In 2009–2010, the prevalence of obesity among U.S. adults was 40%, and the prevalence was 69% among long haul truck drivers. Researchers have not established a clear relationship between working environment and weight among truck drivers. This quantitative cross-sectional study, using an ecological framework, evaluated the relationship between the working environment (sleep performance, food choices, driving environment, and activity level) and weight severity (e.g., body mass index [BMI]) among long haul truck drivers. One hundred and twenty six adults (46 + 10, years of age), including both genders (male = 97 and females = 29) completed an online questionnaire evaluating their weight and work environment. BMI ranged between 19.7– 77.0 (35.4 + 11.0) kg/m2 among respondents. None of the respondents were underweight, 20 were healthy weight, 28 were overweight, and 78 were obese. Using multiple regression analysis, no statistically significant associations were found between the working environment and weight severity. Statistically significant (p < 0.05) mean differences between weight groups were found using a 1-way ANOVA. Regarding physical activity level, there was a statistically significant difference between the overweight and obese Class II groups (M = 1.034, p = .026). There was also a statistically significant difference between the overweight and obese Class III groups (M = -.506, p < 0.001) regarding physical activity within the prior month. The findings of this study support the need for further research to advance the knowledge of associations between weight groups and physical activity among this population, which could promote positive social change by guiding public health officials and trucking industry stakeholders toward effective interventions to reduce BMI among long haul truck drivers.

Obesity continues to weaken our nation physiologically, psychologically and financially with an overall prevalence rate of 34.9% or 78.6 million Americans affected. Variance in obesity prevalence rates, in the state of Virginia, account for over a 15% difference from one health district to the next. The purpose of this research was to better explore the regional obesogenic factors that may exist among five health districts in the state of Virginia. The socio ecological theory provides the conceptual framework of the study to understand the variance in regional obesity rates, as a function of the contributing risk factors that a region exhibits. This study was a quantitative retrospective secondary analysis that investigated four obesogenic risk factors using the Center for Disease Control's 2013 Behavior Risk Factor Surveillance Survey. Binary logistic regression analyses were conducted for each of the four obesity factors in five regions in Virginia and the results emphasized that specific regional obesity prevention efforts in targeted areas are identifiable and specifically, attention to ethnicity, poverty, and exercise intensity are warranted in all Virginia's health districts. Understanding obesogenic factors can further empower public policy makers to identify obesity prevention and treatment strategies most aligned with the health district needs such as exercise or nutrition campaigns targeting ethnic communities. Creating a statewide profile of regional obesogenic factors using this research model can bring about effective community intervention strategies leading to impactful improvements in individual health, wellness, and quality of life which can be a force in the community's positive social change.

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or older, had an annual income of less than $50,000, and were food insecure. Results of the chi square analyses indicated a significant association between food insecurity and DSM activities (χ2 = 48.99, p < 0.0001); however, results showed no significant association between low-income or race (p > 0.05). Results of a binary logistic regression model revealed that food secure and younger women had 1.618 and .584 times the odds of having effective DSM activities than food-insecure and older women (OR=1.618, 95% CI=1.282 - 2.041, p < 0.001; OR=.584, 95% CI=.465 - .733, p < 0.001, respectively). These results might provide researchers with guidance regarding food insecure and younger women with diabetes who might require additional support for their diabetes management. Tailored public health interventions might lead to positive social change by increasing food stability and nutrition knowledge, potentiating improvements in hemoglobin A1C, a 90-day measure of glucose control, which could reduce risk of diabetes-related morbidity and mortality.

Older adults are encountering harsh recovery after disasters, and compounding this problem is the lack of research on older adults' perceptions on disaster preparedness as aging affects the ability to react to emergency situations. To partially address that gap, the purpose of this general qualitative research study was to use Rotter's spectrum of locus of control theory to examine the level of preparation regarding disaster preparation of older adults who were living independently in single-family homes in a state affected by Hurricane Sandy. Data were collected through a qualitative survey distributed to adults aged 65 to 80-years (N=88) and publicly available documents from federal and state emergency management agencies. These data were inductively coded and subjected to a thematic analysis procedure. Findings identified 3 themes that consisted of (a) delayed acceptance, (b) defective instinct, and, (c) unexpected effects of disasters. This study contributes to social change by helping emergency management officials understand the deficiencies in preparedness by an aging population which may in turn improve the quality of life for older adults by stressing proper preparation for sheltering in place or evacuation in the event of a disaster.

The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the completion of these screening tests. The electronic medical records of 142 HIV seropositive women were reviewed. Univariate analysis, bivariate analysis, and logistic regression were conducted to create a model associated with the completion of preventive health care screening tests. For breast cancer, cervical cancer, and colorectal cancer, 69%, 71.8%, and 69.7% failed to complete screening, respectively. Number of years living with HIV infection and HIV stage were associated with breast cancer screening; distance between residence and health care facility, and HIV stage were associated with cervical cancer screening; and age and marital status were associated with colorectal cancer screening. Addressing issues related to the completion of cancer screening tests over the lifespans of HIV seropositive women can result in positive social change by preventing disease and disability, which can negatively impact these women, their families, and their communities.

