bluuebunny/crossref_metadata_2025 huggingface dataset:
Parents’ Perspectives on Curbing Gun Violence among Children in Three Counties in Indiana
Authors: Obeng Cecilia S. , Bowman Sean M.
Published: July 2019

The occurrence of fatalities associated with gun violence among children, as reported in the media, makes studying gun violence and its prevention among children a priority. The purpose of this study was to investigate parents’ views on gun violence and whether gun safety education should be provided in schools. Thematic analysis was conducted on open-ended questions and descriptive statistics for closedended questions. Of the 200 participants, 79% (n= 158) of them indicated that gun safety instructions should be taught in schools, whereas 21% (n= 42) disapproved. Forty-five percent of the 158 participants who agreed to gun safety education suggested that police/military personnel teach gun safety to children. Overall, the parents questioned believed that gun safety education would help children to understand the seriousness of this issue. Some parents were not in favor of gun safety education. However, because the overwhelming majority was in favor of it, it is important for stakeholders in schools to consider offering it as one possible way to reduce gun violence among children.
Exploring Faculty and Staff PA Barriers at a Large University
Authors: Das Bhibha M. , Rinaldi-Miles Anna I. , Evans Ellen M.
Published: July 2019

Introduction: Physical inactivity is a leading cause of morbidity and mortality. Worksites provide an ideal environment for physical activity (PA) interventions. The aim was to use the Nominal Group Technique (NGT) to examine university employees’ perceptions of worksite PA barriers and benefits. Methods: A focus group using the NGT and the Health Belief Model was conducted to assess employees’ perceived susceptibility of physical inactivity, perceptions of barriers and benefits to PA, and cues to action. Results: Findings showed university employees experienced similar barriers to PA as employees in other sectors, including lack of time and knowledge. Participants reported unique benefits to being physical active, notably being physically active allowed them to maintain demanding professional and personal lifestyles. Discussion: Results imply university employees experienced benefits to PA consistent with other worksite populations; the surprising benefits of PA for this population are strong motivators and would provide an excellent basis for interventions. Results also indicate although university employees face similar barriers to PA as other worksites, the unique barriers for this worksite should be the focus for worksite programs for this population. Similarly to the benefits, the unique barriers of this population should influence development of interventions to promote PA on campuses.
Curbing the Hepatitis B Epidemic in Asian American Communities
Authors: Carabez Rebecca , Yoo Grace J. , Fang Ted , Quan Kelvin P. , Zola Janet , So Richard
Published: July 2019

Background. In the United States, more than 50% of the 1.2 million living with hepatitis B infection are Asian Americans (Centers for Disease Control and Prevention [CDC], 2013). In the city of San Francisco, Asian Americans make up 33% of the population and the city itself has the highest rate of liver cancer in the nation (United States Census Bureau, 2010, California Cancer Registry, 2011). In 2007, to address the risk of hepatitis B and liver cancer, the San Francisco Hep B Free Campaign (SFHBF) drew together a comprehensive coalition of key leaders and organizations from media, health care, government, community and business sectors within and beyond the Asian American community. Methods. Based on 13 key informant interviews with stakeholders, this paper explores how SFHBF incorporated local city hospitals as coalition partners to increase knowledge and screening of hepatitis B among Asian Americans throughout San Francisco. Results. Key findings include the various steps needed to involve hospitals including 1) Identify mission and key stakeholders, 2) Create collaborations among hospitals; 3) Identify benefits to hospitals. Implications. This research makes a unique contribution to the literature on engaging hospitals in community health partnerships. The findings have implications for other public health initiatives that are seeking to engage and involve hospitals as partners and collaborators.
Conceptualizing and Measuring Risk Perceptions of Skin Cancer
Authors: Nahar Vinayak K. , Vice Michael A. , Ford M. Allison
Published: July 2019

Background: Perceived risk is commonly conceived as a joint function of the perceived evaluations about the probability estimate of a negative outcome, and the perceived seriousness of the consequences of that negative outcome. Theories typically posit that once people perceive their vulnerability to health risks or outcomes, they form intentions to take preventive actions to reduce their risk. This theoretical proposition is not supported in skin cancer preventative behavior studies, which could be due to improper measurement of perceived risk. Purpose and Methods: The purpose of this manuscript was to assess how risk perception of skin cancer has been conceptualized and measured in the literature to date. Literature retrieval was facilitated through EBSCO, PubMed, PsycInfo, MEDLINE, and ERIC databases. Twenty potentially relevant articles were identified for this review. Results: In the literature, skin cancer risk has been operationalized in two ways: absolute risk and comparative risk. However, these measures have some serious limitations. For example, there is great uncertainty regarding the quality of risk perception measurements (i.e., whether the items used to measure perceived risk are reliable and valid). Future studies are warranted to better understand the significance of using conditional risk measures.
Obesity, Parent Perceptions, Child Feeding, and Food Security in First Generation Hispanic Families
Authors: Berg Jill , Tiso Susan , Grasska Merry , Tan Edwin , Chowdhury Yasmin , Zender Robynn , Knudtson Mary
Published: July 2019

