Mutually Dependent Health Beliefs Associated With Breast Self-examination in British Female University Students

Abstract

Objective: Whereas research suggests young women's beliefs about breast cancer (susceptibility/severity) and its early detection (barriers/benefits) reliably distinguish breast self-examiners from nonexaminers, this study assessed whether these impressions are interreliant, especially in the context of familial risk. Participants: The sample comprised over 200 female undergraduates from a university in England, United Kingdom. Methods: Participants completed a self-administered survey on their attitudes concerning breast cancer and early detection. Data were analyzed using logistic regression analysis. Results: Nonexaminers were distinguished by a combination of greater perceived hindrances to self-examinations and stronger appraisals of breast cancer severity, and also by a permutation of fewer perceived benefits in self-examinations and lower perceived susceptibility to breast cancer. The latter interaction persisted after accounting for family history. Conclusions: Interwoven attitudes may depict sophisticated efforts on the part of nonexaminers to justify inaction. Clinical implications for college health providers are considered.     

Chapter 16: Integration of Occupational Health Services in the Federal Sector

Abstract

Federal Occupational Health (FOH) is a federal sector model of the integration and collaboration of occupational health (OH) programs that includes on-site health clinics, and environmental health as well as EAP, work-life, and wellness/fitness programs. This article reviews several aspects of integration at various levels of this public health organization.

The broad objectives of occupational health programs are to promote, support, and provide a healthy and productive, highly functioning workforce to the employer. FOH staff has special expertise and knowledge related to federal procedures, regulations and agency culture, as well as the OH disciplines. With its mission to provide occupational health services to federal agencies and federal employees, FOH has the unique opportunity to provide integrated OH services, thereby providing a more comprehensive approach to the occupational health care of the individual employee, as well as a more comprehensive approach to the health and productivity efforts of the federal agencies.

Although we have made strides and engage in continuing efforts to promote integrated programs and care, a number of additional program enhancements are in discussion and/or in process. FOH is a unique entity and the largest provider of comprehensive OH services within the federal government. It has achieved some notable success with the integration of its services across various levels of the organization with different federal organizations. Efforts have been particularly successful in bringing a coordinated response to various crises and emergency situations. With increasing knowledge and data on the benefits of integration, FOH is working to reduce both internal and external organizational barriers to bring integration of services to their maximum potential.     

The Benefits of Dispositional Mindfulness in Physical Health: A Longitudinal Study of Female College Students

Abstract

Objective: This article examines the relationship between dispositional mindfulness, health behaviors (eg, sleep, eating, and exercise), and physical health. Participants: Participants included 441 college women. Methods: Women completed self-report surveys at the beginning and end of a 10-week academic quarter. The study was conducted over 5 academic quarters from fall 2008 to fall 2010. Results: Findings indicated that higher levels of dispositional mindfulness were related to healthier eating practices, better quality of sleep, and better physical health. Dispositional mindfulness contributed to better physical health even after controlling for traditional health habits. Finally, bidirectional mediational relationships were found between healthy eating and dispositional mindfulness as well as between sleep quality and dispositional mindfulness when physical health was the outcome variable. Conclusions: Findings suggest that incorporating mindfulness training into programming on college campuses may be beneficial, as results indicate that dispositional mindfulness is related to positive physical health among college students.     

Bite Mark Evidence in Crimes Against Persons

Abstract

Bite marks are often found on victims of homicide, sex crimes, and child abuse. Since this type of physical evidence often links victims and assailants, it is essential that bite mark evidence be recognized and properly preserved. The superior courts of several states and United States military courts have accepted this evidence as admissible.

