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Background: Approximately 8% of elementary school-aged children in the United States have food allergies, a complicated health management situation that requires parents to use many types of health literacy, empowerment, and advocacy skills to work with school staff to protect their children. Objective: This cross-sectional study examined (a) whether the highest versus lowest levels of functional, communicative, and critical health literacy are associated with higher perceived effectiveness of parental advocacy behaviors for safe food allergy management in schools [parental advocacy]; and (b) whether communicative and critical health literacy are more strongly associated with parental advocacy than functional health literacy. Methods: A sample of parents of elementary school-aged children was recruited through 26 food allergy organizations and a research patient registry. Participants completed an anonymous online survey. Self-reported measurements of parental health literacy, empowerment, and advocacy were adapted and refined through pre-testing and pilot-testing. General linear model analyses were conducted to predict parental advocacy. Key Results: Participants (N = 313) were predominantly White, college-educated mothers with moderately high levels of food allergy knowledge, health literacy, empowerment, and parental advocacy skills. Parents who scored at the highest levels in the three dimensions of health literacy reported they engaged in more effective advocacy behaviors than parents who scored at the lowest levels. Parental advocacy was predicted largely by parental empowerment and the quality of the relationship with the school (B = .41 and B = .40, respectively). Functional health literacy and the child's diagnosis of asthma were smaller predictors. While accounting for covariates, functional health literacy was significantly associated with parental advocacy whereas communicative and critical health literacy were not. Conclusions: Interventions to impact parental empowerment and parent-school relationships, including a health-literate universal precautions approach of communicating food allergy school policies, may influence parental advocacy for food allergy safety in schools. Further research could use a performance-based multidimensional measure of health literacy. [HLRP: Health Literacy Research and Practice. 2023;7(3):e165–e175.]

Abstract Background In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual’s preferences. Few studies have included individuals under age 50. In this study, we use a multicriteria decision analysis technique called the Analytic Hierarchy Process to explore preferences for screening strategies and evaluate whether preferences vary by age. Methods Participants evaluated a hierarchy with 3 decision alternatives (colonoscopy, fecal immunochemical test, and computed tomography colonography), 3 criteria (test effectiveness, the screening plan, and features of the test) and 7 sub-criteria. We used the linear fit method to calculate consistency ratios and the eigenvector method for group preferences. We conducted sensitivity analysis to assess whether results are robust to change and tested differences in preferences by participant variables using chi-square and analysis of variance. Results Of the 579 individuals surveyed, 556 (96%) provided complete responses to the AHP portion of the survey. Of these, 247 participants gave responses consistent enough (CR

Background Asian American women face disproportionate burden of cervical cancer (CC) than non-Hispanic white women in the U.S. The goal of this study was to assess the feasibility and impact of a culturally tailored intervention to promote Human papillomavirus (HPV) self-sampling test among hard-to-reach Asian American women. Methods We adopted the community-based participatory research (CBPR) approach to conduct this efficacy study. A total of 156 female participants (56 Chinese, 50 Korean, and 50 Vietnamese) were recruited from community-based organizations (CBOs) in the greater Philadelphia metropolitan area. The intervention components included HPV-related education, HPV self-sampling test kit and instructions, group discussions, and patient navigations, all available in Asian languages. We examined several outcomes, including the completion of HPV self-sampling, HPV-related knowledge, perceived social support, self-efficacy, and comfort with the self-sampling test at post-intervention assessment. Results The majority of Asian American women had low annual household income (62.3% earned less than $20,000) and low educational attainment (61.3% without a college degree). We found significant increase in participants’ knowledge on HPV (baseline: 2.83, post: 4.89, P

This research examines how and why trust in health information from medical authorities (i.e., doctors or health care professionals and government health agencies) predicts acceptance of the HPV vaccine for one’s child among African American parents. A survey of African American parents recruited from community venues revealed that low trust in health information from government health agencies was associated with less favorable attitudes and intentions toward vaccinating their child against HPV. Trust in health information from a doctor or health care professional did not predict vaccine acceptance. Mediation analyses indicated that the relationship between trust in health information from government health agencies and vaccine acceptance was partially mediated by perceived vaccine efficacy. Implications of the findings on communicating to the African American community about the HPV vaccine are discussed.

Objective Health education interventions during pregnancy can influence maternal oral health (OH), maternal OH-behaviors and children’s OH. Interventions that can be delivered at anytime and anywhere, for example mobile-health (mHealth) provides an opportunity to address challenges of health education and support activation of women in underserved and rural communities to modify their health behavior. This pilot study was undertaken as a part of a mHealth initiative to determine knowledge, attitudes, and behaviors related to pregnancy and ECC prevention among women attending obstetrics/gynecology (OB/GYN) practices at a large rurally-based clinic. Methods A cross-sectional survey study was voluntarily engaged by women (n = 191) aged 18 to 59 years attending OB/GYN visits, over a 3-week period from 12/2019 to 1/2020. Survey results were analyzed applying descriptive statistics, X 2 and Fisher’s Exact tests. The significance level was set at P