Purpose: This study aimed to determine the relationships between parent and child weight status, parental perceptions of weight, child feeding, food insecurity, and acculturation in Hispanic preschoolers and their parents in a southern California school district. Methods: Eighty-five parent-child dyads participated. Height and weight, parental weight perceptions, child feeding, acculturation, and food insecurity data were obtained. Results: Eighty-five percent of parents were born in Mexico, although 94% of their children were born in the US. Eighty percent of parents and 43% of the children were overweight or obese. None of the constructs measured predicted child BMI, although parents significantly underestimated their children's body size. Parents' BMI correlated positively with restrictive child feeding practices, and obese parents pressured their children to eat more than did non-obese parents. Conclusions: Obesity exists disproportionately in Hispanics compared to other ethnic populations. While factors predicting children's weight status are difficult to identify, parents' weight, perceptions of child's weight, adherence to the Hispanic culture, and food insecurity do appear to impact parental concerns and parenting behaviors, particularly restrictive and pressuring-to-eat behaviors. Parental underestimation of their children's weight may hinder behavior change if concerns about unhealthy weight are inaccurate. Interventions should consider parental weight, weight perceptions, and feeding practices.
The Nutrition Education Initiative Resource Guide
Authors: Ralston Penny A. , Greenwood Bonnie , Cornille Thomas , Brown Linda L. , Gaskin Dykibra , Young-Clark Iris
Published: July 2019

Background and Purpose: With obesity in children and youth continuing to be a major health problem in the U.S., schools are considered an important setting to implement programs to address the issue but few have focused on middle school students. The purposes of this study were to: 1) determine the effectiveness of a school-based nutrition education program, the Nutrition Education Initiative (NEI) Resource Guide, in improving school lunch eating behaviors of middle school students, and 2) identify science teachers’ perceptions of the materials. Implementation: The project was implemented by 16 middle school science teachers and 309 seventh grade students in a medium-sized north Florida community. The NEI Guide included three conceptual areas (Build a Healthy Base, Choose Sensibly and Aim for Fitness), major concepts, objectives, narrative information, and teaching strategies. Evaluation: Using a pre-/post without control group design, the study involved collecting data via food recall surveys with students, and surveys and interviews with teachers. Data were analyzed using descriptive statistics and paired t-tests. Results: During lunch time, a higher proportion of students met the recommended dietary servings for dairy, meat, vegetables, fruit, juice and grains from pre-test to post-test. Students also significantly increased dietary intake of meat (p< .01), fruit (p< .01) and fruit/juice combined (p< .05); and significantly decreased intake of fried vegetables (p< .001), with decreased fat intake approaching significance (p< .06). Differences in dietary patterns were noted between the two schools studied. Science teachers perceived the NEI Guide as effective; yet they also identified challenges including lack of adequate training, lack of time to implement the materials, and lack of collaboration with the project team. Conclusion: The project outcomes suggest that middle school science teachers can positively impact school lunch eating behaviors of middle school students in selected schools by incorporating nutrition education in their curricula.
Predictors of Long-term Exercise Maintenance among College Aged Adults
Authors: Scioli-Salter Erica R. , Sillice Marie A. , Mitchell Karen S. , Rasmusson Ann M. , Allsup Kelly , Biller Henry , Rossi Joseph S.
Published: July 2019

Background and Purpose: Participation in regular exercise is low among young adults and is contributing to a rapid increase in obesity and chronic health conditions. Enhancing motivation is a key element in exercise initiation and maintenance. The current investigation considers factors relevant to the transtheoretical model (TTM), self-determination theory (SDT), self-efficacy (SE), and body image anxiety (BIA) in relation to college students’ motivation to exercise. Design and Main Outcome Measures: In this cross sectional study, lower division college students (N=614, 64% female, 36% male) completed an online survey of exercise behavior, motivation, SE and BIA. Results: BIA was related to both controlled extrinsic (external and introjected regulations) and autonomous extrinsic (integrated regulation) SDT motivational variables, as well as intrinsic motivation. Exercise maintenance was most strongly associated with integrated regulation, a “selfdetermined” motivational state, and SE. Conclusion: The current study provides support for the central tenet of SDT indicating that intrinsic and extrinsic motivation are not mutually exclusive constructs. Helping individuals with BIA develop a more intrinsic approach to exercise is integral for fostering long-term exercise maintenance. Thus, future research should focus on developing interventions that enhance integrated regulation and SE in order to promote exercise maintenance and reduce associated BIA.
Promoting Dietary Behavior Using the Mediterranean Diet in an Online College Environment
Authors: Aboul-Enein Basil H. , Bernstein Joshua
Published: July 2019

