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Mobile health apps have been widely considered in the healthcare sector as innovative channels to reach patients and their families. Accordingly, the aim of the chapter was to investigate factors that influence the customers' adoption of digital health apps in Algeria. The authors adopted an extende...

The college student population is among the highest risk group for contracting sexually transmitted infections (STIs) such as gonorrhea, chlamydia, and HIV. Safe sex practices, which are intended to mitigate risks associated with sexually transmitted infections, are often negated in the population of heterosexual college students. Historically, research on safe sex practices has shown that the burden of behavior change and the focus on educational efforts historically fall onto the female population. There is little published on how safe sex education for males impacts attitudes and behaviors towards safe sex practices. This community-based participatory research (CBPR) project explored heterosexual college male attitudes and behaviors about safe sex responsibilities with the goal of creating effective health promotion messages to increase safer sex. The research team comprised almost entirely of undergraduate male students, which strengthened the design and translation of results to practice. A mixed methods design was employed utilizing both focus groups and surveys as data collection (n=121). Results showed that young men are still prioritizing pregnancy prevention over disease contraction and/or testing, and relying on female partners to initiate safe sex. Implications for health promotion practice efforts on college campuses include: male-led peer education programming and support and messaging around screening and prevention of STIs. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

The use of Critical Race Theory, Photovoice, and Community-Based Participatory Research has helped uncover the root causes of issues such as systemic racism in the fields of public health and health promotion. Often, we see studies using traditional research methods to investigate potential causal factors of disparities in minoritized communities report only quantitative data. While these data are imperative for understanding the severity of disparities, quantitative-only approaches cannot address nor can they improve the critical root causes of these disparities. As a team of BIPOC graduate students in public health, we conducted a community-based participatory research project using Photovoice methodology to explore inequities in Black and Brown communities exacerbated during the COVID-19 pandemic. The participatory nature of this research revealed cumulative challenges across the social determinants of health in New Haven and Bridgeport, Connecticut. It allowed us to engage in local-level advocacy to promote health equity as our findings illuminated the need for community-led and community-engaged action. Health and racial inequities cannot be effectively addressed if public health research and programming do not collaborate with the community to build community capacity, empowerment, and trust. We describe our experiences doing community-based participatory research to investigate inequities and provide reflections on their value for public health students. As responses to health inequities and disparities become more politically polarized in the United States, it is critical for public health and health education students to use research methodologies that elevate communities that have been historically marginalized and neglected. Together, we can catalyze equitable change.

Black women in the United States (U.S.) disproportionately experience adverse pregnancy outcomes, including maternal mortality, compared to women of other racial and ethnic groups. Historical legacies of institutionalized racism and bias in medicine compound this problem. The disproportionate impact of COVID-19 on communities of color may further worsen existing racial disparities in maternal morbidity and mortality. This paper discusses structural and social determinants of racial disparities with a focus on the Black maternal mortality crisis in the United States. We explore how structural racism contributes to a greater risk of adverse obstetric outcomes among Black women in the U.S. We also propose public health, healthcare systems, and community-engaged approaches to decrease racial disparities in maternal morbidity and mortality.

Objective: Recent epidemiological research has found food insecurity to be a growing public health concern among college students. This study investigated food insecurity, mental health, and substance use behaviors among state university undergraduate students. Study Design: Cross-sectional survey. Methods: This was a secondary data analysis of the Student Health Survey. Undergraduate participants ( n = 589) completed the paper-based survey, which had an 84% response rate overall. Results: Approximately 38.5% of students were considered food insecure, 24.8% experiencing low food security, and 13.8% experiencing very low food security. Having a diagnosis of depression, experience of depressive symptoms, and marijuana use in the past 30 days were associated with food insecurity. Conclusion and Implications: Food insecurity is a serious health concern for college students. The results of this study indicate collocating food security and counseling services may enhance existing student resources to better support students facing food and nutrition insecurity, substance use, and depression.