Objective. To examine the gender, age, and region of residence in the anthropometric and nutritional profiles of children and adolescents aged 6–18 in Henan Province, China’s third most populous province. Design. This cross-sectional study of the China National Nutrition and Health survey (2010–2013) used a multistage cluster sampling technique. The sample included Chinese schoolchildren and adolescents aged 6 to 18 years (1,660 boys and 1,561 girls). Multiple logistic regression models were used to estimate the associations between sociodemographic correlates and overweight or obesity and stunting. Setting. Nine districts/counties in Henan Province. Participants. 3,221 subjects completed the questionnaire. Sociodemographic information was obtained. Body weight and height were measured. Results. There were statistically significant regional differences in average height and weight for boys in all age groups. Girls followed the same trends except for height when 15–18 years old. The urban-rural residence differences were found in relation to prevalence of stunting and weight status. Subjects in poor rural areas (15.43%) and ordinary rural areas (15.34%) had higher rates of stunting compared to their urban counterparts. Prevalence of overweight or obesity was highest in big city areas (15.71%) and lowest in ordinary rural areas (6.37%). Being a boy (OR = 1.69, 95% CI = 1.314–2.143), living in a big city (OR = 2.10, 95% CI = 1.431–3.073), or in a small-medium city (OR = 2.28, CI = 1.606–3.247), or being in a younger age group was associated with being overweight or obese. In addition, being a boy, living in a big city, or in a small-medium city, or being younger in age meant they were less likely to be stunted. Conclusions. A substantial dual burden of malnutrition among children and adolescents in Henan Province was revealed. The urban-rural differences in nutritional status were found. Stunting was more prevalent in rural areas than in urban. In contrast, while the rising problem of childhood and adolescent obesity still exists in the big city, we also found a great spike in obesity in small-medium cities. Evidence also indicated that boys were more likely to be overweight or obese. Our findings suggest that nutrition education, as well as environmental and policy interventions, is needed to target specific geographic regions.

Objective The study was conducted to evaluate the stability of commercial coated lipase (CT-LIP) in vitro. Methods The capsules were tested under different conditions with a range of temperature, pH, dry heat treatment and steaming treatment, simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) in this work, respectively. Free lipase (uncoated lipase, UC-LIP) was the control group. Lipase relative activities measured in various treatments were used as a reference frame to characterize the stability. Results The lipase activities were decreased with increasing temperatures (p

Health literacy experts and the American Medical Association have developed recommended communication techniques for healthcare providers given that effective communication has been shown to greatly improve health outcomes. The purpose of this study was to determine the number and types of communication techniques routinely used by Maryland physicians.In 2010, a 30-item survey was mailed to a random sample of 1,472 Maryland family physicians and pediatricians, with 294 surveys being returned and usable. The survey contained questions about provider and practice characteristics, and 17 items related to communication techniques, including seven basic communication techniques. Physicians' use of recommended communication techniques was analyzed using descriptive statistics, analysis of variance, and ordinary least squares regression.Family physicians routinely used an average of 6.6 of the 17 total techniques and 3.3 of the seven basic techniques, whereas pediatricians routinely used 6.4 and 3.2 techniques, respectively. The use of simple language was the only technique that nearly all physicians routinely utilized (Family physicians, 91%; Pediatricians, 93%). Physicians who had taken a communications course used significantly more techniques than those who had not. Physicians with a low percentage of patients on Medicaid were significantly less likely to use the recommended communication techniques compared to those providers who had high proportion of their patient population on Medicaid.Overall, the use of recommended communication techniques was low. Additionally, many physicians were unsure of the effectiveness of several of the recommended techniques, which could suggest that physicians are unaware of valuable skills that could enhance their communication. The findings of this study suggest that communications training should be given a higher priority in the medical training process in the United States.

Minority populations are underrepresented in fields of science, perhaps limiting scientific perspectives. Informed by recent studies using social cognitive career theory, this study examined whether three conceptual constructs: self-efficacy, perceived adult support, and perceived barriers, along with several discrete and immutable variables, were associated with intent to pursue college health science education in a sample (N = 134) of minority youth (67.2% African American). A paper-and-pencil survey about pursuit of college health science was administered to 10th graders with a B- or better grade point average from six high schools in an underserved community. Results indicated that the three conceptual constructs were bivariate correlates of intent to pursue college health science. Only perceived adult support and knowing whether a parent received college education were significant predictors in a multiple regression model. These results build on previous research and provide further insight into youth decision-making regarding pursuit of college health science.

Objective The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency. Methods A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and women. Results Overall, 71.4% of the sample reported having never been screened and 28.6% reported being screened for HBV Demographic, acculturation, and barrier factors were differentially associated with screening rates among the subgroups. Demographic factors associated with never-screened were: lower education, younger age, being male, and no insurance for Chinese; lower education, lower income and no insurance for Cambodians; younger age and unmarried for Koreans; and no health insurance for Vietnamese; Acculturation factors associated with never-screened were: not speaking English for Chinese; not speaking English, not reading newspapers in English, and watching TV in one's native language for Cambodians; not speaking English for Koreans; while no significant factors were found for Vietnamese. All barriers were associated with never-screened for Cambodians and Chinese. Those who lacked knowledge about HBV and had language and transportation barrier were more likely to be never-screened for Koreans. There were no significant relationships between the barriers and the screening status for Vietnamese. Conclusions High incidence of HBV and liver cancer in Asian Americans mandates a more vigorous and more culturally and linguistically appropriate educational effort to increase screening and vaccination for HBV in these underserved and mostly uninsured populations.

