bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Educators as Problem Solvers/Policy Advocates
Authors: DeBarr Kathy
Published: July 2019

In the United States many children are malnourished. We very rarely think of over-nutrition as malnutrition, but it is. Furthermore, our children are suffering because of it. No one would tell their child to go play in the street, because imminent harm and perhaps death would ensue. Yet we fail to recognize the threats posed by overweight and obesity. Not only is one’s quality of life greatly diminished, but morbidity and premature mortality from Type II diabetes, hypertension, and cardiovascular disease are the consequences. Obese persons are the subject of ridicule in television programming and the motion picture industry. This negative attention contributes to the stigma and resulting psychological pain endured by adults and children alike. Health educators must actively pursue resolution of the obesity crisis, not only through education, but through policy advocacy for PE standards, recess, school vending machine policies, nutrition education, and improved nutrition within our schools. Individual intervention has not proven effective, and it is time to address the environmental forces at work.
Factors Associated with Smoking Cessation and Risk of Smoking Initiation in Bulgarian Youth
Authors: Anatchkova Milena D. , Redding Colleen A. , Rossi Joseph S.
Published: July 2019

The goal of this project was to explore the factors associated with smoking behavior among Bulgarian adolescents. A sample recruited from 12 high schools in Bulgaria (N = 673, mean age = 16.52, 65% female), was used for the analyses in this paper. A series of logistic regressions were performed to explore the factors associated with smoking cessation and increased risk of smoking initiation. Based on self-reported smoking status participants completed different sets of questionnaires and were included in separate models exploring smoking cessation and increased risk of smoking initiation. Variables consistently associated with smoking like stress, coping strategies, peer influence, family influence, exposure to tobacco related marketing were included as predictor variables in both models. In addition each of the two models included the relevant constructs of decisional balance and temptations from the Transtheoretical Model (TTM). The final logistic model differentiating smokers/ex-smokers included age, parental smoking status, Temptation to smoke, and support for smoking bans in public places as variables, correctly classifying 82.3% of the sample. The final model among nonsmokers differentiating higher risk/lower risk of smoking initiation included the strength of the belief that smoking is harmful, Temptations to try smoking, Pros of being smoke-free, and support for smoking bans in public places, correctly classifying 72.7% of the sample. These results provide better understanding of the factors associated with smoking behavior in Bulgarian adolescents that can guide the development of smoking cessation and prevention programs for this population.
Parental Sunscreen Use
Authors: Megargell Andrea , Shive Steven E.
Published: July 2019

The purpose of this study was to describe the relationship between parents’ knowledge and attitudes about sunscreen use and their reported sunscreen use behaviors with their children, ages one to twelve, when playing outside and at the pool or beach in a rural and diverse population. Door-to-door surveys were conducted in randomly selected neighborhoods. Knowledge of doctors’ minimum SPF recommendation was found to be significant in how often sunscreen was used outside and at the pool or beach. Knowledge of the sun’s strongest hours was significantly related to how often sunscreen was used with children when at the pool or beach. Knowledge of consequences from a bad sunburn was found to be significant in how often sunscreen is used outside with children. Participants knowing that most of skin damage occurs prior to eighteen years old was significantly related to how often participants use sunscreen with children at the pool or beach. A weak positive correlation was found for seriousness of skin cancer. A weak negative correlation was found for remembering to use sunscreen, for difficulty remembering sunscreen and limited use due to cost. A weak positive correlation was found for increasing use leading to reduced cancer risk. Asians and Caucasians reported the highest sunscreen use. Knowing what knowledge and attitudinal factors lead to sunscreen use with parents is crucial to planning appropriate health education programs. Children are the most vulnerable population to skin damage and it is important that parents know how to properly protect them.
Conducting HIV Prevention Programs for the Severely Mentally Ill
Authors: Perehinets Ihor , Mamary Edward , Rose Valerie
Published: July 2019

Recent studies have shown that the severely mentally ill (SMI) are at higher risk for HIV infection than the general population. At the same time, the number of HIV prevention programs available for this priority population is extremely low. The purpose of this study was to identify the extent to which community-based organizations conduct HIV prevention for severely mentally ill people. Telephone interviews with HIV prevention program managers in San Francisco were conducted over two weeks in 2003. Of the 21 agencies funded by the San Francisco Department of Public Health, only three agencies included severely mentally ill people as a priority population for their prevention efforts. However, 16 agencies reported that they provided prevention services to the SMI, even though they were not considered a priority risk population. Three providers reported no SMI among the population they served. Additional studies are also needed to examine the capacity building elements that are necessary for HIV prevention program providers to plan, design, and implement prevention programs tailored for SMI individuals.
Statewide Policy Advocacy Intervention in California
Authors: Constantine Norman A. , Nevarez Carmen R. , Miller Michael , Hamilton Paula
Published: July 2019