Objective: We examined students’ perceptions and opinions regarding others’ COVID-19 mitigation behaviors and how these behaviors impacted feelings of safety and desire for on-campus engagement. Participants: Undergraduate and graduate students enrolled at a midsize regional state university during the Spring 2021 semester (n = 893). Methods: A cross-sectional survey design was utilized with an online and anonymous questionnaire. Scale means were calculated followed by ANOVAs to determine significance. Results: Two independent variables impacted students’ feelings of safety for on-ground courses and activities: living situation (on campus, with roommates) and school year (freshman/sophomores). Underclassmen were more likely to desire in-person campus engagement. Conclusions: Students showed a willingness to return to campus, but also concern over peer behaviors and remaining safe. Returning to a pre-pandemic social environment is critical for students’ mental health, and making students feel safe on campus is an important first step to return campuses to vibrant educational and social communities.

Purpose: The purpose of this study is to describe the prevalence of food insecurity among college students and its relationship to on-campus food purchasing patterns and barriers to eating a healthy and sufficient diet, including the relative cost of food items on campus compared to national chain grocery stores. Design: A campus-wide survey using stratified sampling among undergraduates and food audit. Setting: An urban public university in New England. Subjects: A total of 951 surveys completed by undergraduates. Measures: Demographic characteristics, behavioral factors and food security status (measured using the USDA 6-item short form) were collected. Method: Descriptive and multivariable analyses were conducted to describe differences between food insecure and food secure undergraduates. Results: Overall, 35% of undergraduates experienced food insecurity in the past year (response rate = 92%). Food insecure undergraduates had different on-campus purchasing patterns than their food secure counterparts. Food insecure students were more likely to report barriers to healthy eating on all measures, including prices (AOR= 8.12, P <.0001), to experience housing insecurity (AOR= 2.64, P =.001) and to report that transportation is a barrier to buying groceries (AOR= 1.63, P =.01). After multivariable adjustment, food insecure undergraduates had higher odds of being African American (AOR= 1.57, P =.031) or other races (more than 1 race) (AOR= 3.35, P =.002) compared to white undergraduates. Conclusions: Food insecure college students face a variety of barriers to healthy eating on campus, including high food pricing on campus and limited transportation options. Further research is needed to inform campus resource development, policies and programming focused on food insecurity prevention for college students. © The Author(s) 2022.

Breastfeeding has health benefits for both infants and mothers, yet Black mothers and infants are less likely to receive these benefits. Despite research showing no difference in breastfeeding intentions by race or ethnicity, inequities in breastfeeding rates persist, suggesting that Black mothers face unique barriers to meeting their breastfeeding intentions. The aim of this study is to identify barriers and facilitators that Black women perceive as important determinants of exclusively breastfeeding their children for at least 3 months after birth. Utilizing a Barrier Analysis approach, we conducted six focus group discussions, hearing from Black mothers who exclusively breastfed for 3 months and those who did not. Transcripts were coded starting with a priori parent codes based on theory-derived determinants mapped onto the Socioecological Model; themes were analysed for differences between groups. Facilitators found to be important specifically for women who exclusively breastfed for 3 months include self-efficacy, lactation support, appropriate lactation supplies, support of mothers and partners, prior knowledge of breastfeeding, strong intention before birth and perceptions of breastfeeding as money-saving. Barriers that arose more often among those who did not exclusively breastfeed for 3 months include inaccessible lactation support and supplies, difficulties with pumping, latching issues and perceptions of breastfeeding as time-consuming. Lack of access to and knowledge of breastfeeding laws and policies, as well as negative cultural norms or stigma, were important barriers across groups. This study supports the use of the Socioecological Model to design multicomponent interventions to increase exclusive breastfeeding outcomes for Black women.