The study was designed to evaluate the effects of probiotics (Bacillus subtilis) to enhance immunity, antioxidation, digestive enzymes activity and hematological profile of Shaoxing duck. A population of 200 laying ducks (160 days old) was divided into two groups each further divided in five replications. The control (G1) were fed on basal diet and (G2) with B. subtilis 1×108 cfu/kg in addition of basal diet for thirty five days. The results showed that, ducks were treated with probiotics (B. subtilis), their serum IL-2 increased and IL-10 decreased (P

The purpose of the present study was to characterize, geographically and temporally, the patterns of acquired immune deficiency syndrome (AIDS) death disparity in 67 Florida jurisdictions, and to determine if the detected trends varied according to age, race, and sex. The space-time scan statistic proposed by Kulldorff et al was used to examine the excess AIDS deaths that occurred between 1987 and 2004. Results were geographically referenced in maps using EpiInfo and EpiMap made available by the Centers for Disease Control. Miami-Dade and the nearby counties including Broward, Martin, and Palm Beach are the most likely clusters (observed/expected: 1505.16) with temporal dimension (also called cluster's age) persisting from 1996 to the present. Union county had the longest cluster for the cluster period 1987–1998, but not for 1999–2004. African-Americans contributed to more clusters compared with whites. Time trends indicated that AIDS mortality peaked in 1995 and then sharply dropped until 1998, when the decrease stopped. By accounting for the temporal dimension of disease clustering, the present study revealed the persistence of geographic clusters, which is not often provided by other geographic detection methods. These findings may be informative for medical resource allocation and better focus public health intervention strategies for AIDS care.

This study examined proprioceptive responses under equivalent rising and falling blood alcohol concentrations (BAC), using a repeated-measures design. Seven volunteer subjects, 21 to 35 years of age, participated in the study. After alcohol consumption, BAC readings were obtained every 5 minutes, and the proprioceptive responses were measured at the following BAC levels (in %): 0 (baseline), rising 0.05, 0.075, 0.1, falling 0.075, and 0.05. The analysis focused on the comparisons of these measures at the equivalent rising and falling 0.05% and at the 0.075% BACs. Results showed that the proprioceptive response was less accurate during the rising than the falling BACs.

The effects of family migration and family life cycle on the employment status of married, college-educated females are dissected using log-linear analysis. The best-fit or logit model selected indicates that both family life cycle and family migration significantly influenced wives' employment status. Results show that the negative effects of family migration on wives' employment can be altered by the effects of family life cycle. The findings also indicate that only extremely highly educated women initiate family migration.

An examination of the heights and weights of members of the Parade Magazine's High School All-American Football Teams from 1963-1971 indicates no significant changes in the Body Mass Index of these elite athletes whereas an increased pattern in Body Mass Index was noted within this group from 1972-1989. The large increases in Body Mass Index after 1971 among the All-American high school football players raise interesting research questions; in particular, what portion of these gains can be attributed to improved nutrition and training techniques and what portion is the result of use of performance enhancing drugs such as anabolic steroids?

This study examined reaction time (RT), anticipation time (AT), and visual performance under the influence of blood alcohol concentration (BAC), using a repeated-measures design. Subjects (8 men and 8 women), 21 to 40 yr. of age, participated in both single- and double-dose sessions, in which they drank approximately 2.3 oz. and 4.6 oz. of 86-proof vodka, respectively. The breath BAC was measured at 5-min. intervals. The RT, AT, and visual performance were tested every 20 min. for 140 min. in both sessions. In general, results indicated that RT, AT, and stereoscopic vision were impaired more in the rising BAC curve than the falling BAC curve. In addition, the impairment tended to be greater for the double-dose than the single-dose session. The far and near visual acuities were not affected by the BAC.

Background: Hospital investments in care coordination services and innovative delivery models represent an important source for improving care efficiency and population health. Objective: The aim of this study was to explore variation of hospital-initiated care coordination services and participation in Accountable Care Organizations (ACOs) by community characteristics within an organizational theory framework. Methods: Our main data sets included the 2015 American Hospital Association Annual Survey, Survey of Care Systems and Payment, American Community Survey, and Area Health Resource File. Two main outcomes were (a) hospital reported initiation of care coordination practices (such as chronic disease management, post-hospital discharge continuity of care, and predictive analytics) and (b) participation in ACO models. State fixed-effects models were used to test the association between the adoption of care coordination practices and hospital characteristics, community level sociodemographic characteristics, and health policies. Results: Hospitals with large bed size, located in urban areas, and/or with high volume of operations were more likely to adopt care coordination practices and participate in the ACO models. Hospitals serving communities with high uninsurance rates and/or poverty rates were significantly less likely to provide care coordination practices. More stringent Community Benefit Laws (CBLs) were positively associated with the implementation of care coordination practices suggesting strong normative impacts of CBLs. Conclusion: Greater hospital-initiated care coordination practices and innovative ACO models were available in well-resourced areas. Policymakers may consider increasing resources for care coordination practices in rural, underserved, and high-poverty--high-uninsured areas to ensure that vulnerable populations can benefit from these services. [ABSTRACT FROM AUTHOR]