California has made substantial progress since 1991 in reducing its teen birth rate, and its rate reduction now leads the nation. Yet more than 50,000 Californian teens continue to give birth each year, and many more became pregnant. And due to changing demographics and the recent reversal in the last decade’s poverty rate declines, California’s improvements are at risk. The No Time for Complacency (NTFC) initiative is a policy advocacy intervention designed to promote effective statewide teen pregnancy prevention policy and funding in California. This initiative employs legislative-district data analysis to provide a politically compelling organization of teen birth data, cost analyses to heighten the societal relevance of teen births, policy analysis to identify promising and effective state policies, and media advocacy to focus attention on these issues in all regions of the state. The process and results described show how it was possible to achieve impacts on state-level health policy and program funding.
Human Trafficking, Illegal Immigrants and HIV/AIDS
Authors: Johansen Pamela Stowers
Published: July 2019

Human trafficking or “modern day slavery” has been the subject of increasing media and public policy attention. This single case study is an illustration of the complex policy and practice issues involving immigration, human trafficking, and HIV/AIDS. HIV/AIDS and other infectious diseases create ethical, legal, and economic dilemmas for health care practitioners serving undocumented immigrants. This paper provides an overview of policies impacting immigrants with HIV/AIDS, the Trafficking Victims Protection Act (TVPA) of 2000, and potential “real life” implications of these policies. Suggestions for policy and practice that may provide both individual justice and protection of the larger society are offered. Health education, both domestic and on a global level, has potential to reduce the risks to both individuals and community public health.
Gay Men and Loose Women – Southeast Idaho Mexican Migrant Women’s Beliefs About Who Gets HIV
Authors: Davis, Jr. Peter C. , Rankin Linda L.
Published: July 2019

Since the beginning of the HIV/AIDS epidemic in the 1980’s, there have been stereotypes about certain groups of people being infected with the disease. This paper is based on a qualitative study consisting of twenty (n=20) interviews with Mexican migrant women in Southeast Idaho. The study investigated who Mexican migrant women believe are most likely to be infected with HIV, and then analyzed the beliefs in a socio-cultural context, examining a loss of both social and material capital as a catalyst for these beliefs.
Intentions For Having Sex
Authors: Binggeli Amy L. , Montgomery Susanne , Lee Jerry W. , Modeste Naomi
Published: July 2019

The intentions of 614 adolescents to have sex were examined in conjunction with their participation in risky behaviors (hard drugs, violence and suicide, alcohol and marijuana use) and protective factors (community connected and against teen sex, educational aspirations, emotional support from family, friends and girlfriend/boyfriend or sexual partner). Key findings from bivariate and linear regression analyses revealed that alcohol and marijuana use were correlated with intention to have sex among adolescents, as was emotional support from a boyfriend/girlfriend or sexual partner. This study offers insights regarding intentions to have sex among adolescents, pointing particularly to the issue of emotional support in a dating relationship as a motivation for having sex. Findings from this study can be used to develop health education and promotion programs focusing on delaying sexual intercourse.
Applying Behavioral Economics to Changing Health Behavior
Authors: Heshmat Shahram
Published: July 2019

Despite documented short-term success, dieting has a very low success rates, most dieters regain their weight back within three to five years (IOM, 2003). Relapse, temporary loss of control, and return to old behavior is common in dieting. This paper presents some insights from a behavioral economics perspective to explain why people fail to stick to their goal for eating healthy diet in order to lose weight. Knowing why people fail to maintain a desired healthy behavior over time will go some way towards avoiding relapse. Know the why makes it much easier to handle the how when we need to. A better understanding of changing preferences could also shed light on the proper role of health promotion policy. Behavioral economics identifies a number of circumstances in which people seem to behave inconsistently. Identifying these conditions provide an understanding of what factors make it harder for dieters to resist attractive food, and will help dieters to resist temptation. A recent review of studies on the effectiveness of weight-maintenance strategies conclude that programs that incorporate continued skills in problem solving and coping with challenges, and techniques for sustaining behavior change lower the rate of relapse (IOM, 2004). The research summarized in this paper can be seen in the light of this overall goal.
Diet, Overweight, Elevated Blood Pressure, and Acanthosis Nigricans Among K-9th Grade Native American Students
Authors: Wolff Cindy , Hoang Sabrina , Flannery Diana , Wermuth Laurie
Published: July 2019