Pharmaceutical products, including active pharmaceutical ingredients and inactive ingredients such as packaging materials, have raised significant concerns due to their persistent input and potential threats to human and environmental health. Discourse on reducing pharmaceutical waste and subsequent pollution is often limited, as information about the toxicity of pharmaceuticals in humans is yet to be fully established. Nevertheless, there is growing awareness about ecotoxicity, and efforts to curb pharmaceutical pollution in the European Union (EU), United States (US), and Canada have emerged along with waste disposal and treatment procedures, as well as growing concerns about impacts on human and animal health, such as through antimicrobial resistance. Yet, the outcomes of such endeavors are often disparate and involve multiple agencies, organizations, and departments with little evidence of cooperation, collaboration, or oversight. Environmental health disparities occur when communities exposed to a combination of poor environmental quality and social inequities experience more sickness and disease than wealthier, less polluted communities. In this paper, we discuss pharmaceutical environmental pollution in the context of health disparities and examine policies across the US, EU, and Canada in minimizing environmental pollution.

The current paper describes the process and results of an effort to find a way to effectively manage and diffuse prevention knowledge. This study shows the role that today's communication technologies can play in ensuring collaboration and participation in both the design and use of a knowledge management system (KMS) for prevention research, practice and policy. In the context of this study, 'prevention research' includes primary through tertiary prevention efforts consistent with general applied public health research in the US. An online Delphi study was used to engage a set of prevention research constituencies in the design of a mechanism to enhance the potential for effective technology transfer. A three-round Delphi was conducted with 58 stakeholders and key informants involved in prevention: government-level policy makers, researchers and front-line practitioners. The study resulted in consensus on 34 functions and 32 output/content elements of a proposed web-based KMS called Prevention-Effects.net. The paper also describes the implications of both the processes of development and the benefits of the proposed system for those interested in prevention.

Assisted Reproductive Technology (ART) is a modern technological tool that provides otherwise infertile individuals and couples an opportunity to conceive. As a multimillion dollar business, ART faces challenges common to other highly profitable enterprises, such as how and when to measure success. This poses ethical challenges as well, though these are unlike the ethical challenges faced by businesses which trade in consumer goods. ART makes babies. Individuals and couples seeking ART may be both vulnerable and fragile, thus ART providers must gently balance smart business practices with ethical care delivery. Applying Laura Nash's integrated approach to business ethics may offer ART providers a suitable model that combines ethically sound care with economically sound business practice. Key to Nash's approach are value creation, economic and social benefit, and relationship building. Not a short-term approach to quick business decisions, Nash's approach requires a long-term commitment as a way of doing business. © Common Ground, Deborah Flynn, All Rights Reserved.

Objectives: Assess the association of helmet use with motorcycle crash mortality and identify characteristics of riders who do not wear helmets in Connecticut crashes. Methods: Police crash data for Connecticut motorcycle crashes 2001-2007 were analyzed. Bivariate analysis and multivariable logistic regressions were performed including age, gender, seating position, road type, season, time of day, and recklessness. Results: Of the 9,214 crashes with helmet use data available, helmets were worn in 4,072 (44.2%). Non-helmeted riders, age > 18, riding interstate or state roads, in the evening or at night, and whowereridingrecklesslywere associated withhigher odds of fatality. Predictors of nonhelmet use included males, passengers, age <18 or 30 to 59, and riding in the summer, evening or at night, and on US, state, and local roads. Conclusion: Current crash data affirm that helmets reduce fatal crashes in Connecticut. A set of factors help predictnon helmeted riders to whom safety training could be targeted.

