Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults with OA as evidenced by improved Arthritis Self-Efficacy Scale (ASES) scores pre- to post-program. Concepts and theory used to inform the doctoral project were SE, pain, SM and OA, and Bandura's theory of SE. The sources of evidence were obtained from a variety of peer-reviewed journals related to OA management, and the outcome was measured using the ASES. Thirty-five participants (16 males and 19 females) with a mean age of 62 from a physical medicine and rehabilitation clinic in San Antonio, Texas participated in the project. The National Institute of Arthritis and Musculoskeletal and Skin Disorders 2015 Handout on Health: OA was used as the SE OA toolkit. Mean scores from pre- and post-program were tabulated and compared to determine the outcome. Results showed improved ASES levels by 11.84%. Implications for nursing practice and positive social change include the enhancement of SE levels, which can improve compliance in SM by use of a toolkit and further as policy implementation for OA patients to improve SE and SM abilities.

Self-efficacy and treatment adherence reduce substance dependence. Yoga has been suggested as an adjunct to substance dependence treatment to enhance outcomes. This study was designed to assess yoga as a moderator of substance abuse treatment effectiveness, as indicated by the Exercise Self-Efficacy survey and Treatment Effectiveness Assessment scores. This study was guided by self-efficacy theory and used a nonequivalent quasi-experimental design to evaluate self-efficacy changes and treatment effectiveness. A drug treatment program that did not incorporate yoga as an adjunct to treatment was compared to another treatment program that did. Convenience sampling strategy was utilized to recruit 100 voluntary yoga and nonyoga participants from each substance abuse treatment facility in urban south central and southwestern United States. Independent one-way t tests, linear regression, and a nonparametric test were performed to determine yoga adherence effect on substance abuse treatment effectiveness. The results demonstrated no significant difference with respect to treatment effectiveness for either the yoga or nonyoga treatment groups. This study contributes to positive social change by showing that yoga exercise is not, contrary to earlier suggestions, effective at reducing substance addiction severity. While this study furthers the advance and understanding of the impact of yoga exercise, it demonstrated no increase in treatment effectiveness, suggesting that other areas of research should be pursued to identify adjuncts to improve substance abuse treatment.

Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors of hearing level or deaf acculturation style using the Health Belief and Deaf Acculturation Scale surveys, respectively. A total of 241 participants from Gallaudet University participated in this study. Independent sample t tests and multiple linear regressions were used. There were no differences in BMI (t = -0.285, p = 0.777) and nutritional and physical activity self-efficacy (t = -0.962, p = 0.338 and t =0.766, p = 0.446) between deaf/HoH adults and hearing adults. Among deaf/HoH adults, there were no associations between obesity as well as self-efficacy and factors of average hearing level and deaf acculturation style. This study offers evidence to the literature regarding the relationships between obesity or self-efficacy and factors of average hearing level or deaf acculturation styles among deaf/HoH adults. In addition, this study provided implications for social change as a basis for further research and reducing obesity through adopting current obesity programs while ensuring communication and information access for all deaf/HoH adults with varying levels of hearing and acculturation styles.

Although speech language pathologists' (SLPs) knowledge of communication and swallowing has been undisputed, their knowledge and skills related to tracheostomy and mechanical ventilation (MV) seem varied. The consequences associated with the presence of tracheostomy or MV demonstrate the necessity of training. Guided by Bandura's social cognitive theory, this study was designed to determine if SLPs' training influenced self-efficacy and real knowledge, and to evaluate trends associated with SLPs' pursuit of specialized training. A total of 236 SLPs practicing in the United States responded to a researcher-developed knowledge and confidence test for tracheostomy and mechanical ventilation (KCT-TMV). Data were analyzed via ttest, one-way ANOVA with post hocs, regressions, and correlations. Knowledge scores of SLPs were low as identified by responses on the KCT-TMV. SLPs reported confidence and high self-efficacy, yet those ratings did not correlate with high levels of knowledge. Therefore, some SLPs may not recognize they lack knowledge/competency. A lack of competency in continued practice is a violation of the Rules and Code of Ethics of the American Speech Language Hearing Association as well as nonmaleficence. Trends related to the pursuit of training were focal to a lack of resources from employers and inconsistencies in healthcare practice. These results may bring positive social change to the training of SLPs. By doing so, the social impact may result in improved patient care and patient health outcomes for the tracheostomized and MV patient populations.