This study sought to predict the use of dietary supplements marketed to enhance athletic performance among 1,737 adolescent athletes. An anonymous, paper-and-pencil, self-report survey was administered to the participants. Grade level. participation in multiple sports, and scales representing attitudes, subjective norms. and intention were all significant predictors of current dietary supplement use. The results of this study allow for the development of more appropriate prevention and intervention strategies that can target specific groups of adolescent athletes. The authors recommend that attitudes of adolescent athletes he addressed in interventions and that salient others he included in program planning. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we sought to determine the impact of oral health literacy (OHL) on use of prenatal dental care and knowledge, understanding, and practices related to preventing dental caries (tooth decay) among low-income pregnant women in Maryland. Methods: We conducted a mixed methods study using a survey and a structured guide for one-on-one interviews or focus groups. The study included 117 pregnant women and was conducted between July 2016 and April 2018 in Maryland. Results: Respondents had a low level of OHL. Maryland Medicaid covers prenatal dental care, but only 53% of participants reported seeing a dentist during their pregnancy. Most women were unaware of the Medicaid dental program for pregnant women and the importance of prenatal dental care. They could not afford care if there was an associated cost and had difficulty finding a Medicaid dental provider. Importantly, they lacked understanding of how to prevent caries and did not practice behaviors to prevent this disease. Conclusions: To decrease caries rates, policies and programs must be implemented to increase the OHL of low-income pregnant women because the OHL of caregivers is associated with their children's oral health status. [ABSTRACT FROM AUTHOR]

Objectives The overall purposes of this first US national pilot study were to (1) test the feasibility of online administration of the Bioethical Issues in Biostatistical Consulting (BIBC) Questionnaire to a random sample of American Statistical Association (ASA) members; (2) determine the prevalence and relative severity of a broad array of bioethical violations requests that are presented to biostatisticians by investigators seeking biostatistical consultations; and (3) establish the sample size needed for a full-size phase II study. Design A descriptive survey as approved and endorsed by the ASA. Participants Administered to a randomly drawn sample of 112 professional biostatisticians who were ASA members. Primary and secondary outcome measures The 18 bioethical violations were first ranked by perceived severity scores, then categorised into three perceived severity subcategories in order to identify seven 'top tier concern violations' and seven 'second tier concern violations'. Results Methodologically, this phase I pilot study demonstrated that the BIBC Questionnaire, as administered online to a random sample of ASA members, served to identify bioethical violations that occurred during biostatistical consultations, and provided data needed to establish the sample size needed for a full-scale phase II study. The No. 1 top tier concern was 'remove or alter some data records in order to better support the research hypothesis'. The No. 2 top tier concern was 'interpret the statistical findings based on expectation, not based on actual results'. In total, 14 of the 18 BIBC Questionnaire items, as judged by a combination of 'severity of violation' and 'frequency of occurrence over past 5 years', were rated by biostatisticians as 'top tier' or 'second tier' bioethical concerns. Conclusion This pilot study gives clear evidence that researchers make requests of their biostatistical consultants that are not only rated as severe violations, but further that these requests occur quite frequently. [ABSTRACT FROM AUTHOR]

This study compared physiological data from an elite collegiate soccer player to those of his teammates over 2 seasons. The player of special interest (player A) was the winner of the MAC Hermann Trophy and was therefore considered the top player in National Collegiate Athletic Association (NCAA) division I soccer for each of the 2 seasons in which data were collected. Maximal oxygen consumption (...o2max) was measured during preseasons and heart rate (HR) was recorded during competitive matches. Polar Training Loads (PTL) were calculated using the Polar Team2 Pro (Polar USA) system based on time spent in HR zones. Player A had a lower than the team average in 2012 (56 vs. 61.5 ± 4.3 ml⋅kg-1⋅min-1) and a similar value in 2013 (54 vs. 56.9 ± 5.1 ml⋅kg-1⋅min-1). During matches, player A showed consistent significant differences from the team in percentage of time spent at 70-79% maximal heart rate (HRmax) (12.8 ± 5.5% vs. 10.1 ± 4.0%), 80-89% HRmax (54.3 ± 11.5% vs. 29.3 ± 6.8%), and 90-100% HRmax (23.1 ± 10.6% vs. 45.4 ± 8.5%). This led to a consistently lower PTL per minute accumulated by player A compared with his teammates (3.6 ± 0.4 vs. 4.4 ± 0.3), which may be beneficial over a season and may be related to his success. Thus, the ability to regulate moments of maximal exertion is useful in reducing training load and may be a characteristic of elite players, although whether our findings relate to differences in the playing style, position, or aerobic capacity of player A are unknown. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the influence of psychosocial factors on HBV screening. Methods: Sample consisted of 1716 Vietnamese participants in our previous HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using the Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. Results: Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening; knowledge had the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. Conclusion: To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits, decreasing perceived barriers, and accounting for the dynamic cognitive processing. [ABSTRACT FROM AUTHOR]