Background and Purpose: The prevalence of obesity has prompted calls for broad public health education solutions to reduce, if not reverse, overweight and obesity among college students in the United States. This study investigated change in student dietary behavior and food choices following an education intervention that introduced the Mediterranean diet (MD) as a weight management tool in a Houston, Texas community college. Methods: Online survey data were collected at pre-test and post-test assessments from a convenience sample of 65 college students enrolled in an online undergraduate nutrition course during the summer of 2013. The Mediterranean Diet Quality Index (KIDMED) survey evaluated dietary behavior change based on the MD Principals. Results: The intervention improved total participant population from a mean KIDMED score of poor (4.12) to a mean score of high (8.45), indicating improved dietary behavior change, particularly among men. Significant differences in KIDMED change scores by ethnicity and heart disease (HD) history were also observed. Conclusion: This study provides a unique pedagogical illustration of e-learning to promote MD patterns among college student populations.
Maximizing the Impact of Digital Media Campaigns to Promote Smoking Cessation
Authors: Lee Youn Ok , Momin Behnoosh , Hansen Heather , Duke Jennifer , Harms Kristin , McCartney Amanda , Neri Antonio , Kahende Jennifer , Zhang Lei , Stewart Sherri L.
Published: July 2019

Background and Purpose: Digital media (e.g., banner ads, video ads) is often used to encourage smoking cessation by increasing quitline call volume through direct promotion to smokers or indirect promotion through smoker proxies. This process evaluation study highlights the use of digital media in a proxy-targeted campaign to promote the California Smokers’ Helpline to health care professionals. Methods: Data were collected from October 2009 to September 2012. We describe the iterative development of the campaign’s digital media activities and report campaign summaries of web metrics (website visits, webinar registrations, downloads of online materials, online orders for promotional materials) and media buy (gross impressions) tracking data. Results: The campaign generated more than 2.7 million gross impressions from digital media sources over three campaign waves. Online orders for promotional materials increased almost 40% over the course of the campaign. Conclusion: A clearly defined campaign strategy ensured that there was a systematic approach in developing and implementing campaign activities. It also ensured that lessons learned from previous waves were incorporated; one lesson included the frequent rotation of new ad content to keep the target audience engaged.
Energy Drink Consumption and its Relationship to Risky Behavior in College Students
Authors: Buchanan Julia , Ickes Melinda
Published: July 2019

Background and Purpose: Energy drinks have become popular among college students, with over half reporting consumption of at least one energy drink per month in the current semester. Risk of negative physiological and psychological effects has been linked to energy drinks consumed alone or mixed with alcohol. The purpose of this study was to assess the relationship between energy drink consumption and other risky behaviors among college students at a large southeastern university in the United States. Method: A convenience sample of 277 college students was recruited during January-February 2012 via e-mail through undergraduate academic courses. Participating students completed an online survey that assessed energy drink consumption (with and without alcohol) and participation in other risky behaviors. Results: Energy drink users participated in risky behaviors more often than non-energy drink users within the past year (p = 0.00). Energy drink use was significantly related to the risky behaviors of tobacco (p = 0.00), marijuana (p = 0.00), amphetamine (p = 0.00), and alcohol (p = 0.02) use, as well as missing class (p = 0.05), performing poorly on a test or important project (p = 0.05), and participating in an extreme sport (p = 0.03). Conclusion: These findings suggest that energy drink consumption is associated with other risky behaviors among college students. The benefits of health promotion efforts related to energy drink consumption may be furthered through co-occurrence with other education and prevention programming on the topics of substance use and abuse.
Get Cookin’
Authors: Morris Janelle , Goto Keiko , Wolff Cindy , Bianco Stephanie , Samonte Aurelia
Published: July 2019

Background and Purpose: Healthy eating practices have been associated with prevention of chronic diseases. There is limited information about strategies for healthy eating practices among families. The current study examined the effectiveness of Get Cookin’, a six-week intervention consisting of nutrition education and hands-on cooking and tasting activities among low-income families. Methods: Lowincome adults participated in Get Cookin’, a six-week intervention consisting of nutrition education and hands-on cooking activities. Ninety-six participants completed a retrospective survey which examined their meal planning, budgeting and cooking behaviors, as well as fruit and vegetable consumption. Thirteen graduates of the program participated in focus groups. The Wilcoxon signed ranks test was used to examine pre-to-post changes. Results: Participants showed significant improvements in meal planning and budgeting skills. They started cooking meals at home more frequently and increased consumption and variety of healthy foods such as fruits, vegetables and whole grains. Focus groups revealed that participants shared cooking and nutrition information and skills learned with their families. Additionally, participants with diverse backgrounds gained a sense of empowerment to overcome personal challenges to make healthy choices. Conclusions: Nutrition education, combined with cooking and tasting activities, appears to have a positive impact on healthy behaviors among low-income families. Further research with a control group would be needed to more definitively understand the effectiveness of the Get Cookin’ intervention.
Health Education across Academic Disciplines (HEAAD)
Authors: Sbarbaro Vic , Smith Theresa M. Enyeart
Published: July 2019

