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OBJECTIVES: To explore the role of partner communication and relationship status on HIV testing among Chinese/Chinese American college students in northern California. METHODS: We used a cross-sectional study design to conduct focus groups and an online or paper-pencil questionnaire (N = 230). RESULTS: The majority (60%) of respondents were in committed partnerships, with 21% in casual partnerships. Less than one third (30%) of respondents had ever obtained an HIV test. History of HIV tested was associated with relationship status and partner communication. CONCLUSIONS: Interventions to increase partner communication skills while taking into account sociocultural factors among this population and their partners are needed. [ABSTRACT FROM AUTHOR]

This study explored the extent to which church members thought the assets they might have to engage in HIV/AIDS prevention and control activities were important. Eight hundred and thirty members from 83 Christian churches in Aba, Nigeria completed a multi-item survey questionnaire designed to obtain information on the importance they attached to church-based assets relevant to HIV/AIDS prevention and control. The rating of importance of assets was on a scale of 1 to 5. Rating on the importance of assets was highest in the spiritual asset category (mean = 4.20), followed by health education (4.02), capacity building (4.01), social (3.62), and financial assets (3.54). Among the denominational assets, free HIV/AIDS drug donation was rated higher (4.10) than other assets in the subcategories. This study demonstrates the usefulness of ascertaining members' perspectives on the importance of church-based assets and provides a basis for recommendation to health education administrators. [ABSTRACT FROM AUTHOR]

This study used a population-based sample of 407 Seventh-day Adventists in Barbados to determine the relationship between physical activity, blood sugar, hypertension, and cholesterol levels. A systematic random sampling technique was used to select participants: 37.6% were male and 62.4% female. No significant association was found between exercise and the outcome variables: blood sugar, blood pressure, and cholesterol levels of participants. However, females appeared to be more sedentary when compared to males. A significant association was seen between weekly exercise and triglycerides, but only in male participants. [ABSTRACT FROM AUTHOR]

Utilizing a sample of students (N = 504) from Matabeleland, Zimbabwe, Africa, this study investigated the extent to which knowledge of AIDS and two components of the Health Belief Model are related to: 1) attitude toward condom use, and 2) intentions to use a condom in future sexual encounters. Results indicated that knowledge of AIDS is not significantly related to any of the two dependent variables. However, belief in the efficacy of condoms, and lack of barriers to the use of condoms were significantly related to both dependent variables. Discussion focused on the role of religion and SES in influencing attitudes and decisions about condom use. [ABSTRACT FROM AUTHOR]

This descriptive study identifies oral health practices, attitudes, knowledge, and beliefs about dental care among Fijians living in Vanua Levu. Using convenience sampling, people attending a free community dental clinic volunteered to complete a structured questionnaire. Oral health practices, knowledge, beliefs, and attitudes about dental care, identified included: more females (95%) than males (88%) practiced brushing their teeth after every meal; the majority (83%) had problems with their teeth and 56% were missing one to five teeth; and knowledge about dental health was higher in females than males. This study supports the need for ongoing education in dental care and will be used for planning future interventions in health education and prevention of caries and other preventable dental problems in this population. [ABSTRACT FROM AUTHOR]

Background: The Affordable Care Act provides Medicare Part B beneficiaries access to cost-free Annual Wellness Visits (AWVs). Patients receive health behavior recommendations from a Personalized Prevention Plan (PPP) during AWV encounters., Aims: To identify factors clinical pharmacists can use to influence adoption of PPPs in primary care practices., Method: Utilizing a cross-sectional design, 77 Medicare patients (mean age 74.05 ± 8.04 years) presenting for subsequent AWV completed a theory of planned behavior (TPB) based questionnaire at two primary care practices., Results: 66.2% reported they were in the process of implementing PPPs and 51.9% reported implementing recommendations in the previous 12 months. TPB constructs accounted for 35.8% (p < .001) of the variation in intention, with subjective norm (SN) (β = 0.359, p = 0.004) as the strongest determinant, followed by attitude (β = 0.195, p = 0.093), and perceived behavioral control (PBC) (β = 0.103, p = 0.384). Intention accounted for 27.1% of the variance for implementing PPPs and was not a significant determinant (β = 0.047, p = 0.917). Addition of past behavior with TPB constructs significantly improved the predictability of the TPB model, accounted for 55% of the variation in intention (p < .001), and demonstrated a significant positive influence (β = 0.636, p < 0.001) on future PPP implementations., Discussion: This study demonstrates utility of the TPB in predicting implementation of PPPs., Conclusions: Clinical pharmacists positioned as providers of AWVs can strengthen intention to adopt PPPs by integrating referents into AWV processes, and evaluating past behavior trends to improve future PPP implementation., (Copyright © 2021 Elsevier Inc. All rights reserved.)

