosis (TB). U.S. medical laboratory microbiologists confront similar hazards but have not been studied outside of the HCP aggregate. The purpose of this study was to fill this gap by examining the relationships between the predictor variables of self-reported history of bacille Calmette-Guerin (BCG) immunization, place of birth, and years of laboratory experience and the outcomes of self-reported lifetime TST positivity, preventive treatment noninitiation, and barriers to treatment adherence for this subgroup. This quantitative, cross-sectional study was guided by the epidemiologic triad model. A researcher-designed self-administered questionnaire including Part A of the Brief Medication Questionnaire was mailed to 4,335 U.S. microbiologist members of the American Society for Clinical Pathology. From the 1,628 eligible respondents, results showed that prevalence of positive TSTs (17.0%) and treatment noninitiation (9.8%) was low. Multivariate analysis identified BCG and foreign birth, as well as age, nonoccupational exposure, history of TB, work in mycobacteriology, and work outside of microbiology as predictors of a positive TST; foreign birth was a predictor of treatment noninitiation. Additional research is needed to identify other laboratorian groups at increased risk for developing TB. These results enhance positive social change by helping to inform recommendations in the global fight to stop the spread of TB, as well as improve allocation of resources among this specific group of HCP.

Maintaining due diligence on safety practices at the workplace of battery technicians is the most cost-effective intervention against lead-related hazards. The safety practice on lead poisoning in Nigeria is below average, and the compliance level is far from the expected target of 90%. Using Dejoy's workplace self-protective behavior theory, this study investigated multilevel factors that influence safety practices on lead poisoning and compared the rate of utilization of personal protective equipment by battery technicians in the organized and roadside settings. The study was a quantitative, cross-sectional survey design, and a multistage and systematic sampling technique was used to select 293 adult battery technicians aged 18 years and above. Hypotheses were tested with chi-square and multivariate logistic regressions at the significant level of p < 0.05 and 95% confidence interval. The outcome of the safety practice status of battery technicians is 20%, and the rate of utilization of personal protective equipment is 18% in Lagos, Nigeria. Findings revealed that workplace conditions, blood lead levels, knowledge, education, and the rate of utilization of personal protective equipment are predictors of the safety practice status of battery technicians. There was no significant difference between battery technicians in the organized and roadside setting considering the perceived risk of lead poisoning and utilization of personal protective equipment. The positive social change implications of this study include recommendations for battery technicians to use the evolved alternative safety approaches to reduce lead-related hazards. Public health professional and policymakers should invest resources towards reducing the impact of lead poisoning on battery technicians at the workplace.

Osteoporosis is a serious disease which often brings pain, disability, hospitalization, and even death. An increasing number of studies have been conducted on the prevention and treatment of osteoporosis in White women, yet a paucity of research exists to explain disparities in screening and treatment of osteoporosis in Black women. This narrative study describes the perspectives of Black women regarding individual barriers to osteoporosis screening. The purpose of this study was to better understand the perspectives of Black women regarding prevention of and screening for osteoporosis. Selections included purposive, criterion sampling of 10 Black women who were 50 years and older, could speak and write English, and lived in Southeastern Virginia. Recruitment flyers were distributed to Black women who were members of 3 local churches. The conceptual framework for this study was the behavioral model of health services, which holds that individual's acceptance to use health service is partly controlled by that individual's predisposing, enablement, and need. Data were collected by in-depth face-to-face interviews and analyzed using open, axial, and selective coding. Four major themes emerged in this study including awareness of osteoporosis, knowledge of the screening, health beliefs, and sharing of information. While the narratives indicated positive effects from engaging in osteoporosis screening, there was a discrepancy in understanding the disease and explanations of screening results. This study addresses social change by identifying how awareness and knowledge may help Black women become more effective when they engage in osteoporosis screening, which can help to ensure health and a better quality of life.

Failure of emergency response personnel to communicate effectively with different cultures can have dire consequences during an emergency, including loss of lives and litigation costs. For emergency response personnel to communicate the risk of an emergency, it is important to understand how different groups, especially newly arrived foreign immigrants, perceive warnings and related messages. This study addressed how one of the largest category of immigrants in Michigan perceived severe tornados, influenza pandemics, power outages, severe floods, and snowstorms. The research question examined the degree to which the equation, Risk = Hazard + Outrage, explained perceptions of these hazards in Michigan among newly arrived Iraqi immigrants. A concurrent mixed-method design was used. In-person interviews were conducted using quantitative and qualitative questions based on the equation and the PEN 3 model with 84 immigrants from Iraq who lived in the United States 4 years or less. Respondents' levels of outrage and hazard were compared using ANOVA. The calculated levels were compared with the qualitative comments made during the interviews. Snowstorms measured the highest outrage, and power outages measured the least. The reported awareness level was lowest for snowstorms with the highest being power outages. More information needs to reach Iraqi immigrants regarding unfamiliar hazards. Communicators should use Iraqi immigrants' experience with familiar hazards to identify effective ways of responding to this population. The results of this study may promote social change of more effective communication and saving lives in the future should an emergency occur in Michigan that affects Iraqi immigrants.

Many people in the United States suffer from substance dependence, which leads to depression, anxiety, work impairment, difficulties in interpersonal relationships, crime, and health care problems. Mindfulness meditation has been applied in many aspects of mental health treatment and all belief systems. The purpose of this phenomenological study was to explore substance dependents' experiences related to their mindfulness meditation practice of at least 6 months and up to 3 years. A constructivist conceptual framework, which states that human beings create systems for understanding reality based on their individual beliefs, emotions, and interpretations, was used for this study. Research questions focused on 4 themes: (a) substance dependents' experiences of cravings, (b) their experiences of emotional states or feelings, (c) their experiences of their behavioral actions, and (d) their explanations about the effectiveness of mindfulness techniques. Data were collected from in-depth interviews with 12 volunteer participants from a public meditation center in Baton Rouge, Louisiana, and they were analyzed using Moustakas' transcendental phenomenology framework. According to study results, positive social change may occur through increased understanding of varied emotional and behavioral states experienced by substance dependents as they strive for sobriety using mindfulness meditation techniques.