Introduction: Like medicine, public health practitioners seek to understand causes of mortality, practices of humans and issues that can change population conditions, in order to preserve and care for life. The murder pandemic has been such in Jamaica that the World Bank sponsored a qualitative study on crime in urban areas in Jamaica in the late 1990s to provide a platform to guide policy intervention and programmes. As a result this study will fill the gap in the literature by providing the evidence to support that divorce and marriage are public health concerns from the perspective of murders. Objective: To evaluate the role of divorce and marital relationships on murders. Materials and methods: The data for this study are taken from various Jamaica Government Publications. The period for this work is from 1950 through 2013. Data were recorded, stored and retrieved using the Statistical Packages for the Social Sciences (SPSS) for Windows, Version 21.0. The level of significance that is used to determine statistical significance is less than 5% (0.05). Ordinary least square (OLS) regression analyses and curve estimations were used to determine models and best fitted models. Results: On average, annually, 523 Jamaicans are murdered (± 484), with there being 9,531 marriages (±22,747) and 904 divorces (±468). Logged marriage rate and divorce rate are factors of murder rate, with both independent factors accounting for 82.2% of the variability in the murder rate. Both factors are positively correlated with the murder rate, with the divorce rate accounting for most of the variance in the murder rate (R2 = 79.2%). Conclusion: Death can be extremely devasting to families, however, murder among married couples can severely disrupt the lives of both families along with any children from such relationship. © 2014, Chevron Publishing Corporation. All rights reserved.

Purpose: Evaluate five different recruitment strategies for their capacity to enroll and retain both healthy and vulnerable older adults as part of a multiyear influenza vaccination study. Methods: We analyzed recruitment methods and other characteristics of individuals who participated in or were considered for five sequential one-year studies. Results: Of 940 screened individuals, 820 met eligibility criteria with 795 enrolled over the five-year study (307 primary participants). Among these enrollees, 63.4% were female and 95.5% were white, with mean ages of 75.3 (older group) and 30.6 (younger group). More than a half (56.7%) of the participants enrolled more than once, participating an average of 2.56 (SD=1.6) times. The majority (81.9%) of individuals recruited each year were return participants identified during earlier recruitments. Physician referrals resulted in only 5.3% recruitments. Conclusions: Recruitment and retention of study subjects, especially older adults, was facilitated by the existence of a database listing past participants.

Introduction: The educational system of Jamaica is designed whereby performance is assessed based on formal evaluation (or test). This test culture places immense pressure on students at the primary level to successful complete some examinations in order for placement into select schools. Objectives: The present study seeks to evaluate psychological stress among students who take the G.S.A.T examination in the Corporate Area schools in Jamaica and assess whether psychological stressors influence academic performance. Methods: For this research, mixed methodology was employed to investigate the phenomenon of stressors among students who took the 2013 G.S.A.T examination. For the survey instrument (questionnaire), the large volume of data were stored, retrieved and analyzed using the Statistical Packages for the Social Sciences (S.P.S.S) for Windows version 21.0 (SPSS Inc; Chicago, IL, USA). Findings: The overall academic performance of the surveyed respondents was high (75.8 ± 19.4; 95% CI: 72.4- 79.2), with students in the preparatory school (92.4 ± 4.1) outperformed those in the primary school (71.0 ± 19.4)- t-test =10280, P < 0.0001. The level of stress experienced by those in the public school was greater (29.9 ± 6.0; 95% CI: 28.9 - 30.1) than those in the private school (26.0 ± 3.9; 95% CI: 24.5- 27.4- t-test=-3.300, P=0.001). Five factors determine overall academic performance: 1) stress level, 2) parental involvement, 3) school type, 4) nervous on taking the first G.S.A.T examination and 5) school choice (traditional or non-traditional high school). The five factors accounted for 35.8 percentage points of the variance in overall academic performance (Adjusted R2). Conclusion: Parental involvement is crucial in academic performance among students who took the 2013 G.S.A.T examination and students experienced moderately high stress, which offers some insight in the examination and the information can be used to better guide policy formulation. © 2015 Bourne PD, et al.