OBJECTIVE: To identify key beliefs that influence behavior, regarding Medicare's Annual Wellness Visit (AWV) and older patients' willingness to implement personalized prevention plans.
DESIGN: Cross-sectional. In-depth semi-structured focus group sessions with Medicare patients in July 2018.
SETTING: Two primary care physician-based practices.
INTERVENTION: A trained moderator facilitated two focus group sessions, and used open-ended questions based on the theory of planned behavior to elicit behavioral, normative, and control beliefs associated with implementing personalized prevention plans.
MAIN OUTCOME MEASURE: Content analysis of the focus groups' transcribed data was used to identify modal salient beliefs. Transcribed focus group sessions were analyzed utilizing grounded-theory methods for emergent themes.
RESULTS: A total of 13 older patients participated in the focus group sessions. Prevalent behavioral beliefs among participants influenced by patient-centered care outcomes included improvement in physical activity, adopting a healthy balanced diet, and weight loss.
Interpersonal and environmental disparities influenced commonly reported control factors such as lack of support at home and affordable fitness facilities. Macro-level influences such as physicians and social marketing by insurance providers, and health partners and spousal support were identified as important normative factors.
CONCLUSION: Identified salient beliefs were congruent to social determinants of health in Medicare patients. Results of the study demonstrate perceived enablers and barriers of elderly patients regarding implementing health-promoting advice. AWV pharmacists should address perceived barriers to improve attitudes and self-efficacy; and incorporate enabling beliefs into adherence strategies to improve adoption of health recommendations.

Objectives: Health beliefs (HB) and fall and balance-related outcomes were examined following a 26-week community-based exercise intervention among cancer survivors (CS)., Methods: Fall and balance-related measures and HB were quantitatively and qualitatively examined during a 26-week intervention among CS (N = 33). Of the 33 participants, 28 consented to an interview about their physical activity (PA) behavior., Results: Participants scored high on balance efficacy (median ± range = 8.68 ± 1.53) and reported high perception of having barriers to PA (mean ± SD = 4.66 ± 0.59). Fall-related measures improved after the 26-week intervention (p = .002). Most cues to action to engage in PA were delivered by a healthcare professional (N = 18). Once enrolled in the intervention, social benefits and access to a program tailored toward CS emerged as motivating factors to engage in PA (N = 12, N = 11, respectively)., Conclusions: There is a need to design fall risk reduction programs tailored to CS and to offer these programs in an environment that fits the unique physical and social needs of CS.

Purpose: This study explored the relationships between systemic- and individual-level contextual factors and health-related quality of life (HRQOL) in a cohort of African American and Latina breast cancer survivors (BCS)., Methods: Baseline questionnaire data of 320 BCS who participated in a HRQOL psycho-educational intervention were abstracted from the parent study. Hierarchical regression analysis tested the independent effects of contextual factors on HRQOL., Results: HRQOL was higher in BCS who: were diagnosed at < stage 2 (b = -1.38, p < 0.05), expressed satisfaction with their health care (b = 0.20, p < 0.001), had fewer comorbidities (b = - 0.60, p < 0.001) and depressive symptoms (b = -0.30, p < 0.001), and practiced healthy diet and exercise habits (b = 0.02, p < 0.05). Demographic and cancer-related factors accounted for 14 % of the variance in HRQOL (F[6, 274] = 7.25, p < 0.001). The socio-cultural context (i.e., ethnicity, life stress, perceived social support) explained 20 % of the variance in HRQOL (FΔ[3, 271] = 27.32, p < 0.001). The health care system context contributed an additional 8 % to explaining HRQOL (FΔ[1, 270] = 34.88, p < 0.001). Health status and behavioral factors accounted for 18 % of the variance (FΔ[4, 266] = 29.55, p < 0.001). The full model explained 59 % of the variance in HRQOL (F[14, 266] = 27.76, p < 0.001)., Conclusions: HRQOL in ethnic minority BCS is multifaceted and is significantly influenced by cancer-related, socio-cultural, health care system, health status, and behavioral contextual factors. Therefore, survivorship research and practice must address broad multi-level domains to achieve equitable and optimal breast cancer outcomes., Implications for Cancer Survivors: To enhance HRQOL, survivors must be provided the know-how and support to maintain healthy lifestyle and self-management practices. Advocates must engage the care team to consider systemic factors, including life stress and community resources, to be more patient-centered.