Background and Purpose: Studies have shown that teens who hypertext are at a higher risk to engage in other health risk behaviors including binge drinking, tobacco use, illicit drug use, partaking in physical fights, engaging in risky sexual behavior, and driving distracted. Interventions addressing excessive use of mobile devices have mainly focused on mobile phone use while driving. The aim is to describe the Health Education Across Academic Disciplines (HEAAD) teaching tool and implementation, which may help to educate and raise awareness of the risks associated with excessive cell phone use among adolescents and young adults. Educational Teaching Tool: HEAAD includes introductory activities ranging from identifying risks related to excessive cell phone use to follow-up interactive activities with examples applied across academic disciplines other than health. HEAAD targets students in grades nine through twelve and can be adapted to the college population for freshmen and sophomores enrolled in personal health and wellness classes and/or other health orientation and first year experience classes. Conclusion: HEAAD intends to engage students in practicing decision-making skills related to excessive cell phone use, which may be applicable to their lives. Pilot testing of HEAAD is recommended to determine its effectiveness and potential.
Predictors of Gestational Weight Gain in Mexican American Women in Los Angeles
Authors: Mielke Ruth , Gorman Nicholas
Published: July 2019

Background and Significance: Extremes of gestational weight gain (GWG) are associated with newborn and pregnancy complications, postpartum obesity and chronic illnesses. In the United States, Mexican American women are the largest subgroup of Hispanics but have been studied least often. The purpose of the study was to determine the prevalence, characteristics, and predictors of GWG in Mexican American women. Methods: A retrospective, correlational design used data from charts (n=684) in a federally qualified health center in Los Angeles. Prevalence of GWG was inadequate, 22%; adequate, 33%; and excessive, 45%. Risk factors for excessive GWG were hypertension (p = .04), overweight (p = .00), or obese pre-pregnancy BMI (p = .01). Conversely, women who had gestational diabetes (p = .02), ate more snacks (p = .01), were multiparous (p = .03), and less acculturated (p = .03) experienced less excessive gain. Conclusions: Efforts to prevent excessive GWG in Mexican Americans should be targeted to women having their first baby and those with high pre-pregnancy BMI. One strategy may be recommending diet/exercise similar to that used in women with gestational diabetes. For women who are less acculturated and/or who are multiparous, strategies that will minimize inadequate GWG may improve newborn outcomes.
Diabetes Mellitus and the Hmong
Authors: Mitchell-Brown Fay , Newman Susan
Published: July 2019

Background and Purpose: Upon immigration to the US, the Hmong people transition to a more industrialized society which places them at an increased risk for diabetes. Hmong Americans are at increasing risk for developing diabetes. This article scopes research literature on the prevalence of diabetes and factors affecting diabetes care in the Hmong population. Methods: The literature was systematically scoped using four databases to search for studies examining factors that influence diabetes care in the Hmong. Results: A total of ten studies were retrieved. Key findings suggest that those living with diabetes have limited knowledge of the disease, and the Hmong possess cultural characteristics that ultimately affect diabetes care. Conclusion: This review revealed that there are limited published studies of diabetes in Hmong Americans and future research is needed to address these knowledge gaps in this population. Language, religion, and cultural beliefs are also significant factors to consider in diabetes care of the Hmong.
Intersection of Place, Working Parents and Food Assistance
Authors: Vasquez Liset L. , Shaw-Ridley Mary , Baig Kamran
Published: July 2019

Background/Purpose: The cumulative effects of the environment, educational system, and social injustices contribute to child health disparities. Collectively, these factors create barriers to national efforts aimed at reducing childhood obesity. Thus, behavioral, social, and cultural contributing factors were examined. Methods: Parents and guardians of Texas (n=714) children were interviewed by telephone using the National Survey of Children’s Health (NSCH). Weight status and variables of interest were analyzed using logistic regression. Results: Based on parental response, Hispanic children were more likely to be overweight/obese (p =0.002). Child recipients of food stamps had higher obesity rates (p- =0.011). Parents with less than a high school education had significantly more overweight/obese children (50% and 56% respectively, p
Social Justice in the Borderlands
Authors: Blair Robert G. , Kozel Charles T. , Hubbell Anne P. , Watson Krista N.
Published: July 2019

Background and Purpose: Along the U.S./Mexico border, poverty, unemployment, and no to low access to health care is the norm. A primary goal of this article was to discuss a framework based on agendasetting theory to aid community members in getting relevant health care issues on the community “agenda.” To accomplish this, we aimed to better understand the demographics of influential people, or agenda-setters, in the area. Methods: We identified and interviewed 30 agenda-setters in communities on both sides of the U.S./ Mexico border. Health promotion agenda-setting (HPA-S) theories guided our study, and primarily qualitative research methods were utilized to analyzed transcripts taken from individual interviews with. Results: Participants indicated that community members can best advocate for health care resources by creating a shared vision among community members prior to asking for resources- by understanding the priorities of those holding the purse-strings, by framing the community wants within the bounds of those priorities, and by fostering strategic partnerships with influential agenda-setters in their communities. Conclusion: Through application of this framework, community members can increase their social justice by becoming better able to advocate for and obtain needed health care resources.
Prevention of Adolescent Depression in Primary Care
Authors: Mahoney Nicholas , Gladstone Tracy , DeFrino Daniela , Stinson Allison , Nidetz Jennifer , Canel Jason , Ching Eumene , Berry Anita , Cantorna James , Fogel Joshua , Eder Milton , Bolotin Megan , Van Voorhees Benjamin W.
Published: July 2019