This article is intended to familiarize college and university health workers and security personnel with the appearance of bite marks as they may be found on victims. Further, it describes techniques of photography and related procedures, necessary for the preservation of this essential evidence. Photographs of actual bite marks and diagrams illustrating correct techniques for photography are included. This article is intended to alert college health and security personnel that early recognition and preservation of bite mark evidence is essential to investigative procedures.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

Applying health determinants and dimensions in social work practice

Dimensions and determinants related to physical health, mental health and well-being can be used as tools in social work practice. These frameworks are useful for assessment, planning and intervention activities in complex client situations, alerting social workers to consider diverse features and processes that influence well-being in people's lives. They can be applied in social work with individuals, families, groups, and communities. In our view health and well-being need to be viewed holistically, broadly and in each unique situation, changing over time over the life course. Literature based on key word searches of concepts we use in our teaching and research and that has informed our conceptualisation of dimensions and determinants in physical health, mental health and well-being, is reviewed. A case illustration is presented to illustrate how the dimensions and determinants are used to inform practice and compare and apply alternative frameworks. Finally, the implications of these and other frameworks for social work, not only in health care settings, but also in other fields of social work practice, are discussed.     

A National Survey of the Provision of Sexual Health Clinical Services by Public Health in Canada: First Insights

Objectives: Data documenting the scope of sexual health clinical services offered as public health in Canada are unavailable. This article provides first insights into the scope of STI and clinical sexual health services available nationally. Methods: Data were gathered using an online survey of 113 Canadian public health units. Results: Almost half of the clinics were not providing expedited partner therapy, one third were not providing point of care testing for HIV and one third were not using syndromic management of sexually transmitted infections (STIs). Low rates of physician support were evident. Conclusion: Given the ever-higher rates of STIs, findings from this study identify important challenges to providing comprehensive services.     

A Community's Perceptions of Pediatric Social Outcomes in a Downsized Urban Hospital System

This article describes parental perceptions of pediatric services at Los Angeles County King/Drew Hospital and Medical Center after the hospital and its community clinics were restructured in the 1990s. Qualitative and quantitative measures are used to capture parental perceptions of service utilization, service convenience, and quality of care. The results are compared to hospital institutional operational data from patient flow analysis reports, appointment delay reports, and improving organizational performance committee reports. A comparison of parental perceptions of pediatric care is also made with findings from other post-devolution studies on access and quality of care at the Los Angeles County Department of Health Services. The implications of the findings for hospital quality assurance processes and health services outcomes research are discussed.     

Integrating Sexual Health Services Into Primary Care: An Overview of Health Systems Issues and Challenges in Developing Countries

ABSTRACT

Current attempts to address the high burden of sexual health morbidity and mortality in developing countries remain limited in scale due to a range of health system constraints. We conducted a literature review of the policy and programmatic issues that influence the integration of sexual health into primary care services in developing countries. Forty-seven reports were identified from a search of both peer-reviewed and gray literature. Key issues identified were intersectoral and intergovernmental coordination; management and organizational issues including decentralization, health sector reform, logistics, and referral systems; human resources, including training and support required to increase service scope; relationships between the public and private sectors; and scaling-up and financing issues.     

Sex Differences Among College Students in Awareness of the Human Papillomavirus Vaccine and Vaccine Options

Abstract

Objectives: To explore awareness of human papillomavirus (HPV) and use of HPV vaccines (Gardasil and Cervarix) by college students. Participants: The sample was composed of 817 undergraduates at 2 northeastern US universities; they participated between February and May 2010. Methods: Students were provided with a link to an anonymous, self-administered, Web-based survey comprised of 76 questions. The survey included questions about health behaviors, awareness, and knowledge of HPV and the 2 HPV vaccines, and vaccine uptake. Results: Results indicate high levels of awareness of HPV as well as marked sex differences related to vaccine awareness and uptake. Both sexes are largely unaware of Cervarix and the differences between Cervarix and Gardasil. Conclusion: The study affirms the importance of a clinician's recommendation for HPV vaccination. Public health messaging should become more inclusive of adolescent and young adult males. College students’ awareness of HPV vaccine options mirrors Gardasil's market dominance in the United States.     