Childhood overweight is associated with increased rates of hypertension (HTN) and acanthosis nigricans (AN), a known risk factor for diabetes. This cross-sectional study of predominantly Native American students examined relationships between diet and overweight, AN, and HTN among K-9th grade students. Eighty-six students completed a questionnaire regarding fruit and vegetable (F/V) consumption and physical activity (PA) behaviors. Anthropometric data, blood pressure (BP), and presence of AN were determined by trained screeners. Fifty-three percent of the Native American study participants were overweight or at-risk-for-overweight (BMI ≥85th percentile), while 35% of the non-Native American participants were overweight or at risk for overweight. At 60% vs. 35% respectively, the percentage of students either overweight or at risk for overweight was significantly higher (p=.02) among fourth through ninth graders compared with students in kindergarten through third grades. Fourteen percent were positive for AN, and 33% had either Pre-HTN or HTN (≥ 90th percentile) based on the first blood pressure reading. Analysis of variance results indicated that students with either pre-HTN or HTN had a significantly higher mean BMI (24.1 ± 8.0) vs. those with normal BP (20.4 ± 5.1; P=.012). BMI was positively correlated with AN (r=0.433, p=.01) such that all students positive for AN had a BMI ≥ 85th percentile (p=.001). Students who agreed with the Likert statement that they usually eat ≥5 F/V a day had a significantly lower mean systolic BP (107mmHg ± 17) vs. those who did not (123mmHg ± 17, P=.001). Regression results indicate that BMI and attitude toward the importance of fruit and vegetable consumption are independent predictors of systolic BP (p=.001). Results suggest that significant numbers of students in this sample are positive for AN, are overweight, and are at risk for hypertension and that more positive attitudes toward fruit and vegetable consumption are associated with lower blood pressure levels. Prevention programs to address these health problems are discussed.
Transitioning Health Educators to Clinical Settings
Authors: Hoke Mary M. , Byrd Theresa L. , Gottlieb Nell H.
Published: July 2019

Objective: A support model consisting of a local health educators’ network, a technical assistance team with academic and practice experts, and an evolving sequence of professional continuing education activities supported health educators transitioning from community or school health education sites to health care sites as part of the Clinic Health Education and Life Style Promotion Project (Clinic HELP) designed to increase health education options for individuals within the Paso del Norte Region of the United States-Mexico Border. Methods: Focus groups, interviews and surveys were used to evaluate intervention activities designed to assist in the transition. Results/Conclusions: Lack of familiarity with health care settings and role delineation were identified as barriers while “expert” sounding boards, professional development activities, and advanced education assisted in the transition. Use of the professional network was less than anticipated. Practice Implications: Based on the Clinic HELP experience, recommendations are provided for professional education and support for health educators within clinical practice settings.
Social Smoking by University of California, Santa Cruz Students
Authors: Males Mike
Published: July 2019

While many health interests worry about persistently high rates of cigarette smoking among college students, little research has tracked qualitative changes in student habits such as “social smoking.” A survey of 670 University of California, Santa Cruz, undergraduate students ages 18-43, mean age 20.6, found 57% of the weighted sample smoked cigarettes in the past year, compared to 37% of college undergraduates nationally and 34% of UCSC students’ parents. However, two-thirds of UCSC student smokers smoke socially (less than daily), compared to 60% of student smokers nationally and 16% of parent smokers. Half of UCSC social smokers report smoking less than an entire cigarette per occasion and 70% report smoking less today than in the past; the fraction who smoke heavily tend to have parents who smoke heavily. Students’ reports indicating their social smoking is an equilibrium behavior unlikely to lead to heavier smoking need longitudinal investigation.
Effect of Item Order on Physical Activity Estimates Using the IPAQ
Authors: Barnett Jodi , Nigg Claudio , De Bourdeaudhuij Ilse , Maglione Christine , Maddock Jay
Published: July 2019

Objective: To investigate the effect of item order on physical activity (PA) estimates using the International Physical Activity Questionnaire – short form (last 7 day) telephone interview (IPAQ-S7T). Method: The IPAQ-S7T was conducted for Time 1 (Hawai`i) and sample 1 (Belgium). Then item order was reversed for Times 2, 3 (Hawai`i), and sample 2 (Belgium). Results: In Hawai`i, vigorous activity levels were higher, walking levels lower for Time 1, compared to Times 2 and 3. Moderate activity was higher at Time 1 than Time 3. The Belgium study reported higher levels of vigorous activity for sample 1, compared to sample 2. Total volume of PA across time points was unchanged for the Hawai`i study, but decreased with reversed items in the Belgium study. Conclusion: Item ordering affects the levels and duration of reported PA using the IPAQ-S7T. This warrants further research on order efficacy and whether other PA measures are affected.
Community, Family and School-based Interventions for HIV/AIDS Prevention in African American Adolescents
Authors: Ickes Melinda J. , Sharma Manoj
Published: July 2019