Chlamydia trachomatis is a sexually transmitted disease, and its incidence has been increasing in recent years in the U.S. population. Certain demographic factors have been identified as posing an increased risk to acquire this disease. The purpose of this mixed-methods research was to examine how population demographics (quantitative section) and cultural and behavioral factors (qualitative section) affect risk for contracting chlamydia trachomatis in the Miami-Dade, Florida area. The theory of reasoned behavior was the theoretical framework of the study. The quantitative component used secondary data from Jackson Health System (2012- 2018) pertaining to 333 Miami-Dade young adult individuals with incidents of chlamydia trachomatis by gender, ethnicity, and race. For the qualitative component, 13 health care providers were interviewed using purposeful sampling, and the qualitative data were transcribed verbatim and analyzed thematically. Quantitatively, proportion of sample data was compared to national data using z statistics. Chlamydia cases were more often in the Black versus White group and Hispanics versus non-Hispanics group in Miami-Dade area compared to the similar national proportions (z=4.9, p<0.0001, and z=6.4, p<0.0001, respectively). Qualitatively, health care providers reported a significant lack of education and awareness on the infection, especially in young populations in the Miami-Dade area. Social change can be achieved by using findings of this research to develop more effective public health initiatives regarding the spread of chlamydia trachomatis in the Black and Hispanic population as well as with health care providers.

Scarce knowledge exists about the lifestyle of college students from heterogeneous racial/ethnic backgrounds and how race/ethnicity may influence their diet and physical activity behaviors. College students, especially those who are members of minority groups, are at risk for unhealthy lifestyles resulting in negative health outcomes. The purpose of this quantitative study was to examine the role of racial diversity on dietary and physical activity habits. The study was guided by social cognitive theory, and the research questions examined the relationship between race/ethnicity on diet and physical activity in a multiracial ethnic population. The study research design was a quantitative cross-sectional survey using a 34-item questionnaire on a convenience sample of 307 college students. Statistical analysis consisted of descriptive statistics to characterize the sample and logistic regression was used to examine the odds of race/ethnicity predicting meal consumption and physical activity behaviors as well as parental influence on meal consumption. The results indicated that only some race/ethnic groups (Hispanic/Latino, Caribbean) predicted frequency of breakfast meal consumption but all race/ethnic groups predicted dinner meal consumption. Race/ethnicity did not predict lunch meal consumption. Race/ethnicity did not predict physical activity. Parental influence did not have any of the race/ethnicity groups on their meal consumption. The positive social change implications from this study may help explain situational and sociocultural factors that affect lifestyle in this population to policy creators and health education specialists; these stakeholders, in turn, may create specific intervention programs for each race/ethnic group to increase healthy behaviors.

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, as well as self-regulation, dual process, and social learning theories. The DSMES educational module created for clinic staff consisted of a lecture presentation on current diabetes information and management guidelines, and a pre and posttest survey based on 13 close-ended questions. The generated data were summarized and analyzed using McNemar's test for paired, binary data. Results revealed that the module was useful for clinic staff in updating their T2DM and DSMES knowledge. Improvement in staff expertise might lead to positive social changes related to improved patient self-care of diabetes and reduction in financial burden in the longer term.

Minority immigrant women are more likely to be diagnosed with and suffer from cervical cancer compared to other minority women in the United States. The purpose of this qualitative ethnographic study was to explore cultural health perceptions, behaviors, and barriers to cervical cancer prevention among Korean immigrant women (KIW) in Hawaii. The health belief model and the social-ecological model were used to guide the study. Data were collected using individual structured interviews with 20 KIW ages 21 to 65 who are first-generation KIW immigrant to Hawaii. Data were coded and analyzed to identify themes. Findings revealed that participants (a) prefer a female gynecologist and Korean-speaking physicians; (b) are highly motivated to maintain physical health, including prevention; (c) prefer culturally appropriate community-based cancer prevention programs, and (d) expect innovative health maintenance approaches. Findings may be used by healthcare providers to identify culturally specific health needs of KIW related to cervical cancer screening and to implement appropriate preventive measures for KIW to reduce cancer death.

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression were used to analyze the data. The results revealed a significant association between parental education and malaria prevalence. There was also a significant association between parental economic status and malaria prevalence. However, there was no significant association between ITN ownership and malaria prevalence after controlling for parental education and ownership of structure. These findings may foster social change by helping public health authorities in Liberia integrate ITN use with other strategies like mosquito larvae elimination and indoor/outdoor insecticide spraying as part of a comprehensive approach to malaria control. Additionally, massive awareness and economic capacity building should be undertaken to empower malaria endemic communities with the understanding that malaria can be rapidly reduced with other robust strategies in combination with ITN use. These strategies, if implemented, may effectively control malaria prevalence among children and the emotional and financial burdens endure by their families.