Psychosocial experiences of concussed collegiate athletes: The role of emotional support in the recovery process

Abstract

Objective: Understand from whom concussed football players seek and receive emotional support, and whether this support is associated with injury perceptions. Participants: Football players (N?=?26) from three NCAA Division I programs. Methods: With approval from the head athletic trainer, concussed athletes (2017 season) completed short surveys within 4–6?days of diagnosis and when cleared to return. Results: Concussed athletes perceived their injury as a normal consequence of playing football, not serious, and reported little, if any, depression and anxiety. Athletes reported the most support from athletic trainers; the least from coaches and teammates. Emotional support was associated with fewer adverse psychosocial reactions, more sport-injury related growth, and greater intentions to report future concussion symptoms. Conclusion: Results from this pilot study suggest that emotional support during the concussion recovery process should be understood and fostered by university officials charged with the health and well-being of collegiate football players.     

Uptake of HPV vaccine in traditional-age undergraduate students: Knowledge,behaviors, and barriers

Abstract

Objective: This study investigated potential factors associated with HPV vaccine uptake in a diverse population of traditional-age undergraduate students. Participants: One hundred and twenty-nine undergraduate students aged 18–24 attending a small southeastern university completed surveys in January to March of 2013. Methods: Questionnaires included demographic information, basic HPV knowledge, HPV vaccine uptake, and factors influencing uptake decision. Survey results were analyzed with chi-square and t-test analyses. Results: Vaccine uptake was significantly higher in students who reported that health care provider, public health information, parents, and access to vaccine were important factors in their decision to get vaccinated. Female students had a significantly higher vaccine uptake in comparison to males and the HPV knowledge scores differed significantly by race but not gender. Conclusions: It is especially important to consider how public health campaigns and communication with parents and health care providers help promote HPV vaccine uptake in this high-risk group.     

Protecting the economic health of the poor in India: Are health mutuals the right medicine?

In addition to government‐sponsored health insurance schemes (GSHIS), many microfinance institutions (MFIs) and community‐based organizations (CBOs) in India have started microinsurance health insurance schemes. These include health mutuals for the benefit of their members. This article explores these as an alternative health‐financing model in India. A literature search produced 926 relevant publications. After applying advanced search options and removing duplicates, abstracts of 324 papers were read and then 47 papers reviewed, and finally 29 were included in this review. Five key themes emerged: (1) “Health for all” arguments and opportunities in favour of micro health insurance schemes; (2) micro health insurance products; (3) impact of micro health insurance schemes; (4) systematic irregularities and regulatory framework; and (5) innovation. We also look at the emerging market patterns that will define micro health insurance products. Health mutuals can effectively provide mass health protection to the poor and not so poor through efficient business models, bespoke benefit packages and multiple payment plans. They can reduce financial vulnerability and improve health outcomes. While GSHIS can cover a substantial tranche of expected health‐related costs, the balance can be supplemented through innovative financial products that reduce financial risk.     

Proposing a model for promoting Children's Health in Early Childhood Education and Care Settings

This pilot study was conducted in one early childhood pre-school nursery setting in an area of high deprivation in England to explore the under-researched area of how practitioners promote the health of children. The research used an original tool, Child Health Promotion: A Toolkit for Early Childhood Education and Care Practitioners, containing a 5 Step Programme as a model to guide practitioners in identifying and implementing a health promotion activity. The findings will help to set the onward agenda for a larger scale study which will foreground the voices of practitioners and highlight the role that ECEC practitioners can play in promoting the health of children.     

Heart checks in college-aged students link poor sleep to cardiovascular risk

Objective: To describe the relationships between the cardiovascular health, lifestyle behaviors, and lifestyle beliefs among college-aged students.

Participants: Seven hundred and twenty-nine college-aged students participated between October 2016 and April 2017.

Methods: Heart checks, consisting of a cross-sectional survey and biometric screening, were conducted on a large Midwestern university campus.

Results: A small proportion of students (24.5%) engaged in the recommended 150+ minutes of physical activity per week and 7.9% consumed 5+ servings of fruit/vegetables daily. Half (49.6%) slept 7 hours or less per night. Biometric screenings found that 26.4% of the students had high stress, 31.9% were overweight or obese, and 17.3% had prehypertension or hypertension. Less sleep was significantly associated with higher risks of being stressed, being overweight/obese, and having elevated blood pressure.

Conclusions: Early detection, treatment, and education is critical to identify individuals at risk for cardiovascular disease and to promote healthy lifestyle changes before heart disease develops or progresses.     