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an intervention group (n = 18) and a comparison group (n = 15) by self-selection. Only participants in the intervention group received the diabetes self-care education program. Both groups completed pretest and the posttest questionnaires that collected demographic data and data from the Summary of Diabetes Self-Care Activities, the Diabetes Knowledge Test, and the Self-Efficacy for Diabetes tool. Statistically significant differences between the groups were found in the posttest scores of self-care activities, diabetes knowledge, and self-efficacy. The differences can most likely be attributed to the diabetes education intervention. This project demonstrated that diabetes self-care management education can be provided effectively in the clinic office setting, making diabetes education more available to and accessible for patients who need it most. Integrating diabetes self-care education into primary care providers' offices has the potential to address the gap-in-practice that exists for African American men with type 2 diabetes and contribute to social change by preventing disease progression.

Mexican immigrants living in the United States face academic challenges as well as being exposed to stereotypes. Additionally, Mexican immigrants tend to report lower self-efficacy compared to their American counterparts. This quantitative study aimed to fill a gap in the literature by examining the impact that stereotype threat (STT) has on Mexican immigrants' academic performance and social self-efficacy using a two-way between subjects design. Self-efficacy theory and stereotype threat theory provided the theoretical foundation for the study. Caucasian and Mexican immigrants were randomly assigned to one of two groups- a group exposed to STT (Caucasian n = 94, Mexican immigrant n = 10) or a group who was not exposed to STT (Caucasian n = 155, Mexican immigrant n = 21) for a total of N = 280. All participants were given quantitative analysis questions, analytical reasoning questions, and a social self-efficacy questionnaire. Results showed that Mexican immigrants in the stereotype threat group and Mexican immigrants in the no threat group underperformed on the quantitative analysis and analytical reasoning measures compared to Caucasians in both of those groups. Mexican immigrants in the stereotype threat group and the no threat group also reported lower social self-efficacy scores compared to Caucasians. This research highlighted the importance of the impact stereotypes may have on academic performance and social self-efficacy, especially among immigrants. The implications for social change include insight for Mexican immigrants about the types of challenges they may encounter upon moving to the United States. Additionally, this research could extend the conversation about the various negative effects that stereotypes may have on immigrants' lives.

As achievement gaps for indigenous, low SES, and ethnically diverse students widen, teacher education programs in Hawaii continue to be charged with preparing teachers to meet the needs of an increasingly diverse student population. Despite efforts to expand accreditation diversity requirements for teacher education programs, it is unknown whether these programs provide the preparation needed for teachers to develop culturally responsive teaching self-efficacy. Guided by self-efficacy theory, this mixed methods study examined teacher candidates' culturally responsive teaching self-efficacy (CRTSE) beliefs, their relationships with demographic and other variables, and candidates' perceptions of factors that might affect these beliefs. Teacher candidates (N = 175) in a 4- year urban university teacher education program in Hawaii completed a demographic questionnaire and the CRTSE scale. Follow-up interviews were held with 9 participants who agreed to be interviewed to further expand on the quantitative findings. Correlational analysis suggested that as participants advanced to higher terms in college, their CRTSE increased. Regression analysis found that 2 variables predicted CRTSE scores: participant experiences with diverse students and their diversity course ratings. Interview data were transcribed, open-coded, and thematically analyzed. Qualitative findings appeared to support the quantitative results, including participants' perceptions that having more experiences with diverse students and having more diversity courses better prepares them to teach diverse students. This study is socially impactful because it shows that culturally responsive skills training and related experiences may increase teachers' CRTSE and thereby may contribute to mitigating achievement gaps for diverse students, particularly in Hawaii.

Teaching styles used by educators throughout the world are diverse and complex, resisting simple comparisons between large groups, such as countries. To allow easier comparisons, data from the Teaching and Learning International Study (TALIS 2013) were applied to construct a picture of an “ideal educator” in each of eight countries: Australia, The Czech Republic, France, Japan, Latvia, Mexico, Singapore, and The United States. Principles of social acceptance and teacher self-efficacy were applied to teachers in each country in order to construct this ideal educator paradigm: first testing for (and finding) correlation between social acceptance and teacher self-efficacy, and then finding educators who were above average in both social acceptance scores and teacher self-efficacy scores in order to separate out a group of elite teachers from the general sample. Both linear regression and comparisons of median scores were employed to examine differences between countries. Scores revealed that each country displayed a distinct mix of Grasha’s Teaching Styles allowing for a simple comparison of teaching styles between countries.