Background: Use of technology is increasing in health promotion and has continued growth potential in intervention research. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this paper reports on the adoption, reach, and implementation of Project HEAL (Health through Early Awareness and Learning)-a community-based implementation trial of a cancer educational intervention in 14 African American churches. We compare adoption, reach, and implementation at the organizational and participant level for churches in which lay peer community health advisors (CHAs) were trained using traditional classroom didactic methods compared with a new online system.Methods: Fifteen churches were randomized to one of two study groups in which two CHAs per church were trained through either classroom ("Traditional"; n = 16 CHAs in 8 churches) or web-based ("Technology"; n = 14 CHAs in 7 churches) training methods. Once trained and certified, all CHAs conducted a series of three group educational workshops in their churches on cancer early detection (breast, prostate, and colorectal). Adoption, reach, and implementation were assessed using multiple data sources including church-level data, participant engagement in the workshops, and study staff observations of CHA performance.Results: The project had a 41% overall adoption rate at the church level. In terms of reach, a total of 375 participants enrolled in Project HEAL-226 participants in the Traditional group (43% reach) and 149 in the Technology group (21% reach; p < .10). Implementation was evaluated in terms of adherence, dosage, and quality. All churches fully completed the three workshops; however, the Traditional churches took somewhat longer (M = 84 days) to complete the workshop series than churches in the Technology group (M = 64 days). Other implementation outcomes were comparable between both the Traditional and Technology groups (p > .05).Conclusions: Overall, the Project HEAL intervention had reasonable adoption, though reach could have been better. Implementation was strong across both study groups, suggesting the promise of using web-based methods to disseminate and implement evidence-based interventions in faith-based settings and other areas where community health educators work to eliminate health disparities. [ABSTRACT FROM AUTHOR]

The article discusses the authors' claim that an increase in the number of minorities in America's health science workforce is needed in order to reconcile the health disparities that disproportionately impact non-Whites. It states that the majority of minority high school students who are gifted in the health-related sciences do not pursue health-based college programs or occupations. Research involving African-American and Hispanic American 12th graders in Washington, D.C. is examined.

Background: Hepatitis B Virus (HBV) disproportionately affects new immigrants from endemic regions such as China. Untreated infections increase health risks for liver diseases including cancer. Yet most of those infected are unaware of their disease limiting prevention and early treatment options. The purpose of this community based study was to evaluate a heuristic model identifying factors contributing to Hepatitis B (HBV) screening among Chinese Americans. Methods: A cross-sectional design included a sample of 924 Chinese men and women 18 years of age and older of which 718 had complete data for final analysis. Confirmatory factor analysis verified conceptual indicators including access/satisfaction with health care and enabling, predisposing, cultural, and health belief factors. Structural equation modeling was used to identify direct and indirect predictors of Hepatitis B screening. Results: Bivariate analysis revealed that Chinese respondents who were never screened for HBV were significantly more likely to be below age 40 (69.8%), male (69.2%), had less than a high school education (76.4%), with less than 6 years living in the US (72.8%) and had no health insurance (79.2%). The final model identified enabling factors (having health insurance, a primary health care provider to go to when sick and more frequent visits to a doctor in the last year) as the strongest predictor of HBV screening (coefficient = 0.470, t = 7.618, p < .001). Predisposing factors (education variables) were also significantly related to HBV screening. Cultural factors and Satisfaction with Health care were associated with HBV screening only through their significant relationships with enabling factors. Conclusions: The tested theoretical model shows promise in predicting HBV testing among Chinese Americans. Increasing access to health care by expanding insurance options and improving culturally sensitivity in health systems are critical to reach new immigrants like Chinese for HBV screening. Yet such strategies are consistent with DHHS Action plan for the Prevention and Treatment of Viral Hepatitis. Implementing community-based strategies like partnering with relevant Community-Based Organizations are important for meeting HBV policy targets. [ABSTRACT FROM AUTHOR]

We describe the feasibility of a Web-based portal for training peer community health advisors (CHAs). We conducted a community-based implementation trial in African American churches between 2012 and 2014. The Web-based portal allows CHAs to log in and view 13 training videos, preparing them to deliver 3 cancer early detection workshops in their churches. Of 8 churches, 6 completed the training, each certifying 2 CHAs. These CHAs took an average of 26 days to complete the training, requiring little technical assistance. Additional technical assistance was required to implement the workshops. The Web-based system appears to be a feasible method for training lay individuals for the CHA role and has implications for increasing the reach of evidence-based interventions. [ABSTRACT FROM AUTHOR]

Measures are needed to assess youth perceptions about health science careers to facilitate research aimed at increasing youth pursuit of health science. Although the Indiana Instrument provides an established measure of perceptions regarding nursing and ideal careers, we were interested in learning how high-achieving 10th graders from relatively low socioeconomic areas who identify as black/African American (black) perceive health science and ideal careers. The Indiana Instrument was modified, administered to 90 youth of interest, and psychometrically analyzed. Reliable subscales were identified that may facilitate parsimonious, theoretical, and reliable study of youth decision-making regarding health science careers. Such research may help to develop and evaluate strategies for increasing the number of minority health scientists. [ABSTRACT FROM AUTHOR]

Objectives. We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education. Methods. In 2011–2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques. Results. Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques. Conclusions. Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate. [ABSTRACT FROM AUTHOR]