Background: With the increase in scaling up of antiretroviral therapy (ART), knowledge of the need for adherence to ART is pivotal for successful treatment outcomes., Design and Methods: A cross-sectional study was carried out between October and December 2013. We administered theory of planned behaviour (TPB) and adherence questionnaires to 358 women aged 18-49 years, from a rural and urban ART-clinics in southern Malawi. Hierarchical linear regression models were used to predict intentions to adhere to ART., Results: Regression models show that attitude (β=0.47), subjective norm (β=0.31) and perceived behavioural control (β=0.12) explain 55% of the variance in intentions to adhere to ART. The relationship between both food insecurity and perceived side effects with intentions to adhere to ART is mediated by attitude, subjective norm, and perceived behavioural control. Household (r=0.20) and individual (r=0.21) food insecurity were positively and significantly correlated with perceived behavioural control. Household food insecurity had a negative correlation with perceived side effects (r=-0.11). Perceived side effects were positively correlated with attitude (r=0.25). There was no statistically significant relationship between intentions to adhere to ART in the future and one month self-report of past month adherence. These interactions suggest that attitude predicted adherence only when food insecurity is high or perception of side effects is strong., Conclusions: This study shows that modification might be needed when using TPB constructs in resource constraint environments. Significance for public healthThe knowledge of the rates of adherence to antiretroviral therapy (ART) could be used to evaluate planning and project, which could lead to better outcomes predicted by treatment efficacy data. In addition, knowledge of adherence behaviour could help the development of interventions focusing on collaboration between healthcare providers and Malawian government to provide food support for patients on ART. The interventions could also focus on providing better counselling support to improve beliefs regarding control over taking the medication and perceived versus real side effects. It is relevant for public health professors to understand factors influencing women's ART adherence, in order to create interventions that are appropriate for increasing ART adherence, which may lead to improved outcomes among women with HIV living in endemic regions with limited treatment access.

Background: Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in the United States. We sought to examine the association between religious involvement and lifestyle practices among Black SDAs in Canada., Method: A convenience sample of 509 Black SDA church members 18 years and older completed a self-administered questionnaire, assessing religious involvement and seven lifestyle practices promoted by the SDA church: diet, physical activity, water intake, exposure to sunlight, alcohol use, caffeine and tobacco use, and rest., Results: Compliance with lifestyle practices ranged from a low of 10% meeting fitness guidelines to a high of 99% abstaining from tobacco products. Religious involvement and lifestyle were positively related (rs = .11, p < .05). Multivariate analyses indicated that private religious practice (β = .16, p =.003), importance of the health principles (β = .17, p = .003), and acceptance of health principles (β = .65, p = .00001) significantly predicted the number of behaviors practiced., Conclusion: Greater religious involvement is associated with positive lifestyle practices but is not an independent predictor of lifestyle practices for Black Canadian SDAs., (© 2014 Society for Public Health Education.)

Tobacco use is high among Pacific Islanders in general and little tobacco research has been done in Yap, Micronesia. This study aimed to explore perceptions of tobacco use coupled with chewing of betel (areca) nut among adults in Yap using self-administered questionnaires based on the health belief model. A Likert scale (ranging from strongly disagree to strongly agree or very unlikely to very likely) was used to measure susceptibility, severity, benefits, barriers, cues to action, and self-efficacy among individuals aged 18 and older. Older adults felt quitting tobacco or betel nut use would be significantly more difficult because of social reasons and withdrawal problems. Most participants felt susceptible to tobacco-related diseases. These findings possibly indicate a receptive attitude toward any future tobacco use prevention and intervention program. Older Yapese population would need to be especially targeted. Health promotion programs should target smoking behaviors and risk reduction., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Objectives: To determine whether the theory of planned behavior (TPB) predicted intent of child restraint system (CRS) use among pregnant women in the Kingdom of Saudi Arabia (KSA)., Methods: In this cross-sectional study conducted in Dallah Hospital, Riyadh, KSA during June-July 2013, 196 pregnant women completed surveys assessing their beliefs regarding CRS. Simultaneous observations were conducted among a different sample of 150 women to determine CRS usage at hospital discharge following maternity stay., Results: Logistic regression model with TPB constructs and covariates as predictors of CRS usage intent was significant (χ2=64.986, p<0.0001) and predicted 38% of intent. There was an increase in odds of intent for attitudes (31.5%, p<0.05), subjective norm (55.3%, p<0.001), and perceived behavioral control (76.9%, p<0.001). The 3 logistic regression models testing the association of the relevant set of composite belief scores were also significant for attitudes (χ2=16.803, p<0.05), subjective norm (χ2=29.681, p<0.0001), and perceived behavioral control (χ2=20.516, p<0.05). The behavioral observation showed that none of the 150 women observed used CRS for their newborn at discharge., Conclusion: The TPB constructs were significantly and independently associated with higher intent for CRS usage. While TPB appears to be a useful tool to identify beliefs related to CRS usage intentions in KSA, the results of the separate behavioral observation indicate that intentions may not be related to the actual usage of CRS in the Kingdom. Further studies are recommended to examine this association.