A variety of environmental health issues occur within homes along the US/Mexico border region. Individuals living in this region are often not aware that specific issues, including pesticide safety, occur in their homes and may not understand the potential adverse effects of pesticide use on their families’ health. The Environmental Health/Home Safety Education Project created by the Southern Area Health Education Center at New Mexico State University, utilizes promotoras (community health workers) to educate clients on pesticide safety issues. Data from 367 pre/post tests and home assessments were collected from 2002-2005. The data were analyzed to detect changes in clients’ knowledge or behavior as they related to protecting themselves and their families against unsafe pesticide use and storage. Statistically significant changes occurred with both knowledge and behavior in regards to safe pesticide use. Through this culturally appropriate intervention, the promotoras provide practical information allowing clients to make their homes safer.
Effects of an Interactive, Computer-Based, Abstinence Education Curriculum on Selected Student Outcomes
Authors: DiFiore Kathy , Mays Vincent , Ross Sharon
Published: July 2019

A variety of environmental health issues occur within homes along the US/Mexico border region. Individuals living in this region are often not aware that specific issues, including pesticide safety, occur in their homes and may not understand the potential adverse effects of pesticide use on their families’ health. The Environmental Health/Home Safety Education Project created by the Southern Area Health Education Center at New Mexico State University, utilizes promotoras (community health workers) to educate clients on pesticide safety issues. Data from 367 pre/post tests and home assessments were collected from 2002-2005. The data were analyzed to detect changes in clients’ knowledge or behavior as they related to protecting themselves and their families against unsafe pesticide use and storage. Statistically significant changes occurred with both knowledge and behavior in regards to safe pesticide use. Through this culturally appropriate intervention, the promotoras provide practical information allowing clients to make their homes safer.
Mirror, Mirror, Help Me Like My Body
Authors: Oswalt Sara B. , Wyatt Tammy J.
Published: July 2019

Body image is a concern for many individuals but especially for women. Few body image interventions focus beyond the individual and attempt to reach a larger population. A media campaign was developed using the Social Marketing Model and implemented on a university campus to help women recognize conversations and ideas that reinforce negative body image concepts. Details about the development and implementation of the media campaign are reviewed. Follow-up assessment revealed that almost 60% (n = 194) of women surveyed saw the materials. Many responded favorably to the campaign’s impact. Buscards were viewed most frequently, indicating a potential promotion strategy for future health campaigns. Implications for future interventions and recommendations for practitioners are discussed.
Household Social Environmental Influences on African-American Adolescents’ Smoking Habits
Authors: Bell Larry J. , Zimmerli William H. , Duncan David F.
Published: July 2019

Because most smokers begin smoking during adolescence and because there are few studies that focus on African-American adolescent’s smoking behavior, the purpose of this study was to determine if a significant difference exists in the prevalence of smoking between African-American adolescent teens living with household members who smoke and those living with household members who do not smoke. The subjects in this study were 585 adolescents (342 females and 243 males) who received services at the Center Hill Health Center from 2001 to 2004. The data was collected from the medical records of the clients selected for this study. The data in this study was analyzed using chi square tests of independence. The first analysis revealed that a significant difference existed between the smoking status of the household members of adolescents who were smokers compared to those who where non- smokers (? 2 = 14.58, df = 1, p < .05.).
Meaningful Peer Review
Authors: DeBarr Kathy
Published: July 2019

The purpose of peer review is to uphold the integrity of the publishing journal, improve upon research activities and papers, and to further advance knowledge within the field of health education and promotion. This article provides an overview of peer review, some guidelines for accepting review assignments, and guidelines for conducting a thorough review that will serve the journal while assisting authors in making new knowledge accessible.
Psychoeducation
Authors: Atri Ashutosh , Sharma Manoj
Published: July 2019

Mental illnesses contribute to substantial morbidity in the population. Education for prevention and control of mental illnesses is mandatory. Psychoeducation is the specialized education that comprises of educational endeavors directed toward the patients and their families with an aim to help prevent relapse of mental illnesses and restoration of health for mentally ill patients. Several studies have proven the value of psychoeducation in prevention and control of mental illnesses ranging from depression to schizophrenia. Psychoeducation helps the mentally ill by improving treatment adherence. Psychoeducation is a subset of health education. Psychoeducation imparted by medical professionals due to insufficient training, insufficient resources and insufficient time is at best modest. Therefore, health educators who have specialized training in health education are very well suited for psychoeducation. However, the amount of training currently being offered in many health education programs nationwide at the undergraduate and the graduate level is not sufficient to qualify the educator for dealing with mental illnesses. More course work in mental illnesses and their prevention needs to be in place. Also prospective studies need to be designed for testing the efficacy of health educators in psychoeducation. Finally incorporation of behavioral theories to psychoeducation by the profession of health education will make it more effective.
Effect of Exercise on Reported Physical Sexual Satisfaction of University Students
Authors: Lindeman Holly C. , King Keith A. , Wilson Bradley R.
Published: July 2019

