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In the current U.S. military operational environment, it has been estimated that up to 700,000 troop years (cumulative years of service including multiple tours of duty) have been logged over the past decade since offensive campaigns began, following the September 11, 2001, terrorist attacks (Smith, Benight, & Cieslak, 2013). With this influx of eligible beneficiaries, the utilization of Veterans Administration (VA) education benefits more than doubled between 2001 and 2012 (U.S. Department of Veterans Affairs, 2013). This study examined the relationship between peer emotional support and perceived self-efficacy and their implications for, or relationship to, mental health morbidities in a postsecondary educational setting. The study included 39 matriculated student-veterans at an accredited postsecondary institution in New England. Participants answered 32 questions related to three constructs: perceived self-efficacy, peer emotional support, and mental health morbidity. It was found that a moderate, but significant, positive correlation exists between perceived self-efficacy and peer emotional support in student-veterans. A moderate but significant negative correlation was uncovered between perceived self-efficacy and mental health morbidity. In addition, this study found that first-year students report significantly lower peer emotional support than seniors and graduate students. It was also found that those veterans with only one deployment reported significantly greater self-efficacy than those who had deployed twice. This study serves as a conduit into future research on the multifaceted issues facing student-veterans. Copyright © 2017, Association for Continuing Higher Education.

An interpretive qualitative approach insists on the plural and negotiated nature of the meanings that humans attach to their social realities. Thus, the qualitative researcher must navigate multiple and sometimes conflicting commitments to method, data, oneself, participants, and one’s reader. This can lead us to obscure the messiness of data analysis in final research reports and to downplay how methodological choices can make our participants ‘say things.’ In this article, we compare two interpretive methods, thematic and narrative analysis, including their shared epistemological and ontological premises, and offer a pedagogical demonstration of their application to the same data excerpt. However, our broader goal is to use the divergent results to critically examine how our choice of analytic method in interpretive research influences how we (researcher + method) ‘author’ data stories. Ultimately, researcher reflexivity must go beyond acknowledging how one’s position may influence the data analysis or the participant. © 2019, © 2019 Australian and New Zealand Communication Association.

When our photovoice research intersected with the COVID-19 pandemic, we were thrust into a new world of adapting the method in the virtual environment. Between both authors, we had over two decades of experience implementing photovoice. However, that involved tried and true methods of working face to face and side by side with people in community-based settings. This article describes lessons learned from two virtual photovoice projects. One involved pivoting from a project already well underway in person to online and the other was designed for virtual implementation since that was the only option available. Key considerations discussed are navigating our institutional review boards, adapting project management, building community online, and sharing results and advocacy for social change. Dilemmas and key decisions in each of these areas are described for practitioners and community-based researchers who need or seek to transition their photovoice research to the virtual environment. Practical tips and strategies for implementation are described and offered to photovoice researchers.

Relationship strain or dissolution between new parents can affect the co-parenting relationship and parenting engagement. The purpose of this study was to evaluate the effect of a relationship-strengthening intervention on parenting behaviors among adolescent couples. Data from a pilot randomized control trial conducted with predominantly Black and Latino couples were analyzed using repeated measures analysis of variance. Observed intervention * time effects and intervention * time * gender effects were not statistically significant, but had small to moderate effect sizes. Intervention couples demonstrated increased parenting sense of competence compared to control couples. Gender differences in intervention effects were observed for both parenting experiences and parenting engagement. Given the pilot nature of the study, these findings provide preliminary evidence of the effectiveness of this couple-based intervention for improving parenting outcomes. Future research should assess the intervention in a larger sample and leverage technology-based approaches as methods for content delivery. © The Author(s) 2022.