Background and Purpose: Depression affects millions of adolescents in the United States each year. This population may benefit from targeted preventive interventions. We sought to understand the internal factors that affect the ability of healthcare organizations to implement an intervention that involves mental health screening and depression prevention treatment of at-risk adolescents in primary care settings. Methods: From November 2011 to July 2016 we conducted a study of the implementation of a multisite (N=30) phase 3 randomized clinical trial of an Internet-based depression prevention intervention program (CATCH-IT). We describe the prevalence of internal barriers on the screening and enrollment process by reporting REACH (the proportion of target audience exposed to the intervention). Results: A total of 369 adolescents were randomized into the intervention or control program. Mean REACH values for the study clinics were 0.216 for screening and 0.181 for enrollment to CATCH-IT. Mean REACH enrollment lost due to internal barriers was 0.233. This translated to 4,691 adolescents lost at screening and 2,443 adolescents lost at enrollment due to internal barriers. Conclusion: We propose a model of the implementation process that emphasizes the importance of positive relational work that assists in overcoming internal barriers to REACH. We also provide implications for policy and practice.
Knowledge and Opinions Regarding the Interface between Oral and Overall Health among California Physicians, Dentists, Pharmacists and Advanced Practice Registered Nurse Practitioners
Authors: Gavaza Paul , Kim Wonha , Rogers Thomas , Fry-Bowers Eileen , Mosavin Rashid
Published: July 2019

Background and Purpose: Oral health is often related to other medical conditions. This study investigated the knowledge and opinions of California physicians, dentists, pharmacists, and advanced practice registered nurses (APRNs) regarding the interface between oral and overall health and their suggestions for strengthening this interface. Methods: A survey packet was mailed to randomly-selected California healthcare providers in Winter 2015. Twenty five-point Likert-type questions were used to measure the providers’ knowledge and opinions of the oral and overall health interface. Results: Sixtytwo physicians, 117 dentists, 136 pharmacists, and 289 Advanced Practice Registered Nurses (APRNs) responded (total N= 604). A majority of all health professionals agreed/strongly agreed that oral health topics received little attention in the education of non-dental health professionals (n=499, 82.6%), and that the dental discipline remains relatively segregated from other healthcare disciplines (n=500, 82.8%). Dentists and APRNs were more likely to agree/agree strongly that the inadvertent prescribing of medications that can have xerostomic effects without considering their oral health implications is a major problem. Conclusion: There is a need for more inter-professional collaboration by all primary care providers in managing the patients’ oral and overall health, as well as more oral health education and training for all non-dental health professionals.
Environmental Contexts of Vulnerable Populations
Authors: Samuel-Nakamura Christine , Leads Patricia , Cobb Sharon , Truax Fayette Nguyen , Hodge Felicia Schanche
Published: July 2019

Health disparities research has been identified as a priority by the National Institute of Nursing Research (NINR). Training nurse scholars in Vulnerable Populations (VP) research has been one strategy to address this issue. Involvement of university sponsored pre- and postdoctoral nurse fellows in groupdeveloped projects are coordinated to advance the science of VP. A group of pre- and postdoctoral nurse fellows report on research that illustrates environmentally-induced barriers to health care experienced by VP. Topics cover health disparities, VP research, and culturally appropriate approaches to enhance access and acceptability of quality health care. Five studies are presented that illustrate the interplay of biologic, social, economic, behavioral, environmental, and cultural influences in the health and healthcare of individuals, populations, and sub-groups. These studies have common factors as well as unique barriers requiring exploration for better understanding and culturally appropriate intervention. The studies drew upon the VP Conceptualization Framework (VPCF) to describe the unique barriers encountered. These barriers are of significant concern and have implications for nursing practice, research, and education. Key recommendations to address these barriers are provided.
Effects of Age and Sex on Weight-Loss Dynamics in Obese Patients Undergoing Very Low Calorie Treatment
Authors: Jo Edward , Cain Angelina , Prado Carla M. , Brown Ann F. , Ormsbee Michael J. , Smith Dawn , Snyder Katie , Kim Jeong-Su
Published: July 2019