The purpose of this study was to examine sexually active university students’ reported level of physical sexual satisfaction and perceived impact of exercise on physical satisfaction. In addition, this study investigated whether reported physical sexual satisfaction and perceived impact of exercise on physical sexual satisfaction differed based on current exercise status, body mass index, and gender. A sample of 678 college students completed a two page, 35-item survey instrument. Results indicated that students who were regular exercisers (engaged in vigorous physical activity for 20 minutes ? 3 days per week) were significantly more likely than students who were not regular exercisers to report higher levels of physical sexual satisfaction. Body mass index was also significantly correlated to physical sexual satisfaction. A series of multivariate analyses of variance revealed that physical sexual satisfaction and perceived impact of exercise on physical sexual satisfaction differed significantly based on gender. Overall, students perceived body image, sexual desirability perception, and physical strength as the three leading components of physical sexual satisfaction impacted by exercise. Since regular exercise may increase physical sexual satisfaction levels, health professionals could use the results of this study to help motivate individuals to enhance their physical sexual satisfaction by becoming more physically active.
Little Rain Each Day
Authors: Arthur Carlotta M.
Published: July 2019

It seems that nearly every day a new study is published that links psychological stress to poor health outcomes. Psychological stress has been found to cause immunosuppression, increased susceptibility to infectious diseases, delayed wound healing, and to contribute to the development of psychological disorders. Yet, the implications of psychological stress as it relates to health disparities are seldom addressed. Chronic stress is an important but understudied factor that interacts with culture, socioeconomic status, and other psychosocial factors to act not only directly on physiological systems, but also to shape and influence health-related behavior. Research indicates that psychological stress acts through multiple pathways to influence health. Likewise, psychological stress and its impact on vulnerable populations may be addressed and managed at multiple levels. We define stress, and briefly review the literature on psychological stress in health disparities. We briefly describe several models of how stress negatively impacts health generally, and the pathways through which is believed to impact the health of some vulnerable populations specifically. We suggest ways in which policymakers, health systems, organizations, communities, and individuals can begin to work to reduce psychological stress and stress-related health inequities.
Cancer Screening Practices Among Chinese and Vietnamese in the Greater Houston Area
Authors: Gor Beverly , Son Hoang Truong , Yi Jenny , Esparza Angelina , Hernandez Mike , Jones Lovell A.
Published: July 2019

National data on Asian Americans indicate that compared to other groups in the US, cancer incidence and prevalence is relatively lower (Miller, Kolonel et al. 1996; American Cancer Society 2006). However, when the data is examined further based on specific Asian subgroups and for specific cancers, Asian Americans bear a disproportionate burden for cancers of infectious origin, such as cervical, liver, and stomach cancer (Chen 2005). Furthermore, Asian Americans are also experiencing increasing rates of cancers associated with “Westernization,” such as breast and prostate cancer (Kolonel, Yoshizawa et al. 1988; Whittemore, Kolonel et al. 1995; Ziegler, Hoover et al. 1996). Early detection and screening are among the frontline strategies in cancer control, yet Asian American and Pacific Islanders have the lowest cancer screening rates of all ethnic groups in the US (American Cancer Society 2006). The Asian American Health Needs Assessment (AsANA) project was designed to collect data on the rapidly growing Asian American community in the Greater Houston area. The AsANA project included a telephone survey to over 800 randomly selected households in the Chinese and Vietnamese communities, two of the largest Asian American subgroups in Texas. Included in the telephone interview were questions regarding cancer screening practices. This article describes the reported screening practices among the surveyed populations and discusses the implications for developing targeted programs that can address cancer screening disparities in this community.
Effective Educational Strategies Combining Emerging Genetic Science and Native American Cultural Issues
Authors: Bemis Lynne T. , Burhansstipanov Linda
Published: July 2019

The purpose of this paper is to describe how new topics in genetic science are implemented and evaluated within Genetic Education for Native Americans (GENA®) workshops. These workshops are typically implemented during professional conferences, training programs, Native American meetings and at tribal colleges. As genetic science evolves, public health educators are more and more likely to need to understand increasingly complex components within genetic research. These research discoveries are likely to impact cardiovascular health, cancer treatments, prevention and control of diabetes. The public and patients want to understand health information that affects them personally, as well as their communities. The focus of this paper is on GENA® objective 14 (emerging genetic science: microRNA), but the three 2006 3-hour workshops also addressed excerpts of GENA® objectives 5 and 29. at three meetings: the 2006 summer and fall Disparities Training Programs held in Houston, Texas and the 2006 Society for the Advancement of Chicanos and Native Americans in the Sciences (SACNAS) conference (October, Tampa, Florida). The emphasis on objective 14 is because it was updated during spring 2006 (initial focus was on stem cell research) and selected components of objectives 5 and 20 have been published elsewhere. The paper briefly describes the content, interactive learning opportunity and the evaluation from the three 2006 workshops. The overall findings verify the effectiveness (p value of less than .01) of GENA® to significantly increase knowledge level of workshop participants about emerging genetic science breakthroughs.
Interactive Lesson on the Cell
Authors: Burhansstipanov Linda , Bemis Lynne T.
Published: July 2019