Dietary Sodium Intakes and Food Sources of Sodium in Canadian-Born and Asian-Born Individuals of Chinese Ethnicity at a Canadian University Campus

Abstract

Objective: To document the sodium intake and food sources of sodium of Canadian-born Chinese (CBC) and Asian-born Chinese (ABC) individuals at a Canadian university campus. Participants: Healthy adults aged 18–58 years originating from Canada, China, Hong Kong, or Taiwan were recruited from the University of Alberta (n = 40 CBC, n = 41 ABC) between May and December 2010. Methods: Two in-person multipass 24-hour dietary recall interviews were administered for 1 weekday and 1 weekend day. Results: The mean sodium intake was 3,623 ± 1,406 mg/day. The major food sources of sodium were commercially prepared and processed foods for both CBC and ABC (59.9% and 54.7% of sodium, respectively). Condiments contributed substantially to dietary sodium intake of CBC and ABC (27.8% and 35.1% of sodium, respectively). Conclusions: Efforts to reduce dietary sodium among students and other adults of Chinese ethnicity should focus on limiting consumption of commercially processed foods and moderation in discretionary use of salt and soy sauce.     

Adoption of an Outdoor Residential Hall Smoking Policy in a California Public University: A Case Study

Abstract

Objective: Because secondhand smoke is a public health concern, many colleges have adopted bans to ensure healthier environments. This study demonstrates how outdoor smoking policy change can be accomplished at a large public university. Participants: The participants were 1,537 students housed in residential communities at the University of California, Berkeley, who completed an online survey. Methods: A proposal for smoke-free residential communities that included student resident survey data was prepared. Results: The survey data indicated that most students (77%) were bothered by secondhand smoke, and most (66%) favored smoke-free environments. The data were used to advocate for a change in the residential community smoking policy. Conclusion: The survey data and institutional comparisons played a key role in administrators’ decision-making about campus smoking policy. Despite administrators’ concerns about students’ safety and freedom of choice, student-led advocacy was able to influence policy change.     

Lifetime exposure to abuse,current stressors,and health in federally qualified health center patients

ABSTRACT

Purpose: The purpose of this study was to examine the impacts of lifetime exposure to abuse and current stressors on health, an integrative concept of physical, mental and social health, among patients of a Federally Qualified Health Center.

Method: The sample included 1,055 patients (male: N = 346; female: N = 709) who were at least 18 years of age and completed an assessment on their first visit between January 2015 and March 2017 at a Federally Qualified Health Center. The assessment contained subscales of the DUKE Health Profile measuring physical, mental, and social health; four questions assessing lifetime exposure to abuse; and a relational and socioeconomic stressor checklist.

Results: Results from structural equation modeling analyses showed that for both male and female groups, lifetime exposure to abuse, relational stressors and socioeconomic-related stressors were strongly associated with health. In the male group, socioeconomic-related stressors were the strongest predictor of health, while in the female group, lifetime exposure to abuse was the strongest predictor of health.

Conclusions: Understanding the relationships between health and the combined factors of a lifetime exposure to abuse, relational stressors, and socioeconomic stressors can provide insight to patient care professionals who treat patients in lower income, underserved communities. Ecological Systems Theory provides a framework to plan interventions or to prevent potential negative outcomes associated with these stressors.     

Social Entrepreneurship in Communities

The United States ranks low on many measures of population health. In addressing this societal problem, nonprofit health conversion foundations are emerging as important, local social entrepreneurs. We investigated the processes by which these organizations create and implement locally situated innovative approaches to promote health and wellness. Using an inductive, qualitative approach, we identified central themes by which conversion foundations, as social entrepreneurs, developed collaborative solutions to health. We found that they defined the social problem, generated social capital in the community, and educated potential partners. These mechanisms helped build a groundwork for collaboration among community actors. Conversion foundations then convened partners with complementary competencies to develop creative solutions. This research contributes to the literature on social entrepreneurship and nonprofits by expanding understanding of how foundations can foster community collaborations to develop innovative solutions to social problems. Further, this study sheds light on the activities and processes of nonprofit health conversion foundations as actors with the potential to improve population health.