Background. The purpose of this study was to explore healthcare providers' perspectives on antiretroviral (ART) adherence in two ART clinics in southern Malawi. Nonadherence to ART is a significant hindrance to the success of HIV/AIDS treatment. Methods. A one-on-one semistructured interview was conducted with eight healthcare providers in two ART clinics in rural and urban southern Malawi. The interviews were focused on factors facilitating or hindering ART adherence and strategies to improve adherence. Interviews were audio-recorded, transcribed, and content-analyzed with the use of the constant comparison approach. Results. Of the eight participants, 63% were between the ages of 20 and 30 years and 37% were HIV counselors. Factors facilitating adherence include patients' belief and knowledge, HIV/AIDS education, and a supportive network. Barriers to adherence include discrimination, nondisclosure of HIV status, food insecurity, medication side effects, religion, misinformation, and staff and drug shortages. Strategies to improve adherence were identified by participants to include nutritional/food supplementation for malnourished or undernourished patients and patient counseling. Conclusions. There is a need for collaborative efforts between healthcare providers, patients, and faith-based organizations to identify and address hindrances and facilitators to patients' adherence. Further research is needed to develop strategies addressing religion, staff, and drug shortages.

Health intervention programs have the potential to use church-based assets to address a wide range of health issues. This study examined the assets Nigerian church members believed their churches needed, including the assets they thought they had to engage in HIV/AIDS prevention activities. Eight hundred and thirty members from 83 churches completed a questionnaire designed from forum focus group data. Respondents were males and females aged 18 years old and above, with primary, secondary, university, or vocational education, and were more likely to be married than single (never married), separated, divorced, widowed or remarried. The data revealed that church members needed access to health promotion assets, including the expertise of members who are health professionals to engage in HIV/AIDS prevention activities. We recommend an intensive HIV/AIDS prevention reorientation-training workshop for church leaders to ensure a sustainable plan to address HIV/AIDS prevention needs.

This study identified factors that influence regular soda consumption among 707 female students, aged 13-18 years, attending North Los Angeles County public high schools. Participants completed a group-administered Theory of Planned Behavior-based questionnaire. Almost all of the participants, 96.3%, reported that they currently drink soda; 50.1% reported drinking 2 glasses of soda or more per day during the past year. Students reported drinking regular soda more than diet soda and reported drinking phosphoric acid-containing soda more than non-phosphoric acid-containing soda. Attitude, subjective norm and perceived behavioral control had statistically significant positive associations with intention, and were each significant predictors of intention to drink regular soda and together explained 64% of its variance. The strongest predictor was attitude, followed by perceived behavioral control and subjective norm. Our results suggest that efforts to reduce soda consumption among female adolescents should include parents and friends. It is also important that soda should not be excessively available at home or widely accessible to teenagers at schools. Healthy eating messages for adolescents need to be developed and incorporated into existing and future campaigns to reinforce the perception that there are other healthier drinks that quench thirst and that taste good as well.

