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Research supports that office referral data is useful in informing programmatic decisions and planning interventions such as Positive Behavior Supports (PBS). Knowledge of patterns of office referrals may facilitate development of interventions that target specific groups. This study examines patterns in office referrals within an urban district by gender, race/ ethnicity and grade. Findings reveal that there are differences by grade that appear to be related to developmental level, with more referrals for aggression in younger students (grades K-6), disrespectful behavior in middle school students (grades 7-8), and attendance problems in high school students. Gender differences in the rate and type of referrals were found, with significantly more referrals for boys' delinquent/aggressive behavior, which may relate to how schools define unacceptable behavior and the data collection method. Finally, there were significantly more referrals for African American/black students than Hispanic students, suggesting that schools consider racial differences when developing behavioral expectations.

This study identified the types of caregiver stress and the caregiver and care management characteristics that are associated with this stress. 169 caregivers were recruited from a variety of community settings that cater to caregivers in a New England metropolitan area. They completed the Zarit Burden Interview (ZBI) and a questionnaire concerning their care recipient and caregiving arrangements. Principal Components Analysis on the ZBI resulted in five factors: personal strain/loss, uncertainty/inadequacy, social strain/embarrassment, anger, and dependency. The average age of the caregiver was 59.95 years (SD = 11.75) and the average age of the CR was 83.44 years (SD = 7.88). Of the 169 caregivers, 82% were women, 61.5% daughters/in-law or wives (12.9%), 34.3% were solo caregivers; 16.8% little or no burden, 39.9% reported mild to moderate burden, 35% moderate to severe burden, and 8.4% had severe burden. Dependency (22.4%) and personal strain/loss (13.7%) had the highest proportions reported as “often” to “nearly always.” The ZBI was predicted by only two caregiver characteristics, indicating that it is not sensitive to the experiences of different types of caregivers. Caregivers experience different types of burden depending on their gender, kinship roles, and levels of involvement in the care of their older relative. Solo caregiver status and age (younger) significantly predicted most if not all 5 burden types. Solo and young caregivers experienced the highest levels of caregiver burden. Social work practice must identify the caregiver’s life stage and other and self-expectations in relation to dependency, personal loss, embarrassment, anger, or uncertainty. © 2016 Taylor & Francis.

The Reconceptualized Uncertainty in Illness Theory (RUIT) was used to investigate antecedents to, appraisals of, and ways of coping with stressful caregiving. Four focus groups with caregivers (8 males and 16 females) of relatives with dementia were conducted; 15 cared for their parents and the remainder cared for their spouses. They were recruited from an adult care center and other community settings in a metropolitan area in New England. The discussions were audiotaped and transcribed verbatim. Two researchers independently coded the transcripts. Thematic analysis was structured according to the RUIT. The study is unique in its application to caregivers as opposed to patients and to all of the elements of the RUIT. Caregivers experience uncertainty in similar ways to patients with life-altering illness. Symptom severity--lack of personal boundaries, repetitive and aggressive behaviors, and the need for constant care--was the most frequent source of stress. The appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strains, and loss of freedom. Self-improvement and self-care were important aspects of coping. Spirituality and humor were other coping skills that respondents used. Not all respondents said they were coping and some also reported that support from health care providers was not always helpful. Nurses can help improve coping by explaining the factors that contribute to caregiver strain and uncertainty, and by assisting caregivers to anticipate the effects of the caregiving role.

OBJECTIVE: This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008., PARTICIPANTS: Stratified random sampling was used to select undergraduate students enrolled in courses during spring semesters in 2002, 2004, 2006, and 2008., METHODS: Data were collected during regularly scheduled classes for 4 measures of alcohol consumption and 5 demographic categories using the Core Alcohol and Drug Survey., RESULTS: Four groups showed significant increases in both frequency and volume of alcohol consumption-students who were female, over 21 years of age or over, living off-campus, or performing well academically. There were no decreasing trends for any demographic group. These results differ from national college health surveys, which have shown alcohol use remaining steady during this period., CONCLUSIONS: Campus-specific trend data can provide unique perspectives and guide programming efforts. These trends suggest a need for new intervention strategies on this campus.

Background: Fast food establishments are available on many college campuses and, as a result, many students consume foods that are high in calories and contribute to unhealthy weight gain. Purpose: This study measured college students' knowledge of the calorie content for fast food items and whether the provision of calorie information for those foods influenced their future purchasing intentions. Method: Randomly selected undergraduate college students (N = 201) completed an online survey that measured baseline knowledge of calorie content for a fast food item and intention to purchase that item in the future. After provision of accurate calorie information, students were posttested for intention to purchase that item in the future. Results: The majority of students underestimated calorie content for fast food items. After receiving accurate calorie information, those who initially underestimated calorie content were significantly more likely to change their intention to purchase that food item in the future. Discussion: Many college students are interested in avoiding high-calorie fast food items but are uninformed about calorie content. Translation to Health Education Practice: Colleges should provide calorie information for fast food items at the point of purchase so that students can make informed decisions that will promote their health. © 2015, Copyright © SHAPE America.

