Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that personal smoking behaviors by health care professionals are a barrier to effective smoking cessation interventions by those professionals (Lally et al., 2008; Radsma & Bottorff, 2009). This knowledge fueled the creation and distribution of global surveys by the WHO, the Centers for Disease Control and Prevention (CDC), and the Canadian Public Health Association (CPHA) to investigate the prevalence of smoking behaviors in health care professionals and in health care students (“Global Health Professions,” 2014; “WHO/CDC Global,” 2014). This study utilized the Global Health Professions Student Survey. The current study investigated the prevalence of smoking in nursing students of all educational levels at East Tennessee State University, with the expectation that the percentage of students who currently smoke would be substantially lower than that of students who do not smoke. The survey also investigated attitudes towards the role of health professionals in patient smoking cessation and towards personal smoking behaviors.

This study examined the TPB constructs of attitude, perceived behavioral control, and subjective norms and their ability to predict healthy eating and physical activity behaviors among adolescents living in Southern Appalachia. The study also considered the relative utility of subjective norms and social support in predicting these behaviors. Data for this research were derived from a larger study, Team Up for Healthy Living, conducted September 2011 through November 2014 with high school students in the Appalachian region (Study ID: R01MD006200 from the National Institute on Minority Health and Health Disparities). Participants (n=963) completed a three-part paper survey collecting data about eating habits, physical activity, sedentary behaviors, weight status, and demographics. Study results indicated more than half of the study population was classified as overweight (20.7%) or obese (31.4%). They had high rates of physical activity, low rates of sedentary behavior, and healthy dietary behaviors, compared to national norms. Approximately, 42.8% reported drinking at least one soda daily and 42.9% consumed 1-6 sodas over the course of seven days. Multiple linear regression analysis indicated attitude (Beta = .110, t (824) = 2.83, p < .005) and perceived behavioral control (Beta = .147, t (824) = 3.14, p < .001) were the strongest predictors of healthy eating behaviors. For physical activity, the strongest predictors of behavior were attitude (Beta = .186, t (839) = 5.21, p < .001) and social support (Beta = .347, t (839) = 9.09, p < .001). Comparison of subjective norms and social support revealed subjective norms were a better predictor of healthy eating behaviors, and social support was a better predictor of physical activity. The results of this study indicate that behavior theories are effective at identifying motivating factors for health behaviors in unique populations.

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to decrease. All participants who completed the program evaluation reported they learned something new as a result of the tour and were satisfied with the experience. These findings suggest that nutrition education provided in supermarkets is well-received by participants, but additional research with objective measures is needed.

Sexual expression is a natural act that occurs across the life course, unrestricted by age or physical location. Regardless if a person is 75 and residing in an assisted living facility, sex is a facet of life. Although sexual activity may slow as individuals age, interest in sex does not (Langer, 2009). Older adults maintain healthy sexual desires, yet face unique challenges when it comes to sexual expression and sexual health, which can be further complicated within the margins of a community living facility (i.e., assisted living, residential care, and nursing homes). Aside from the physiological changes that occur in mid-to-late life (e.g., menopause, erectile dysfunction), the older adult population faces growing rates of sexually transmitted infections (Centers for Disease Control and Prevention, 2017), particularly in community living facilities (Warso, 2015). Sexual assault and abuse is another issue facing community living facilities, as well as ambiguous or nonexistent policies that support and protect the rights of older persons to express themselves in a sexual manner (Connoll et al, 2012). Mystification surrounding sex in later life further compounds these issues. Moreover, a plethora of misinformation underscores societal taboos and myths surrounding sexuality and its prevalence in later life, the physical and cognitive changes that occur in later life, and the attitudes and biases (of care workers and residents) involving sexual expression of older adults residing in community living facilities. A current review of the research points to more education needed that incorporates a lifespan approach and attends to older adults in community living facilities (Langer, 2009; Villar, Fabà, Serrat, & Celdrán, 2015). Creating an environment that supports open discussion of safer sex practices, as well as encouragement (and normalization) of healthy sexual expression, can lead to an improvement in the overall wellbeing of residents living at these facilities (Syme, 2017). The current project takes a look at the preliminary stages of developing a sexual health forum for seniors residing in an assisted living facility in northern Louisiana. This project was undertaken by an undergraduate sexual health research team comprised of students majoring in Family and Child Studies or Psychology, and/or minoring in Gerontology. The presentation will detail strategies for creating a forum for seniors, highlighting successes and challenges in navigating limited research on sexuality in late life and program development targeting older adults, as well as community standards surrounding sexual health and expression. Additionally, this presentation will offer reflexive activities for educators and practitioners addressing sexual health in aging populations, particularly in residential community living facilities.