Self-Efficacy (SE) has been explored extensively within the field of psychology. Despite a rich literature demonstrating its positive effect on various behavioral outcomes, including psychological treatment outcomes, little is known about the impact of SE on outcomes related to obsessive-compulsive disorder (OCD). To fill this critical gap in the literature, the aim of the present study was to determine whether increasing SE may improve engagement in exposure-based interventions for contamination fears. Nonclinical participants (N = 120) were randomly assigned to complete a contamination-related behavioral approach task (CR-BAT) immediately following either a SE-boosting exercise or a non-SE related control. Results demonstrated that there were no differences between conditions in contamination-related SE or approach behavior during the CRBAT, indicating that the manipulation was ineffective in boosting SE. Interestingly, however, participants in the SE-boosting condition reported lower levels of anxiety during certain phases of the CR-BAT than did those in the control condition, suggesting that the manipulation was effective in reducing subjective distress. Furthermore, SE was positively correlated with approach behavior during the CR-BAT, thus corroborating past research linking SE to behavioral outcomes. Future research, using more effective methods to manipulate SE, is required to examine the causality of this relationship.

Bakgrund:  En främre korsbandsskada med följd operativ-, eller konservativ behandling kan vara en utmanande process för en idrottare och kan leda till en lång, ofrivillig frånvaro från fotbollsspel. Flera studier behandlar olika typer av idrottsskador på ett biomedicinskt och psykologiskt plan. Det råder däremot brist på forskning rörande hur olika upplevelser under en rehabilitering kan påverka en spelares self-efficacy och rörelserädsla.   Syfte:  Syftet med studien är att undersöka hur fotbollsspelares upplevelser under rehabiliteringen av en främre korsbandsskada har påverkat deras nuvarande self-efficacy och rörelserädsla inom sin idrott.   Metod och design: En kvalitativt explorativ design har valts och semistrukturerade intervjuer med totalt fem studiedeltagare har tillämpats för insamling av data. Samtliga intervjuer genomfördes i mjukvaran Zoom och analyserades genom en kvalitativ innehållsanalys.  Resultat:  Informanterna uttryckte både homo- och heterogena upplevelser under rehabiliteringen. Fysioterapeutens vägledning och socialt stöd från omgivning visade sig variera mellan deltagarna, samtidigt som en stark motivation yttrade sig hos majoriteten. Efter återgång till fotboll visade det sig att trygghet och oro skiljde sig mellan deltagarna, samtidigt som undvikandebeteende kunde utläsas hos samtliga individer.    Konklusion:  Studiens resultat visar att det kan antas finnas ett samband mellan en idrottares upplevelser under rehabiliteringen och dess påverkan på self-efficacy och rörelserädsla efter återgång till fotboll. Studiedeltagarna som uttrycker sig har haft goda rehabiliteringsupplevelser beskriver tankar som kan tolkas som högre self-efficacy och mindre rörelserädsla jämfört med resterande deltagare. Samtidigt uppvisar de andra med sämre upplevelser mer otrygghet, rädsla och passivitet vid fotbollsspel. / Background:  An injury of the anterior cruciate ligament with operative or conservative treatment might be a challenging process for athletes and could lead to a long involuntary absence from football. Many studies research different types of sport injuries on a biomedical and psychological level. However, there is a lack of research regarding different experiences during a rehabilitation process and its effect on a player’s self-efficacy and fear of movement.   Purpose:  To investigate how football player’s experiences during the rehabilitation of an anterior cruciate ligament injury have affected their current self-efficacy and fear of movement.    Method and design:  A qualitative exploratory design has been chosen and semi-structured interviews with a total of five participants have been applied for the collection of data. All interviews were conducted in the Zoom software and were analyzed through a qualitative content analysis.     Result:  The informants expressed both homo- and heterogeneous experiences during the rehabilitation. The physiotherapist’s guidance as well as social support turned out to vary between the participants, while a strong motivation was expressed by the majority. After returning to football, the feeling of security and anxiety differed between the participants, while avoidant behaviour was shown in all individuals.    Conclusion:  The results of the study show that it can be assumed that there is a connection between an athlete’s experiences during rehabilitation and its impact on self-efficacy and fear of movement after returning to football. Participants who express positive rehabilitation experiences tend to show higher self-efficacy, while individuals with worse experiences show more insecurity, fear and passivity.