The purpose of this study was to gain an understanding of the ambiguities and uncertainties experienced by a diverse group of African-American caregivers. The study applied Schlossberg's transition theory (TT) and Mishel’s revised uncertainty theory to narratives of self-identified African-American caregivers who provided care at least 5 h a week. The men (6) and women (8) were mostly unmarried, mostly caring for a parent or grandparent. The caregivers’ average age was 52 (SD = 19; ages ranged from 24 to 82 years); and the care recipients’ average age was 84 (SD = 9). Six care recipients had dementia and the remainder had multiple disease diagnoses. Narratives were obtained by in-depth interviews or focus group discussions. These were audio-recorded, transcribed verbatim professionally and analyzed independently by trained coders. Schlossberg’s TT contextualized whereas Mishel’s RUIT illuminated the characteristics of the transition, its associated uncertainty, and their relationship to the development of caregiver stress. Situational factors such as difficulties with illness symptoms of the care recipient, conflict between previous experience and current expectations and the adjustments to the new caregiving role, burdened younger caregivers more than older caregivers. Self-factors related to lack of knowledge about the illness and feelings of lack of control. Social support was predominantly provided by family members, and its absence resulted in conflict among siblings and caregiver stress. The most common coping strategies include religiosity, expectations of reciprocity, and coming to terms with the uncertainty. Understanding the feelings, perceptions and needs of caregivers in transition is tantamount to providing nursing care.

This study sought to understand why college students are food insecure and what the impact is on their academics. A generic qualitative study design was utilized that consisted of written surveys and semi-structured interviews. Participants (n = 19) self-identified as food insecure based upon their answers to the 6-item Short Form Food Security Survey Module. Two researchers independently coded the data for themes and patterns. Risk factors for food insecurity included finances, time, and lack of resources/skills to provide for healthy eating. Time and money put commuter students at risk for food insecurity. While students within this convenience sample reported negative impacts on their academic achievement from food insecurity, their coping mechanisms prioritized cost and convenience over food quality, possibly exacerbating their situation.College food insecurity is a complex issue and raw measurements may not paint a complete picture. Conflicting priorities in addition to income and time pressures mean that interventions should be tailored from current approaches. Colleges may need to find unique ways to ensure food security for at risk students within financial aid packages and/or university programs to ensure student success.

There is a lack of qualitative and strengths-based knowledge about the lived experience of transgender women of color in the US. To address this research gap, a Photovoice project was undertaken with five transgender women living in a small urban area. Thematic analysis of the participants' discussion of their photographs identified three major themes: Hope, courage, and resilience. Analysis suggests a framework for understanding these women's lived experiences and the psychosocial tools that they use to negotiate their daily lives and persevere in the face of interpersonal and structural oppression. © 2019 Nova Southeastern University. All rights reserved.

Approximately 34% of residents from New Haven’s six lowest-income neighborhoods are food insecure, significantly higher than the rest of Connecticut and country (both approximately 12%). To understand the availability, accessibility, and utility of emergency food programs, we conducted 34 semi-structured qualitative interviews with 20 food insecure residents and 14 emergency food providers. Many depend on food programs as a long-term strategy of supplementing groceries rather than a temporary solution in emergency situations; providers are struggling to meet this demand. Transportation and time are barriers to accessing food from programs. Policies and food programs should focus on disseminating accurate information, streamlining policies and practices, and supporting and expanding food programs to meet population need.

Incidence and prevalence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and other sexually transmitted infections (STIs) continue to increase among young heterosexual men and women in the United States. Although research studies examine the reasons why these young people are not engaging in safe sex behavior, many have not explored factors beyond individual behaviors. Much of the current research focuses on young women, for the most part leaving men out of the equation. In this study, a Photovoice methodology was used to examine social norms, media messaging and perceptions of responsibility surrounding safe sex practices, specifically condom use, among male heterosexual undergraduate students. Results showed that college-aged men are still prioritizing pregnancy prevention over disease prevention, which leads to assumptions that their female partners are on birth control and they do not need to use condoms. Participants pointed to media messages and condom placement that supports women’s responsibility for safer sex and condom negotiation. Future health promotion research and practice should focus on including men in the design and implementation process to address social norms and increase their sense of responsibility.

Background: Few studies have explored changing patterns of alcohol consumption among young females and differences based on race/ethnicity. Objective: This study examined differences in alcohol consumption between black and white undergraduate females and compared trends in three different measures of alcohol consumption over a 10-year period from 2004 to 2014. Methods: The CORE Alcohol and Drug Survey was used to collect data from female undergraduates attending a public university in the northeastern USA. Classes were randomly selected into the sample; class acceptance was 68% and student participation was 96%. The chi-square test examined differences between groups and the Cochrane Armitage Test for Trend assessed changes over time. Results: In 2014, for every measure of alcohol consumption examined, a significantly larger percentage of white females engaged in the behavior compared to black females. Trend analysis from 2004 to 2014 demonstrated a narrowing of this gap. Controlling for age, any alcohol use in past 30 days and binge drinking in the past 2 weeks increased significantly for black females 21 years or older. Any alcohol use in the past 30 days decreased significantly for white females under 21 years. Conclusion: These findings introduce many questions which should be explored through additional research.

Adolescent violence is a significant public health problem. The goal of this evaluation was to determine whether communication skills, relationships with adults, and relationships with peers were enhanced through participating in an after-school program aimed at reducing violence-related behaviors among urban middle school youth. Elements that helped to foster success among our population were providing a program that enabled consistent choice in recreational activities in a safe place, and also providing busing home to increase safety. A non-experimental study was conducted with 115 students who participated in the program. Bivariate, ANOVA analysis, and Kruskal–Wallis tests were carried out. Results indicated that participating in the program significantly impacted student relationships with adults and their peers as well as positively impacted their communication skills. The program was designed with purposeful activities that would address pro-social behaviors, enhance youth interest, and increase attendance. The program specifically used recreation to help foster relationships with their peers and the adults in the program, with the intention of reducing conflict, and therefore violence among the students.

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N=1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low-resource urban community settings.