The aim of this study was to explore the health-related beliefs and perceptions of low-income African American women regarding obesity. Phenomenology served as the conceptual framework for this study. African American women, especially those in low-income brackets, have been shown to weigh more than women of other racial/ethnic groups. The consequences of these high rates are increased risks of developing chronic health disorders, such as type II diabetes and cardiovascular disease. The study sample consisted of 7 low-income obese African American women, ranging in age from 20 to 62, who resided in the Pacific Northwest. Recruitment for participation occurred via flyers, which were advertised in hair salons, churches, and community health clinics where African American women frequented. The women participated in audio-taped interviews, which were then transcribed and thematically analyzed. Findings showed that these 7 African American women had poor exercise and dietary behaviors that led to increased health risks. This study uncovered culturally-based traditions and provided insight into how these traditions may have influenced unhealthy behaviors. Educational health topics can be developed to include ways to more effectively address healthy behaviors for these women and how these women can play and more active role in decreasing excessive weight. This research may contribute to the literature by providing more awareness into this growing social and health problem among this vulnerable population. This study has implications for positive social change by increasing greater understanding into the complex reasons for obesity among low-income African American women.

Despite the growing concerns about routine prostate-specific antigen (PSA) screening in men, little is known about the societal and economic impact of screening among the African American population. The purpose of this qualitative case study was to explore beliefs among African American men about PSA screening, funding for screening, and the role of the United States Preventive Service Task Force in addressing the problem. Guided by rational choice theory, data collection consisted of completion of a health beliefs survey, face-to-face interviews, field notes taken during interview, and interview audio recording. The population for the study included African American men residing in a large metropolitan Midwestern city, who are between the ages of 45 and 65, and who have not been diagnosed with prostate cancer disease. Data were analyzed using NVivo10-© to identify themes and patterns. Results from the study show that the decision to participate in prostate screening for African American men is hindered due to concerns about access, cost, and affordability. These three factors should be further evaluated in a larger setting for a greater understanding of their roles in more effective screening programs and policies. Insights gained from this study may positively impact future policy by providing a deeper understanding of the beliefs held by African American men on the issue of prostate cancer screening that may eventually lead to developing and successfully implementing policies that can be cost effective.

There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women using health facilities for childbirth. Applying the health belief model, structured interviews were conducted confidentially with 20 women between the ages of 18 and 45 who delivered at the Juba Teaching Hospital. Interviews were voice recorded, transcribed, and analyzed by hand-coding and through NVivo computer software. A review of copied data, comparison with field notes, and member checking were done to ensure data quality. Five broad themes emerged based on the research questions and linked these to the theoretical model. Findings revealed that women received support and assistance during their childbirth experience at the hospital from their husbands, mothers-in-law, health workers, and neighbors. Women reported negative factors such as hunger and positive factors such as care provided by midwives as affecting their childbirth experiences. This research could contribute to improving health outcomes for women and newborns. This study has implications for positive social change by transforming the provision of maternity services in South Sudan.

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians' field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.

Sugar intake continues to be connected to an increased risk of heart diseases, diabetes, arthritis, and certain forms of cancers, depression, and schizophrenia. The purpose of the study was to examine if sugar intake is related to personality traits in the Millennial population. The health belief model was used as the theoretical framework for conducting the study. The research questions addressed in the current study were in regards to the relationships between Millennials daily sugar intake and openness, conscientiousness, extraversion, agreeableness, and neuroticism. This study was a cross-sectional design in which a panel of randomly selected United States Millennials (N = 106) between the ages of 18-34 were requested to complete a demographic questionnaire and the Big Five Inventory. The survey was conducted online using SurveyMonkey. Multiple linear regression was used to test the five stated hypotheses. Study results indicated no significant relationship between sugar intake and the five personality traits (p > .05). A sequential multiple regression model after controlling for age and gender indicated no significant relationship between the five personality traits and Sugar Intake (p > .05). In effecting positive social change, further investigations are warranted to establish the relationships between personality traits and sugar intake which may help to inform policy to reduce the associated health risks of consuming high sugar.

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day mortality rates for pneumonia, chronic heart failure, and acute myocardial infarction data, while also adjusting for selected organizational descriptors: state of residency, Medicare expansion, safety-net status, ownership type, teaching classification, and number of licensed beds. Linear regression demonstrated that Leapfrog grades are not reliable predictors of the 3 inpatient mortality rates analyzed. The study demonstrated that ownership type was a significant predictor for 2 of the 3 dependent variables. Furthermore, most of the covariates also provided some predictive value for at least 1 of the included outcomes; however, in most cases, the effect (β) was small. This study can help provide positive social change by elucidating that Leapfrog grades are not reliable predictors of patient outcomes for consumers, while also demonstrating that efforts to reduce 30-day mortality rates, especially for pneumonia, can be targeted by selected states, ownership type, and teaching status.