Background Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations. Method This article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support). Results We describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations. Conclusions Project HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control. [ABSTRACT FROM AUTHOR]

Objectives: To examine the physical, social and temporal contexts of physical activity, as well as sex variations of the associations among 314 urban adolescents. Methods: Three-day physical activity recall measured contextual information of physical activities. Logistic regressions and generalized estimating equation models examined associations among physical activity types and contexts, and sex differences. Results: Active transportation was the most common physical activity. Home/neighborhood and school were the most common physical activity locations. School was the main location for organized physical activity. Boys spent more time on recreational physical activity, regardless of the social context, compared to girls. The average physical activity level was significantly lower for girls than for boys after school. Conclusions: Physical activity promotion interventions need to target physical activity environments and social contexts in a sex-specific manner. [ABSTRACT FROM AUTHOR]

Background. Health care providers' use of recommended communication techniques can increase patients' adherence to prevention and treatment regimens and improve patient health outcomes. The authors conducted a survey of Maryland dentists to determine the number and type of communication techniques they use on a routine basis. Methods. The authors mailed a 30-item questionnaire to a random sample of 1,393 general practice dentists and all 169 members of the Maryland chapter of the American Academy of Pediatric Dentistry. The overall response rate was 38.4 percent. Analysis included descriptive statistics, analysis of variance and ordinary least squares regression analysis to examine the association of dentists' characteristics with the number of communication techniques used. They set the significance level at P < .05. Results. General dentists reported routinely using a mean of 7.9 of the 18 communication techniques and 3.6 of the seven basic techniques, whereas pediatric dentists reported using a mean of 8.4 and 3.8 of those techniques, respectively. General dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P < .01) but not the seven basic techniques (P < .05). Pediatric dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P < .05) and the seven basic techniques (P < .01). Conclusions. The number of communication techniques that dentists used routinely varied across the 18 techniques and was low for most techniques. Practical Implications. Professional education is needed both in dental school curricula and continuing education courses to increase use of recommended communication techniques. Specifically, dentists and their team members should consider taking communication skills courses and conducting an overall evaluation of their practices for user friendliness. [ABSTRACT FROM AUTHOR]

This cross-sectional study was designed to identify correlates of blood pressure control behaviors, including participation in physical activity, maintaining a healthy diet, limiting alcohol and tobacco use, discussing blood pressure with a doctor, and getting screened for blood pressure. The study sample included 116 Korean American men and women aged 42 to 77 years (M = 58.7) who resided in the greater Philadelphia area. Intention to exercise, comfort exercising in the neighborhood, and confidence in the ability to find time to exercise were positively correlated with participating in physical activity. Knowledge about the benefits of a healthy diet and confidence in the ability to maintain a healthy diet were positively correlated with maintaining a healthy diet. Intention to visit a doctor, having a regular doctor, satisfaction with the doctor, having confidence in the doctor, and confidence in the ability to ask doctors about health issues were positively correlated with medical adherence (including adhering to medication regimen and seeing a doctor regularly). [ABSTRACT FROM AUTHOR]

Objectives. We evaluated the combined impact of community-level environmental and socioeconomic factors on the risk of campylobacteriosis. Methods. We obtained Campylobacter case data (2002-2010; n = 3694) from the Maryland Foodborne Diseases Active Surveillance Network. We obtained community-level socioeconomic and environmental data from the 2000 US Census and the 2007 US Census of Agriculture. We linked data by zip code. We derived incidence rate ratios by Poisson regressions. We mapped a subset of zip code-level characteristics. Results. In zip codes that were 100% rural, incidence rate ratios (IRRs) of campylobacteriosis were 6 times (IRR = 6.18; 95% confidence interval [CI] = 3.19, 11.97) greater than those in urban zip codes. In zip codes with broiler chicken operations, incidence rates were 1.45 times greater than those in zip codes without broilers (IRR = 1.45; 95% CI = 1.34, 1.58). We also observed higher rates in zip codes whose populations were predominantly White and had high median incomes. Conclusions. The community and environment in which one lives may significantly influence the risk of campylobacteriosis. [ABSTRACT FROM AUTHOR]

Using data collected by the National Center for Health Statistics, we examined the relationships between smoking-related beliefs and attitudes and smoking status for a sample of adolescents (N = 3,198) from southern states. Stepwise logistic regression was used to identify the best predictors of smoking prevalence. Results indicated that 8 of 13 variables in the logistic model significantly differentiated between smokers and nonsmokers. Smokers were more likely to believe that it is safe to smoke for only a year or 2 and that smoking helps reduce stress and boredom while promoting relaxation. Smokers also reported a higher tolerance than nonsmokers for being around other smokers, and reported their parents would not mind their smoking. The logistic model attained a predictive accuracy of 93.2%. The implication of these findings is that if smoking interventions targeted at adolescents address smoking-related beliefs and attitudes, there is an enhanced likelihood that such interventions will positively influence the smoking behavior of southern adolescents. (1994;87:1097-1102) Min Qi Wang et al, Health Studies Program, Box 870312, Tuscaloosa, AL 35487.