Background and Significance: Although known to effectively provoke large scaled weight-loss, less is known regarding age- and sex-related influences on treatment outcomes of bariatric patients treated with a very-low calorie diet (VLCD) program. Purpose: This study retrospectively examined body composition and metabolic changes induced by a 12-wk proprietary VLCD treatment in obese patients while assessing age and sex differences. Methods: Male (n=16) and female (n=16) patients underwent 12 weeks of VLCD under standard medical care. Results: Older patients exhibited a greater relative loss of FFM compared to younger patients (p=0.004). Older patients also lost a greater proportion of total weight-loss as FFM (p=0.003) and lower proportion as FM (p=0.003) compared to the young group. This age-specific difference in weight-loss composition was driven by the older males. Conclusion: The results demonstrate the need for special clinical considerations for VLCD treated patients, such as older adults and perhaps older males specifically, who demonstrate a reduced quality of weight-loss compared to their younger counterpart.
Association of Covered California and Healthcare Access and Utilization among Latino Population
Authors: Nelson Anna , De Leon Aaron , Modeste Naomi , Marshak Helen Hopp , Banta Jim , Shah Huma
Published: July 2019

Background and Purpose: The Patient Protection and Affordable Care Act resulted in establishment of Covered California (Covered CA), a marketplace providing federally subsidized health insurance in California. This study explored whether obtaining Covered CA coverage improves healthcare access and utilization among Latinos, and whether acculturation plays a role in utilization of healthcare. Methods: 270 Latino adults in San Diego community completed a self-report survey. Results: Those with Covered CA were significantly more likely to have a main provider (p
Growing Healthy Communities Initiative
Authors: Snyder Janea , Kanekar Amar , Prince Bennie
Published: July 2019

A contributing factor to the U.S. national obesity epidemic is the built environment-the physical aspects of a community in which we live, work and engage in our everyday activities. Therefore, modifying the built environment can be a solution to address the epidemic. Such an example is the Arkansas Coalition for Obesity Prevention (ArCOP) Growing Healthy Communities (GHC) initiative. The GHC initiative encourages community health workers, health education specialists, government officials and other stakeholders to embrace community collaboration in efforts to improve built environments by equipping them with resources that increase community access to healthy foods and physical activities to help combat obesity. ArCOP to date has funded 100+ GHC communities in Arkansas. One of the five communities being highlighted by the authors for their GHC efforts includes: the University of Arkansas at Little Rock University District community, in which the authors have contributed to implementing various GHC projects for the residents of this community. The GHC, a state initiative, has implications for national and global use, and it is emerging as an exemplary best practice model. It provides communities with effective strategies to help address the health inequities of obesity, through prevention and intervention measures to improve health behaviors.
Eliminating Invisible Barriers
Authors: Rzepka Christine Hagion
Published: July 2019

One of the top reasons given for use of the internet is the ability to search for health information. However, much of the planning for web-based health information often fails to consider accessibility issues. If health care organizations and community agencies’ web sites have the latest, most wellresearched information on the health topics of the day, it is useless to those who cannot access it because of invisible technological barriers. Many flashy, high-tech sites were designed only to appeal to the needs of the mainstream population, with no consideration given to how people with disabilities must adapt their use of the web in order to access information. This article addresses issues of access specific to web site development, and will explore barriers to accessibility frequently experienced by web users with disabilities, requirements for ADA compliance, and how people with disabilities use the web. Web site accessibility guidelines, as well as simple evaluation tools, will be discussed. A thorough review of the article will enable even the least tech-savvy of health educators to enhance their skills in planning and evaluating web sites to promote access for people with disabilities.
Health and Health Care Problems Among the Kumiai of San Antonio Necua and Their Indigenous Relatives in Baja California
Authors: Fleuriet K. Jill
Published: July 2019

The rural Kumiai community of San Antonio Necua is one of the few remaining indigenous communities in Baja California, Mexico. Necuan health and health care problems are best understood through a consideration of the effects of colonialism and marginalization on indigenous groups in northern Baja California as well as a tradition of medical pluralism in Mexico. The lack of traditional healers and biomedical providers in the community, high rates of preventable or manageable illnesses, and a blend of biomedical, folk mestizo, and traditional indigenous beliefs about health and illness reflect current conditions of rural poverty and economic isolation. Descriptions of health and health care problems are based on ethnographic fieldwork among the Kumiai, their Paipai relatives, and their primary nongovernmental aid organization.
California-Mexico Health Initiative Binational Health Week
Authors: Martínez-Rubin Norma D. , Castañeda Xóchitl
Published: July 2019

This paper presents are overview of the University of California, California-Mexico Health Initiative, a health promotion program targeting low-income, immigrant/migrant Latino community that lacks access to health care coverage or immigration status.
Family Eating And Activity Habits Associated With Overweight Risk Among Low-Income Preschool Children
Authors: Gyovai Vanessa , Gonzales Jamie
Published: July 2019