Older adults with infectious and chronic diseases, such as cardiovascular disease and human immunodeficiency virus (HIV), are at high risk for associated chronic comorbidities, which are associated with increased medical expenditures to cover treatment costs. The purpose of this study was to investigate (a) whether adults 65 or older with either HIV or cardiovascular disease were predisposed to increased medical expenditures versus adults 64 and younger, and (b) the impact of race and type of health service used on total direct medical expenditures incurred among adults with HIV or cardiovascular disease. A quantitative, deductive, retrospective cross-sectional design was used, and the behavioral model of health services use and the socioecological model were chosen as the study’s theoretical foundations. Analyses were conducted using binary logistic regression. Controlling for confounding variables of education and region of residence, the key findings were that adults ≥ 65 years had higher odds of incurring higher expenditures overall. White patients had higher odds of incurring higher expenditures for medication (OR 1.251), office-based visits (OR 1.433), inpatient visits (OR 1.245), and outpatient visits (OR 1.451) when compared to other races. Older adults with HIV had higher expenditures for medication and home health (OR 1.850); and older adults with cardiovascular disease had higher outpatient (OR 1.235), inpatient (OR 2.142), and emergency room expenditures (OR 1.063). These findings might promote social change because assessing the influences of cost disparities on infectious and chronic diseases can help address variations in health care costs and can initiate the development of tailored evidence-based practice guidelines that can help older adults.

There is a high prevalence of hypertension in Nigeria. Limited knowledge of hypertension, how to prevent it, its outcomes, rapid urbanization, and the adoption of Western eating habits are implicated. Hypertension is an important issue because chronic disease places economic, social, and disease burdens on society. The purpose of this mixed-methods study was to investigate lifestyle practices, knowledge, and attitudes on risks and prevention of hypertension among residents of Ogun State, Nigeria (N = 79). The conceptual framework for this study focused on how knowledge, attitudes, and practices influence the dietary habits, behaviors, and ultimately blood pressure . The PEN-3 model was also used as the theoretical framework for research. The general linear regression model with sums of squares and Pearson's product correlation were used in quantitative analysis of diet, blood pressures, educational attainment, height, physical exercise, and weight to determine the factors that were predictive of hypertension. The main predictors of hypertension were age (p < 0.03), BMI (p <.024), and educational attainment (p < 0.02). Deductive analysis of qualitative data from focus group discussions revealed mothers are a primary source of health knowledge. Also, Babcock University has made a major impact on community health by providing free health lectures. This study contributes to social change by extending the PEN-3 model with two new domains, support for health behavior, and power to change health behavior. This information can be used to help focus government health outreach programs for improved support of individual and community change.

Breast cancer patients undergoing radiotherapy often experience severe levels of anxiety and depression. There is a gap in the research literature from Africa, particularly from Ghana, with few studies focusing on the assessment of anxiety and depression among breast cancer patients undergoing radiation treatment. A better understanding was essential to promote efforts to help breast cancer patients cope with their diagnosis and treatment and increase their overall quality of life. This mixed method study examined breast cancer patients in Ghana undergoing radiotherapy and their responses related to anxiety and depression through a concurrent triangulation involving an interview with selected professional participants and a detailed patient survey. Patients completed 2 modified scales, the Patient Health Questionnaire and Depression Anxiety Stress Scale. The sample consisted of 100 patients between the ages of 20-89. Individual interviews were held with 6 professionals with a minimum of 5 years of work experience. Themes were generated through open coding of the interview data, while multiple regression was performed to determine the relationship between depression and anxiety with the independent variables . Findings of this study indicated the need intervene through counseling and education on behalf of patients in Ghana as they undergo breast cancer treatment. Age and monthly income of patients were statistically significant in predicting the anxiety and depression among the patients. The study's implications will lead to positive change when all stakeholders take on the responsibility of implementing measures to promote coping strategies for breast cancer patients in Ghana.

From 2004 to 2015, the health sector in Nigeria was substantially underfunded despite the existence of a federal health policy committing 15% of the national budget to health care financing. The purpose of this narrative and phenomenological study was to explore the nature and significance of economic claims made in this policy. The central research question examined the extent to which these economic claims were perceived to be realistic, attainable, and successful in meeting their intended policy objectives and impact. The study's conceptual framework combined Kingdon's ambiguity and multiple streams theory, Roe's narrative policy analysis, and Skocpol's policy feedback theory. Seventeen major health policy documents and transcripts from key informant interviews with a convenience sample of 15 representative health policy experts, were imported into a data software. Twenty-six nodes were identified and then manually organized into 3 themes to generate the findings. Policy experts perceived the 147 economic claims in the policy documents as marginally realistic, and a majority of these experts assessed the claims as unattainable and with limited chance of succeeding in addressing the underfunding of Nigeria's health sector. The study opened a new area of research inquiry in health policy and health care financing by linking the veracity of economic claims made in the national health policy with the actual financing of health care. Health policy experts can use study results to promote the formulation and use of evidence-based economic claims in future health policies. Increased use of specific, measurable, attainable, realistic, and time-bound economic claims will enhance future health policy contributions to human wellbeing and positive social change.