Only 10% of health professionals are from racial/ethnic minority groups, and much research has been focused on encouraging minorities to enter a health career. The lack of health workforce diversity has many implications for the effective delivery of care to an increasingly diverse US population. The goal of this analysis is to examine the influence of personal health experiences on interest in a health career. "Personal Health Experiences" is a newly created scaled variable that assesses the influence of direct and indirect health experiences of respondents. In a sample of 134 predominantly minority 10th graders from underprivileged neighborhoods, the scale had adequate psychometric properties (range 1-7; mean 4-44, SD 1.46, median 4-60, Cronbach's alpha 0.72), and multivariate regression modeling revealed that it predicted increased "Interest in Health Careers" (B=0.46, SE 0.10, P<0.01). Future research is needed to determine the role that personal health experiences play in career choices and one's success in health career decisions. Such information could, for example, help to refine health profession recruitment strategies. [ABSTRACT FROM AUTHOR]

Minority populations are underrepresented in fields of science, perhaps limiting scientific perspectives. Informed by recent studies using social cognitive career theory, this study examined whether three conceptual constructs: self-efficacy, perceived adult support, and perceived barriers, along with several discrete and immutable variables, were associated with intent to pursue college health science education in a sample (N = 134) of minority youth (67.2% African American). A paper-and-pencil survey about pursuit of college health science was administered to 10th graders with a B- or better grade point average from six high schools in an underserved community. Results indicated that the three conceptual constructs were bivariate correlates of intent to pursue college health science. Only perceived adult support and knowing whether a parent received college education were significant predictors in a multiple regression model. These results build on previous research and provide further insight into youth decision-making regarding pursuit of college health science. [ABSTRACT FROM AUTHOR]

The study applied the Geographic Information System (GIS) to identify the need for primary care physicians in Prince George's County, Maryland. Primary care physicians included medical specialists in family practice, internal medicine, pediatrics and obstetrics and gynecology. Two Census variables (population size, percentage of African Americans/Blacks) that can serve as surrogates for need for primary care were selected and compared across the five jurisdictions. A quintile ranking was used to order and compare the ZIP codes by each of four different variables. he results indicated that the primary care physician workforce for Prince George's County was substantially less than the neighboring jurisdictions. Specifically, the rate of primary care physicians for Prince George's County was below the average rate of primary care physicians per 100,000 residents in Maryland, and below any of the four neighboring jurisdictions. When considering the lowest two quintiles as the high primary care need area, the rate of primary care physicians supply was smaller than or equal to 9.6 per 100,000; 138,677 residents (16.2% of the population) in Prince George's County lived in this area. These findings reinforced the previous reports conducted by RAND Corporation. [ABSTRACT FROM AUTHOR]

This study provides 10-year trend data on the psychosocial correlates of physical dating violence victimization (PDV) among male participants (N = 7,949 in 2009) in the national Youth Risk Behavior Surveys from 1999-2009. Unadjusted odds ratios (OR) and 95% confidence intervals (CI) were examined followed by multivariate logistic regression analyses, which included all significant independent variables from the univariate analyses. Adjusted OR and 95% CI assessed the significance of the relationships. PDV was significantly and consistently associated with feelings of sadness or hopelessness, repeated engagement in physical fighting, current and multiple sex partners, and lack of condom use. A less consistent but noteworthy pattern was found for PDV and gun carrying and cocaine use among adolescent males. PDV is an important public health issue for adolescent males, not just females. There appears to be a set of stable correlates of dating violence victimization among high school males in the United States. [ABSTRACT FROM AUTHOR]

Objectives: To test the pathways between perceptions of built environment factors and physical activity in urban youth. Methods: Three hundred fifty high school students' perceptions of neighborhood, and barrier self efficacy were measured by a Web survey. Physical activities were assessed using a one-week diary and accelerometers. Results: Land-use mix/ accessibility and neighborhood satisfaction had direct pathways to walking. Barrier self-efficacy had a direct pathway to walking. In addition, land use, specifically neighborhood accessibility, influenced adolescents' walking behavior via self-efficacy. Similar pathways were found in MVPA models. Conclusions: Neighborhood factors appear to work together with self-efficacy to facilitate physical activity. [ABSTRACT FROM AUTHOR]