Overweight is the most prevalent nutrition related problem for children of all ages in the U.S. Despite this there is a paucity of research linking specific lifestyle behaviors with risk for overweight in young children. The purpose of this descriptive study was to assess family eating and activity lifestyle behaviors associated with overweight in low-income preschool age children. Mothers (n=132) of children (n=141) aged 2-5 participating in the Women, Infants and Children (WIC) Nutrition Program in Butte County, CA, were selected via a sample of convenience. A Family Activity and Eating Habits questionnaire was administered during regularly scheduled WIC appointments. Higher maternal questionnaire scores indicated more positive weight related behaviors. Analysis of variance was used to test for differences in child’s BMI for maternal questionnaire scores, however, no significant differences were found. Correlation analysis identified a positive relationship between mother’s BMI and child’s BMI-for-age percentile such that as mother’s BMI increased, child’s BMI-for-age percentile increased (r=.191; p=.033). Four weight related behaviors were associated with children’s weight, including a significant association between fast food consumption and child’s BMI-for-age percentile (r=.202; p=.016). Mean BMI-for-age percentiles were significantly higher for Hispanic compared to white children (p=.001). 42% of the Hispanic children were above the 85th BMI-for-age percentile compared to 26% for the white preschool age children. Despite this higher rate, Hispanic children were significantly less likely to eat while watching TV (p=.003). Study results suggest that the mothers of these preschool age children were knowledgeable about positive lifestyle behaviors, but additional measures are needed to promote a healthy BMI-for-age for young, low-income children.
Recent Trends in California Hispanic Fertility Rates — a Comparative Analysis
Authors: Davis Clark A. , Brown J. Joshua
Published: July 2019

In this article we did a comparative analysis of recent trends and differentials in Hispanic fertility rates in the State of California. Hispanics, largely composed of individuals of Mexican origins, were the largest racial/ethnic minority population in the State of California from 1999 to 2001, composing roughly 30 percent of the population, contributed approximately 50 percent of the births during this period. Hispanics, compared to other racial/ethnic groups, have high teenage fertility rates, which persist throughout the reproductive years. Hispanic total fertility rates were well above replacement level fertility and higher than those of other racial/ethnic populations. Two prime policy issues related to human reproduction emerged from an analysis of the data—education and medical care. Although teenage fertility rates declined for all racial/ethnic groups during this period, they still remain high, especially for Hispanics and also for Blacks and American Indians, highlighting the need for education on human reproduction for teenagers. With high teenage fertility rates and a diverse racial/ethnic population, the need for more pervasive prenatal care, especially in the first trimester, also emerged as a significant policy issue. / En este artículo hicimos un análisis comparativo de tendencias recientes y diferenciales en las tasas de fertilidad de hispanos en el estado de California. Hispanos, los cuales están compuestos mayormente por individuos de origen Mexicano, fueron el grupo étnico/racial mas grande de la población minoritaria en el estado de California desde el 1999 a el 2001, de manera que componen más o menos 30 porciento de la población y contribuyen a aproximadamente 50 porciento de los nacimientos en este periodo. Hispanos, comparados con otros grupos étnicos/raciales, tienen altas tasas de fertilidad adolescente, las cuales persisten a través de sus años reproductivos. Las tasas totales de fertilidad para Hispanos estuvieron bastante sobre el nivel de reemplazo de fertilidad y más altas que aquellas de otras poblaciones étnicas/raciales. Dos asuntos de política relacionados a la reproducción humana salieron del análisis de la data- educación y cuidado médico. Aunque las tasas de fertilidad para adolescentes disminuyó para todos los grupos étnicos/raciales en este periodo, todavía permanecen muy altas, especialmente para los hispanos pero también para afro-americanos e Indios Americanos, señalando la necesidad de educar a nuestros adolescentes acerca de la reproducción humana. Con las altas tasas de fertilidad de adolescentes y una población étnica/racial tan diversa, existe la necesidad para cuidados prenatales más permeables, especialmente en el primer trimestre de embarazo, lo cual también surgió ser un tema de política muy significante.
Essential Attributes of Wellness and Prevention Programs in Rural, Latino Communities
Authors: Kelsch Christopher , Bishop Sunny
Published: July 2019

This paper describes four ongoing projects that promote wellness and prevention through health education for medically underserved Latino agricultural workers in four counties in California. These projects were developed in response to a grant initiative offered by the County Medical Services Program and The California Endowment. The programmatic aspects of project design and descriptions of the resulting individual projects are reported. Essential attributes found in all four projects — cultural and linguistic competence, collaboration with the health provider community, and extensive inreach and outreach efforts—are highlighted and discussed. Initial evaluation information indicates that these projects are functioning successfully, although challenges to project implementation have occurred. Procedures developed for the evaluation of project impacts are discussed. / Este papel describe cuatro proyectos en curso que promuevan salud y la prevención a traves la educación de salud para trabajadores Latinos de agricultura que son médicamente poco servidas en cuatro condados en California. Estos proyectos fueron desarrollados en respuesta a una iniciativa de concesión ofrecida por el programa County Medical Services Program y El California Endowment. Los aspectos programáticos del diseño del proyecto y descripciones de los proyectos individuos que resultan se revelan. Atributos esenciales encontrados en los cuatro proyectos - la competencia cultural y lingüística, la colaboración con la comunidad del proveedor de salud, y el esfuerzo extensivo de servicio especial de asistencia pública - estan resaltados y discutidos. La información inicial de la evaluación indica que estos proyectos están funcionando existosamente, aunque los desafíos para proyectar la puesta en práctica han ocurrido. Los procedimientos desarrollados para la evaluación de los impactos del proyecto se discuten.
Faith-Based Health Education Project
Authors: Johnston Georgia N. L.
Published: July 2019