Background: For millennia, women with multiple sexual partners have been labeled and stigmatized as whores, prostitutes, promiscuous and commercial sex workers. However, there is little literature comprehensively addressing factors related to reproductive health in this group. Aim: The aim of the current study is to elucidate the reproductive health matters of women who have multiple sexual partners. Setting and design: The data use for this research is taken from the Jamaica Reproductive Health Survey, 2007. Stratified random sampling is used to design the sampling frame. Materials and Methods: The current study extracts a sample of 225 respondents (from 7,168 women ages 15-49 years) who indicate having had multiple sex partners. Statistical analysis used: Data are analyzed using the Statistical Packages for the Social Sciences for Windows, Version 21.0. Multiple logistic regressions were used to analyze factors that explained current method of contraception. Results: Women with multiple sex partners on average are involved with men at least 9.5 years their senior, and 72% of them have become pregnant. Currently, contraception use can be explained by social class (middle class, Odds ratio (OR) = 0.08, 95% CI= 0.01 – 0.59); age at first sexual intercourse (OR = 0.90, 95% CI = 0.68 – 1.21); employment status (employed, OR = 5.07, 95% CI = 1.06 – 24.36); and marital status (married or common-law, OR = 0.09, 95% CI = 0.02 – 0.38). Conclusion: The early sexual initiation among young women is a public health problem because of the increased incidence of teenage pregnancy and increased incidence of sexually transmitted diseases, which must be addressed with the same intensity and resource allocation used to fight against Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS). © 2015, Chevron Publishing Corporation. All rights reserved.

Background: The bullying phenomenon, an aspect of aggression, has gained attention in many countries thus making it a very important issue in schools. Many studies have been done on this issue resulting in deeper analysis and review on the matter because the matter covers physical, verbal or psychological acts of aggression that may be intentional, and, which may occur once or repeated over time. Objectives: This study seeks to examine the following research questions: 1) How is bullying manifested in grades 4-6 in primary schools identified for this study?; 2) What are the specific bullying behaviours exhibited by class bullies in grades 4-6?; 3) How does the behavior of bullies affect the conduct of classes?; 4) What are the characteristics of the students who are targeted by in-class bullies?, and 5) What strategies are currently used by the teachers to deal with bullying in class? Materials and Methods: Two hundred students were conveniently identified (n = 200) for the study in the three schools of which 153 participated in the survey (i.e., response rate of 76.5%). The sample comprises of pupils in grades 4, 5 and 6, which 67 pupils in grades 4 and 5, and 66 in the 6th grade. Likewise 50 students ages 9, 10, 11 and 12 years were recruited for participation, with the least respondents being ages 9 years (46%) and the most being 11 years old (94%). Results: The principals and guidance counselor reported that the bullying phenomenon is a daily occurrence at their schools and that on a daily basis they are called upon to address at least 3 cases and a maximum of 10 cases of bullying. All the parents in this study noted that the bullying phenomenon is widespread in primary schools in St. Thomas and that schools are now considered an unsafe environment. Of the 26 surveyed parents in this research, 92.3% indicated that ‘schools are no longer fun for children to be anymore because of the bullying phenomenon. Conclusion: Now there is empirical evidence that the bullying phenomenon is creating psychological issues that extend beyond the aggressor to those around him/her. The psychology of the bullying phenomenon is far-reaching more than a social issue and as such clearly the psychology of the matter is crying out for public health efforts and/or intervention in Jamaica. © 2015, Chevron Publishing Corporation. All rights reserved.

Since the advent of medical treatments for HIV, the promotion of adherence to these difficult treatment regimens has proven critical to disease management. Three Connecticut state-funded HIV medication adherence programs were evaluated. The purpose of this process evaluation was to explore and compare the goals and modality of each adherence program, assess client and staff satisfaction, and provide recommendations for the improvement of these programs. Focus group interviews with clients and individual interviews with staff were conducted at each of the programs. Interviews were transcribed, coded, and analyzed with a code-and-retrieve method of theme identification. Focus group themes included the importance of social support on medication adherence and the “lifesaving” effect the program has had. The staff expressed that although complete adherence should be the long-term objective, more intermediate objectives should be considered (e.g., behavioral changes to increase clients’ ability, selfesteem, and self-efficacy to take medications). © 2014, 2011, 2008, 2005, 2003, 2001 by Taylor & Francis.