Objective Informatics applications have the potential to improve participation in clinical trials, but their design must be based on user-centered research. This research used a fully counterbalanced experimental design to investigate the effect of changes made to the original version of a website, http://BreastCancerTrials.org/, and confirm that the revised version addressed and reinforced patients needs and expectations. Design Participants included women who had received a breast cancer diagnosis within the last 5 years (N=77). They were randomized into two groups: one group used and reviewed the original version first followed by the redesigned version, and the other group used and reviewed them in reverse order. Measurements The study used both quantitative and qualitative measures. During use, participants' click paths and general reactions were observed. After use, participants were asked to answer survey items and open-ended questions to indicate their reactions and which version they preferred and met their needs and expectations better. Results Overall, the revised version of the site was preferred and perceived to be clearer, easier to navigate, more trustworthy and credible, and more private and safe overall. However, users who viewed the original version last had similar attitudes toward both versions. Conclusion By applying research findings to the redesign of a website for clinical trial searching, it was possible to re-engineer the interface to better support patients' decisions to participate in clinical trials. The mechanisms of action in this case appeared to revolve around creating an environment that supported a sense of personal control and decisional autonomy. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency. Methods: A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and women. Results: Overall, 71.4% of the sample reported having never been screened and 28.6% reported being screened for HBV. Demographic, acculturation, and barrier factors were differentially associated with screening rates among the subgroups. Demographic factors associated with never-screened were: lower education, younger age, being male, and no insurance for Chinese; lower education, lower income and no insurance for Cambodians; younger age and unmarried for Koreans; and no health insurance for Vietnamese; Acculturation factors associated with never-screened were: not speaking English for Chinese; not speaking English, not reading newspapers in English, and watching TV in one’s native language for Cambodians; not speaking English for Koreans; while no significant factors were found for Vietnamese. All barriers were associated with never-screened for Cambodians and Chinese. Those who lacked knowledge about HBV and had language and transportation barrier were more likely to be never-screened for Koreans. There were no significant relationships between the barriers and the screening status for Vietnamese. Conclusions: High incidence of HBV and liver cancer in Asian Americans mandates a more vigorous and more culturally and linguistically appropriate educational effort to increase screening and vaccination for HBV in these underserved and mostly uninsured populations. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated substance use and HIV risk profile using a latent model analysis based on ecological theory, inclusive of a risk and protective factor framework, in sexually active minority adults (N=1,056) who participated in a federally funded substance abuse and HIV prevention health initiative from 2002 to 2006. Methods: Data were collected locally from community-based organizations using a common baseline instrument that was administered within 30 days of program entry. The latent variables included were social support; neighborhood attachment; family cohesion; intimate abuse; alcohol, tobacco/other drugs (ATOD) use; and HIV risk behaviors. Results: The model-fit indices met acceptable standards for African Americans (CFI = 0.962, TLI = 0.956, RMSEA = 0.033) and for Hispanic/Latinos (CFI = 0.927, TLI = 0.917, RMSEA = 0.047). For African Americans, neighborhood attachment was significantly related to intimate abuse (coefficient =.126, p<.01) and family cohesion (coefficient = .281, p<.01). Social support was not significantly related to either family cohesion or intimate abuse. Family cohesion was negatively related to ATOD use. which was also related to sex with risk partners and drug-related sex. For Hispanics, neighborhood attachment was significantly related to intimate abuse (coefficient = .209, p<.01) and family cohesion (coefficient = .209, p<.01). Social support was significantly related to family cohesion (coefficient = .274, p<.01), but not related to intimate abuse, Intimate abuse was negatively related to A TOD use. Conclusions: The results support the inclusion of protective factors as a standard implementation approach for prevention programs targeted to the reduction of ATOD use and HIV risk among sexually active minority adults. [ABSTRACT FROM AUTHOR]

In endothelial cells, NF-κB is an important intracellular signaling molecule by which changes in wall shear stress are transduced into the nucleus to initiate downstream endothelial nitric oxide synthase (NOS3) gene expression. We investigated whether NF-κ light-chain gene enhancer in B cells 1 (NFKB1) promoter polymorphism (-94NFKB1 I/D, where I is the insertion allele and D is the deletion allele) was associated with 1) NOS3 gene expression in endothelial cells under physiological levels of unidirectional laminar shear stress (LSS) and 2) endothelial function in prehypertensive and stage 1 hypertensive individuals before and after a 6-too supervised endurance exercise intervention. Competitive EMSAs revealed that proteins present in the nuclei of endothelial cells preferentially bound to the I allele NFKB1 promoter compared with the D allele. Reporter gene assays showed that the I allele promoter had significantly higher activity than the D allele. In agreement with these observations, homozygous II genotype cells had higher p50 expression levels than homozygous DD genotype cells. Cells with the homozygous II genotype showed a greater increase in NOS3 protein expression than did homozygous DD genotype cells under LSS. Functional experiments on volunteers confirmed higher baseline reactive hyperemic forearm blood flow, and, furthermore, the subgroup analysis revealed that DD homozygotes were significantly less prevalent in the exercise responder group compared with II and ID genotypes. We conclude that the -94NFKB1 I/D promoter variation contributes to the modulation of vascular function and adaptability to exercise-induced flow shear stress, most likely due to differences in NFKB1 gene transactivity. [ABSTRACT FROM AUTHOR]

The study objective was to determine the effect of an international embargo against Haiti, from October 1991 through October 1994, on early childhood protein-energy malnutrition and all-cause mortality in a geographic area where humanitarian aid was continuously available to the children in the study. The authors used longitudinal anthropometric records on 1,593 children, 24 months old or younger, living in the rural Grand Anse Department of Haiti from 1989 through 1996. Kaplan-Meier graphs for all-cause mortality accounting for malnutrition status and stratified by calendar period were applied to the database and assessed using logrank tests. Adjusted relative risks were assessed by Cox regression. The results show that despite the continuous availability of preventive services (1989-1996), higher all-cause mortality was more strongly associated with a calendar period coinciding with the international embargo than with periods before and after the embargo. The incidence of childhood mortality and of severe malnutrition were also higher during the period of the embargo than in the periods before and after the embargo. The findings suggest that future international sanctions, even those with humanitarian/medical exceptions, could result in substantial infant death. [ABSTRACT FROM AUTHOR]