Black women faculty and administrators in the United States are tackling a force of socioeconomic and racial disparities, emotional tolls and invisible burdens within academia, political turmoil, social unrest, and public health crises. COVID-19 has added an additional layer related to work responsibilities, the overall well-being of Black women faculty and administrators and the diverse students they encounter, and management of work and home responsibilities. This paper discusses perspectives and evidence-based strategies regarding Black women faculty and administrators who navigate academia and teach during times of COVID-19 and social unrest. We also outline strategies for university leaders to mitigate cultural and racial gaps in the classroom or workplace and foster diversity and inclusion in academia. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

COVID-19, the pandemic of highly contagious respiratory disease, presents a global public health emergency. The COVID-19 pandemic has increased awareness of the role of public health and its professionals in responding to the pandemic. Racial and ethnic minority groups in the United States are more likely to contract and die from COVID-19 versus Whites, highlighting health disparities. Higher education schools and programs in public health can help prepare students to address this global pandemic through expanded curriculum on social determinants of health disparities in COVID-19 outcomes, teachings on implicit bias and anti-racism, interprofessional education, and practice-based learning. Moreover, eliminating health disparities is a leading public health priority in the United States and can help attain the World Health Organization goal of achieving health equity. This chapter highlights the need for public health curriculum that outlines strategies to address racial and ethnic disparities in COVID-19 to prepare and motivate a future healthcare workforce. How to cite this chapter: Njoku, A. (2022). COVID-19 and health disparities opportunities for public health curriculum enhancement. In  R. Ammigan, R. Y. Chan, & K. Bista, (eds), COVID-19 and higher education in the global context: Exploring contemporary issues and challenges (pp. 139-153). STAR Scholars. https://starscholars.org/product/covid-19-and-higed/

Black and Latinx communities have faced disproportionate harm from the COVID-19 pandemic. Increasing COVID-19 vaccine acceptance and access has the potential to mitigate mortality and morbidity from COVID-19 for all communities, including those most impacted by the pandemic.To investigate and understand factors associated with facilitating and obstructing COVID-19 vaccine access and acceptance among Black and Latinx communities.This community-partnered qualitative study conducted semistructured, in-depth focus groups with Black and Latinx participants from March 17 to March 29, 2021, using a secure video conferencing platform. Participants were recruited through emails from local community-based organizations, federally qualified health centers, social service agencies, the New Haven, Connecticut, Health Department, and in-person distribution of study information from community health workers. A total of 8 focus groups were conducted, including 4 in Spanish and 4 in English, with 72 participants from a diverse range of community roles, including teachers, custodial service workers, and health care employees, in New Haven, Connecticut. Data were analyzed from March 17 to July 30, 2021.Interviews were audio-recorded, transcribed, translated, and analyzed using an inductive content analysis approach. Themes and subthemes were identified on the acceptability and accessibility of the COVID-19 vaccine among participants who identified as Black and/or Latinx.Among 72 participants, 36 (50%) identified as Black, 28 (39%) as Latinx, and 8 (11%) as Black and Latinx and 56 (78%) identified as women and 16 (22%) identified as men. Participants described 3 major themes that may represent facilitators and barriers to COVID-19 vaccinations: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access.The findings of this qualitative study may impact what health care systems, public health officials, policy makers, health care practitioners, and community leaders can do to facilitate equitable uptake of the COVID-19 vaccine. Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic. Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19.

The COVID-19 pandemic has disproportionately affected racial and ethnic minority groups in the United States. Although a promising solution of the COVID-19 vaccination offers hope, disparities in access again threaten the health of these communities. Various explanations have arisen for the cause of disparate vaccination rates among racial and ethnic minorities, including discussion of vaccine hesitancy. Conversely, the role of vaccine accessibility rooted in structural racism as a driver in these disparities should be further explored. This paper discusses the impact of structural barriers on racial and ethnic disparities in COVID-19 vaccine uptake. We also recommend public health, health system, and community-engaged approaches to reduce racial disparities in COVID-19 disease and mortality. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Di-2-ethylhexyl phthalate (DEHP) exposure is widespread in the general population and previous research has suggested that it contains endocrine-disrupting properties that can adversely affect the reproductive health system. The objective of this study was to use the 2013–2016 National Health and Nutrition Examination Survey (NHANES) data to assess the potential association between DEHP exposure and infertility in women. Using a nationally representative, cross-sectional study design, we used multiple logistic regression to measure the association of urinary metabolites of DEHP with self-reported history of infertility among women. Four metabolites of DEHP were examined: mono(2-ethylhexyl)phthalate (MEHP), mono(2-ethyl-5-hydroxy-hexyl)phthalate (MEHHP), mono(2-ethyl-5-oxy-hexyl) phthalate (MEOHP), and mono(2-ethyl-5-carboxy-pentyl)phthalate (MECPP). These metabolites were calculated into a molar sum of DEHP (∑DEHP) and split into quartiles for analysis. After adjusting for age and race, ∑DEHP was associated with increased odds of infertility for the second quartile (AOR = 2.35, 95% CI [1.24,4.44], p = 0.01) and third quartile (AOR = 2.83, 95% CI [1.57, 5.10], p ¡ 0.01) when compared to the first quartile (reference). The adjusted OR for the highest quartile of ∑DEHP found no association and it was not statistically significant (AOR = 0.99, 95 %CI [0.57, 1.73], p = 0.98). The findings of this study add to the already complex existing literature on phthalate exposure and infertility. These findings warrant further population-based cohort studies on phthalate exposure and their relationship to infertility in humans. © 2021 Elsevier Inc.