Working with faith communities in health promotion is widely acclaimed and yet not readily practiced. This article describes a study conducted among four faith communities to determine the process required for sustainable faith-based programs. Face-to-face interviews were conducted among 12 community volunteers who participated to identify their perceptions of the project. Two staff members were also interviewed to identify the process from their perspectives. Project-related documents were also analyzed to provide details and triangulate the data from the interviews. The study followed the project for 2 ½ years. Several factors were identified as significant influences on participation and project sustainability. These included value, active pastoral support, program success, and volunteer commitment. The results of this study indicate that pastoral support and faith community ownership are critical components that should be included in faith-based community building efforts.
Lipid Review and Teaching Tips in Nutrition
Authors: Schmalz Kathleen , Kerrigan Pamela K.
Published: July 2019

This paper reviews lipid structure, function, digestion, absorption, and metabolism. Tips to teach this subject area in college-level health education courses are offered along with the review.
Promoting Health Through Tai Chi
Authors: Fisher K. John , Li Fuzhong , Shirai Machiko
Published: July 2019

This study examined the effects of a 6-month Tai Chi exercise program on health-related quality of life (HRQL) in older individuals. Using a randomized controlled trial, ninety-four local community-residing volunteers aged 65-96 (M age = 72.8 years, SD = 5.1) were randomly assigned to a 6-month, twice a week, Tai Chi condition or a wait-list control condition. The Short-Form General Health Survey (SF-20) was used to assess change in multiple dimensions of health status involving physical-, social-, and rolefunctioning, bodily pain, mental health, and health perceptions. Results showed that, compared to the control group, participants in the Tai Chi group reported significant improvements in all functional domains of HRQL over the course of the 6-month intervention. It was concluded that a 6-month Tai Chi exercise program is effective for improving HRQL among older adults. Tai Chi, a self-paced and low intensity activity appears to be an effective, low-cost approach for promoting health in older persons.
Health Services Career Pathway
Authors: Gon Sheri M.
Published: July 2019

Hawai‘i is facing a healthcare workforce shortage. Factors contributing to this shortage include poor marketing of healthcare professions, lack of preparation for postsecondary education, or attitudes and perception of healthcare careers by youth. This paper presents the Health Services Career Pathway program, a possible model for use in recruiting students for the health education profession. Health Services Career Pathway introduces secondary students to skills, knowledge, and attitudes found universally throughout the healthcare industry. High school education becomes engaging and relevant since it supports the student’s career choice and prepares the student for transition to postsecondary education. Evolution of the Health Services Career Pathway is described and a variety of activities are highlighted. Partnership of secondary, postsecondary, and industry is stressed.
Vietnamese-American Women And Cervical Cancer Screening
Authors: Rangavajhula Ramani , Hofvendahl-Clark Kathleen
Published: July 2019

This article is a meta-analysis of literature that discusses receipt of immunizations by VietnameseAmerican children, and receipt of cancer screening services by Vietnamese-American women. The results of the seven articles identified for inclusion in the meta-analysis were collated to determine what factors contribute to the discrepancies between Vietnamese-American children’s relatively high rates of immunizations, and Vietnamese-American women’s significantly low rates of Pap smear receipt. The article concludes that the difference in immunization rates for Vietnamese-American children, and cervical cancer screening rates for Vietnamese-American women, may be due to federally mandated vaccination requirements for all children entering school, and cultural barriers that dissuade women from receiving pap tests. The article suggests that providing outreach, education, and even cervical cancer screenings to Vietnamese-American women at pediatric and public health clinics that they frequent with their children, would provide an opportunity to increase cervical cancer screening rates for VietnameseAmerican women.
Medical Student Perceptions of Healthy Lifestyles
Authors: Nuss Michelle A. , Reger-Nash Bill , Williams Kimberly , Yasek Van , Juckett Greg , Richards Tammy
Published: July 2019

Medical student’s commitment to personal and professional health promotion decreases during their 4 years of medical school. Changes in their personal health behaviors are accompanied by a congruent set of changes in their attitudes regarding health promotion. The purpose of this qualitative study was to learn more about medical student attitudes about healthy lifestyles. Focus group sessions were conducted among 45 volunteer medical students at West Virginia University School of Medicine using a 9 question script. Healthy lifestyles were defined as balancing the emotional, physical, social, and spiritual aspects of life. Although no differences were observed between basic and clinical science students with regard to their stated priorities, stark differences were observed with regard to their openness to learning about lifestyle, where basic science students were more receptive.