The purpose of this article is to explain how a basic hands-on lesson about the human cell was developed, implemented and evaluated through Genetic Education for Native Americans (GENA®) workshops.
Effectiveness of nutrition programs in increasing healthy eating behaviors among low income women
Authors: Vidourek Rebecca A. , King Keith A.
Published: July 2019

This article presents a review of the literature regarding nutrition education programs targeting low income women. A total of 15 interventions were found, which met inclusion criteria. Inclusion criteria included publication between January 1, 2001 and January 1, 2007, focus on low income females, focus exclusively on nutrition and improvement of dietary behaviors, publication in English, and intervention took place in the US. The 15 studies meeting the search criteria were, in turn, re-reviewed collectively by the authors. Ten main themes were found: 1) WIC and EFNEP-based interventions, 2) collaborative approaches, 3) theoretical framework, 4) learner-centered, 5) skills-based programs, 6) use of produce coupons or vouchers, 7) computer-based programs, 8) culturally-based interventions, 9) peer teaching, and 10) recommendations to include social support or physical activity. A summary of each was developed and emergent themes were identified. In this manner, effective strategies and lessons learned from the research regarding increasing healthy eating among low income females could be more clearly delineated and discussed. This paper could be quite beneficial to health educators and health researchers interested in increasing healthy dietary practices among low income females
Translating Health Information Effectively for Latino Populations
Authors: Macario Everly , Montealegre Boyte Rebeca
Published: July 2019

California is the state with the most Latinos, constituting over one third of California’s population. The majority of Latinos, the fastest growing minority group in the United States, does not speak English at home. With lower levels of education, English-language proficiency, and health literacy, Latino people need health information they can understand. Literal translations of materials from English to Spanish without tailoring are common and often result in products containing egregious inaccuracies and awkward language usage that can also be out of context. In a medical setting, these errors can compromise health and be life-threatening. This commentary and tool provides examples of “translations gone wrong” and tips to follow to help make Spanish-language products and interpretation services more culturally and linguistically appropriate.
Improving Fruit and Vegetable Intake Among Children
Authors: Gaines Alisha , Turner Lori W.
Published: July 2019

Objectives of this review are to identify effective factors of interventions using the Social Cognitive Theory to increase fruit and vegetable (FV) intake among children and to develop strategies for program development based on the interventions reviewed. Articles were obtained from multiple databases; study inclusion criteria were publication in years 1998-2008 and utilization of Social Cognitive Theory to increase FV intake among children primarily 6-11 years old. Creative informational components delivered in non-traditional fashions, inclusion of role-models, and promotion of activities for bolstering self-management skills and self-efficacy were often incorporated in interventions. FV intake programs were child-focused, multi-component interventions utilizing SCT; such interventions have been modestly successful in increasing FV intake among children.
Micronesian Migrant Health Issues in Hawaii
Authors: Yamada Seiji , Pobutsky Ann
Published: July 2019

Increasing numbers of people from the Federated States of Micronesia and the Republic of the Marshall Islands are presenting for clinical and public health services across the U.S., especially in Hawaii. We review the impact of historical and contemporary relationships between the U.S. and these Freely Associated States on the health status and health care access of these migrants. We draw upon both epidemiological evidence and clinical experience to suggest measures to assure health care access and appropriate clinical care for these populations. We also point to potential public health measures, and indicate directions for future research.
Micronesian Migrant Health Issues in Hawaii
Authors: Pobutsky Ann M. , Krupitsky Dmitry , Yamada Seiji
Published: July 2019

Up to 15,000 or more Micronesian migrants currently live in Hawaii. Factors driving this recent emigration include inadequate employment opportunities, a limited economic base, and insufficient health and educational infrastructures in the U.S. affiliated Micronesian island entities in the Western Pacific. The aim of this study was to examine reasons why Micronesians were relocating to Hawaii, since there was evidence of healthcare related migration. This study provides the results of an assessment of health and key social determinants among Micronesian migrants conducted in 2007. Results show that diabetes is the most prevalent reported medical condition (35%) among adults >40 years of age. Micronesian migrants in Hawaii report coming to Hawaii for health care, but also for educational and employment opportunities.
Undermined Determinant of a College’s Success
Authors: Khubchandani Jagdish , Jordan Timothy R.
Published: July 2019

Our society has taken college employees' health and wellbeing for granted and has not recognized that many of the economic, intellectual and artistic accomplishments in American life are in large part due to the invaluable contributions of college employees. The health and wellbeing of college employees is an underappreciated area of intervention for worksite health promotion. In comparison to the corporate world, service industries and the manufacturing industries, the wellness of college employees is often at the bottom of the priority list for the health and wellness of the workforce in the United States. This commentary calls for an increased involvement of health educators in college employee health and wellness promotion programs, wellness initiatives, policy changes and research.
California Wellness Study
Authors: Schanche Hodge Felicia , Kotkin-Jaszi Suzanne T.
Published: July 2019