A random sample (n = 260) of primiparous Jamaican adolescent mothers (12-16 years old) who gave birth in 1994 in the parishes of Kingston and St Andrew, St Catherine and Manchester was selected from vital records and interviewed in 1998 for this historical cohort study. Among programme participants, the incidence of repeat pregnancy was 37 per cent compared with 60 percent among non-participants. Programme participation reduced the risk of one or more repeat pregnancies by 45 per cent with 95% confidence interval (0.22, 0.91). Programme participants were also 1.5 times (1.005, 2.347) more likely to complete high school than non-participants; however, this effect did not achieve statistical significance. The results confirmed that the WCJF Programme exerts a considerable effect on the incidence of repeat pregnancy among participants. The benefits of programme participation were greatest among residents of the Kingston Metropolitan Area from single-parent, female-headed households with average monthly incomes below J$10,000, who wanted to continue their education after the first live birth.

The purpose of this descriptive study was to identify and describe barriers to early detection of breast cancer, as well as current breast cancer screening behaviors and attitudes regarding the disease, among women aged 20 and older on the Caribbean island of Tobago. Tobago is the smaller of the two islands that make up the nation of Trinidad and Tobago. Between February and June 1996, 265 women fitting the age criteria completed a structured survey questionnaire. Women of African descent made up 89% of the respondents. In terms of age, 48% of those surveyed were between 20 and 39, 40% were between 40 and 59, and 12% were 60 or older. Barriers to early detection identified were a low level of breast self-examination, infrequent clinical breast examinations as part of regular care, unavailability of mammography services on Tobago, cost of screening, and difficulty of traveling to Trinidad for mammography. Furthermore, only a minority of the study participants had ever attended early detection or public awareness programs. The results were nearly the same for individuals with a family history of breast cancer, who would have a higher risk of occurrence of the disease. In addition, the majority of the respondents reported what can be considered a cultural barrier to early detection practices, a belief that no matter what they did, if they were to get breast cancer, they would get it. The authors recommend that mammography services be made available on Tobago. The authors also intend to use the findings to help develop an appropriate, culturally sensitive breast cancer awareness and early detection program for women on the island.

This study examined the relationship between caregiver burden and self-care deficit in former rehabilitation patients. We hypothesized that as self-care deficit increases, so does the level of caregiver burden. We employed Spearman correlational analysis and stepwise multiple regression analyses; the mean caregiver burden score was 25.9 (SD = 17.1), indicating mild to moderate burden. Caregiver burden was significantly correlated with social cognition deficit (r = 0.438, p = .001), communication deficit (r = 0.430, p = .001), and self-care deficit (r = .426, p = .002). Significant predictors of burden were social cognition deficit (beta = .408, p = .0018), self-care deficit (beta = .322, p = .0100), and caregiver age (beta = .369, p = .0312).

The purpose of this study was to identify AIDS-related knowledge, attitudes, beliefs, and short-term behavioral intentions of adolescents attending five Seventh-day Adventist (SDA) parochial high schools in the Republic of Trinidad and Tobago. This is the first known research on AIDS to be conducted in parochial and specifically, SDA schools in the Caribbean and particularly, Trinidad and Tobago. Information gathered from this research will be useful in planning appropriate AIDS education and prevention programs for the schools represented in this survey.

Ninety-six percent of respondents knew the cause of AIDS and mode of transmission, but 26 percent felt that they could get AIDS from insect bites. Student knowledge did not correlate with behavior intentions, but there was a high correlation with perception of risk and their intention to use condom or abstain from sexual practice. There appears to be some association between level of education and likelihood of safe sexual practices (p = .06). There was a significant (p < .05) relationship between students attending all girls school and behavior intentions. There was also a significant relationship (p < .05) between knowledge level and newspapers or magazines as the sources of knowledge.

This cross-sectional study presents an assessment of factors associated with elevated blood pressure in Seventh-Day Adventists in the Caribbean. Four-hundred-thirty-three subjects were randomly selected from the English-speaking Caribbean population. Subjects ranged in age from twenty-one to sixty; 150 were males and 283 females. Eighty percent were Negroes of African descent, 12 percent mixed, 8 percent Indians of East Indian descent, and 3 percent of Spanish background. The study utilized the PRECEDE model developed by Green and associates to examine factors for hypertension. A positive correlation was found between body mass index (weight in Kg/height in M2) and hypertension in both sexes. Age was also significantly associated with hypertension. Normotensive females had a slightly higher intake of potassium than hypertensives, while hypertensive males tended to have higher levels of calcium. Other factors, such as parental history of blood pressure, vegetarian diet, sugar and fat intake, or Type A/B personality showed no relationship to hypertension. The vast majority of participants were Type B. This study provides baseline information for use in selecting those features which will be emphasized in a health education program, as well as baseline data for evaluation of health education in the Caribbean.