This paper identifies the prevalence and predictors of obesity among California’s American Indian adults. A cross-sectional study was conducted at 13 rural sites. Indian healthcare clinics served as the sampling frame and were selected because of their proximity and access to the target population. Four-hundred and fifty adult American Indians participated; 74 percent were female and 26 percent were male. The average age was 40, ranging from 18-74. Measures included socio-demographics, general health, BMI, type 2 diabetes, exercise and dietary habits. Eighty-two percent were overweight, obese or morbidly obese. Chisquare tests revealed three variables significantly associated with BMI categories: having type 2 diabetes, female gender and poor general health status. A logistic regression model for obese/morbidly obese (BMI > 30) versus overweight/normal (BMI < 30) persons found gender and diabetes status as significant predictors, while general health status showed trend. Females had 1.59 greater odds of being obese than males (p=0.04). Those that do not have diabetes are less likely to be obese (p=0.02). Those that do not have good general health were 2.5 times more likely to be obese than those that have good general health (p=0.06). Overall goodness of fit was significant (p=0.0009). It is important to identify individuals and population who are normal/overweight, obese/morbidly obese so support and interventions can be planned and implemented.
Children’s Choice of Wii Sports Games and Energy Expenditure
Authors: Haddock Bryan L. , Siegel Shannon R. , Wilkin Linda D.
Published: July 2019

According to a study from the Kaiser Family Foundation, total media use among all 8- to 18-year-olds was seven hours and thirty-eight minutes on a typical day (Rideout, Foehr, & Roberts, 2010). The large amount of time spent in media use has been implicated as one of the causes of the increased prevalence of obesity. The purposes of this study were to measure: 1) the total level of energy expenditure (EE) while middle school children played the Wii Sports games when given free access to all of the games, 2) the length of time they played each game, and 3) the differences in EE between games. Thirty-seven children (15 males and 22 females) with an average age of 12.4 ± 1.0 years participated in this study. Each had experience with Wii Sports. Participants were given 20 minutes to play any of the Wii Sports games they desired while their expired gases were captured by a calibrated portable metabolic cart. Heart rate was monitored with a Polar® heart rate monitor. Baseball and bowling were the most popular games. Energy expenditure was greater after playing the Wii for each game except golf. The average EE during the game playing time was 2.8 ± 0.9 kcal/min, compared to 1.4 ± 0.4 kcal/min while at rest prior to testing. Playing Wii Sports can moderately increase the EE of children over rest.
Case Study in Chamorro Community and Academic Engagement for a Community-Partnered Research Approach
Authors: Tisnado Diana M. , Sablan-Santos Lola , Guevara Linda , Quitugua Lourdes , Castro Keith , Aromin Jay , Quenga Joey , Tran Jacqueline
Published: July 2019

Objective: We describe the development of a community and academic research partnership, share reflections on processes for collaborations, and identify key factors for establishing strong and effective relationships to foster high-quality research. Background: A community-based participatory research (CBPR) effort evaluating a community-based patient navigation program assisting Chamorro women to access breast cancer services in Southern California served as the foundation for the development of the community-academic partnership. Methods: Using a CBPR approach focusing on active involvement of community members, organizational representatives, and academic researchers in all aspects of research process, faculty from a research university and a local community-based organization were brought together to build a partnership. Community and academic partners engaged in a series of meetings where dialogue focused on developing and nurturing trust and shared values, respect for community knowledge, and establishing community-defined and prioritized needs and goals. Partners have also focused on defining and developing explicit structures and policies to implement an equal partnership. Results: Experiences and lessons learned are shared, reflecting the processes of relationship building, and planning and implementing preliminary research steps. Lessons Learned: Adequate time for relationship-building, open and honest communication, flexibility, and ongoing examination of assumptions are keys to developing successful CBPR partnerships.
Promoting Breast Cancer Screening through Storytelling by Chamorro Cancer Survivors
Authors: Manglona Rosa Duenas , Robert Suzanne , Isaacson Lucy San Nicolas , Garrido Marie , Henrich Faye Babauta , Sablan-Santos Lola , Le Daisy , Peters Ruth
Published: July 2019

The largest Chamorro population outside of Guam and the Mariana Islands reside in California. Cancer health disparities disproportionally affect Pacific Islander communities, including the Chamorro, and breast cancer is the most common cancer affecting women. To address health concerns such as cancer, Pacific Islander women frequently utilize storytelling to initiate conversations about health and to address sensitive topics such as breast health and cancer. One form of storytelling used in San Diego is a play that conveys the message of breast cancer screening to the community in a culturally and linguistically appropriate way. This play, Nan Nena’s Mammogram, tells the story of an older woman in the community who learns about breast cancer screening from her young niece. The story builds upon the underpinnings of Chamorro culture - family, community, support, and humor - to portray discussing breast health, getting support for breast screening, and visiting the doctor. The story of Nan Nena’s Mammogram reflects the willingness of a few pioneering Chamorro women to use their personal experiences of cancer survivorship to promote screening for others. Through the support of a Chamorro community-based organization, these Chamorro breast cancer survivors have used the success of Nan Nena’s Mammogram to expand their education activities and to form a new cancer survivor organization for Chamorro women in San Diego.
Acceptance of a Healthier Substitute for Regular Pepperoni Pizza among Campus Consumers
Authors: Goto Keiko , Bianco-Simeral Stephanie
Published: July 2019

One of the best selling items in campus dining facilities is pepperoni pizza, which typically contains high levels of calories, sodium and fat. Excessive consumption of calorie- dense and sodium and fat-laden foods is associated with higher risks for some chronic diseases. Altering the amounts of ingredients used can significantly improve the nutrient composition of these foods. The purpose of this study was to examine the consumer acceptance of a top-selling university pizza with different amounts of cheese and crust. Six treatments of pizza were prepared including regular crust and 100% cheese, regular crust and 75% cheese, regular crust and 50% cheese, thin crust and 100% cheese, thin crust and 75% cheese, and thin crust and 50% cheese. The pizza treatments were evaluated using untrained panelists (n= 84) with a hedonic scale to measure acceptance. Analysis of variance was used to establish significant differences among the pizza treatments. The pizza with thin crust and 75% cheese was the most preferred pizza, followed by regular crust with 75% cheese. The effect of cheese on consumer acceptance was significant. Our research indicates that campus consumers may accept a healthier substitute for regular pepperoni pizza by altering the amounts of cheese and crust.
Body Mass Index and Body Size Perception
Authors: Ratanasiripong Paul , Burkey Heidi
Published: July 2019

The present study investigated actual body size as measured by the Body Mass Index in comparison to self-reported body size among diverse college student population. The study was conducted at a large public university in the western United States. Of the random sample of 15,000 enrolled students selected to receive an electronic survey, a total of 1,798 students elected to participate. Normalizing of overweight and obesity was found among study participants. The results from this survey indicate that, despite the fact that the majority of participants engaged in weight management methods, all gender and ethnic groups underreported instances of overweight and obesity, as well as discrepancies between perceived body image and actual body size. Implications for health promotion and future research are highlighted.
Cultural Adaptation for Ethnic Diversity
Authors: Bender Melissa S. , Clark Mary Jo
Published: July 2019

Obesity disproportionately affects U.S. ethnic minority preschool children, placing them at risk for obesity related co-morbidities and premature death. Effective culturally appropriate interventions are needed to improve health behaviors and reduce obesity in young high-risk minority children, while their behaviors are still developing. All known obesity intervention studies (e.g., diet and physical activity) since 2000 targeting U.S. ethnic minority preschool children were reviewed. Five electronic databases and eight published literature reviews were used to identify the studies. Intervention studies without identified ethnic minority participants were excluded. Ten obesity interventions studies met the review criteria. Published cultural adaptation guidelines were used to develop a mechanism to analyze, score, and rank the intervention adaptations. Cultural adaptations varied widely in rigor, depth, and breadth. Results indicated a relative absence of appropriately adapted obesity interventions for ethnic minority groups, suggesting a need for more rigorous cultural adaptation guidelines when designing obesity interventions for diverse ethnicities. Culturally appropriate adaptations appeared to enhance intervention relevance, effectiveness, and feasibility. The purpose of this literature review was to evaluate 1) the type and extent of cultural adaptations strategies applied to the interventions, and 2) how these adaptations related to the study outcomes.
Clinical Services Used and Types of Health Information Sought by Low-Income Latino Patients at a Large Urban, Free Clinic
Authors: Abejuela Harmony Raylen , Bazargan-Herazi Shahrzad , Worf Kenneth E. , Manousogiannakis Eleni , Kuo Tony
Published: July 2019

The present study describes the clinical services used and the types of health information sought by Latino patients at a large urban, free clinic in Los Angeles County, California, USA. A subgroup data analysis of the 2005-2006 Patient Health Assessment Survey, originally administered as part of a clinic quality improvement program, was conducted using a subsample of low-income Latino patients (n = 301) who rely on the targeted clinic for usual care. The descriptive analysis explored health services utilization, including the types of health information sought by members of this clinic population and patient feedback about provider communication strategies that are conducive for mutual decision-making. Overall, healthy eating (61%) and chronic disease management (58%) were among the most frequently sought after health information by Latino patients at the clinic. Provider communication strategies, including explaining things in a way that the patient could understand and the use of non-medical language, were suggested by a majority of respondents (> 70%) as desirable ways to improve the medical encounter experience. Findings from this study may benefit quality improvement efforts in other community health clinics that provide free care to low-income Latino patients with similar backgrounds.