Objective: Even healthy college students are vulnerable to severe complications associated with seasonal influenza (flu). Despite national directives to increase influenza vaccination compliance, college campuses remain woefully below national goals. This study aimed to identify factors correlated with the decision to voluntarily receive an influenza vaccine. Additionally, students’ reasons for non-vaccination were also examined. Participants: 1021 undergraduate students across four professional schools. Methods: A representative cross-sectional survey was conducted at a public, urban university. Results: The survey measured self-reported influenza vaccination: an overall influenza vaccination rate of 38% was identified. Student characteristics associated with increased influenza vaccination included students’ enrollment in academic health disciplines; being female; human papillomavirus (HPV) vaccination; and no marijuana use in the last month. Barriers to influenza vaccination included contraindications, mistrust issues, and personal reasons. Conclusion: Universities that can identify facilitators and barriers to voluntary influenza vaccination can assist with program initiatives to improve influenza vaccination compliance rates. © 2021 Taylor & Francis Group, LLC.

Objective: Increasing BMI, overweight, and obesity are urgent and grave problems in the US. The goal of this study is to begin to understand trends in overweight and obesity among undergraduate students in the U.S. to assist in informing public health education and health promotion practices. Methods: Data on self-reported weight and height were collected in 2012, 2014, and 2016 from randomly selected college students who were enrolled in a public university in Northeast US. Spearman's Rank Order Test was used to evaluate trends within specific demographic categories. Results: BMI increased for almost all studentsfrom 2012-2016. Groups with significant increases in BMI included: males, females, sophomores, and seniors. Conclusions: Results suggest the need for interventions to reduce increases in overweight and obesity that are experienced during college years. College is a critical transitional time when students adopt health behaviors that they continue into adulthood. Increasing BMI in college students indicates a need for additional research to understand the factors that contribute to the increasing trend of overweight and obesity in this population. College is an optimal setting for implementation of effective interventions that can help prevent BMI increases in this population and establish healthy behaviors for the future. Keywords: Overweight, Obesity, College Students, BMI, Spearman’s Rank, Interventions

Adolescence is an important time for addressing health, including mental health, obesity, substance use, and food insecurity. As the myriad health and wellness needs of community members expands, it becomes increasingly difficult for one profession alone to address these needs. The park and recreation field was founded to address the health and wellness needs of people, and much of their programming is focused on youth. Thus, municipal park and recreation departments are becoming increasingly involved in collaborative partnerships with other health-serving agencies within their community. This study explored park and recreation directors’ experiences in collaborating with health agencies to better address health and wellness factors that affect the youth in their communities. This phenomenological qualitative study employed in-depth interviews with park and recreation directors and used thematic analysis. Nine interviews were conducted from four of the six New England states. The most common health concern seen by the directors was mental health, primarily behavioral health challenges. Parks and recreation collaboration with public health organizations ranged from none to close collaborations; directors regularly spoke about wanting to strengthen their collaborations. Public health and park and recreation staff have similar challenges with staffing and resources; additionally, they have complimentary skills with regard to planning and implementing health-related programs. For that reason, creating purposeful collaborative partnerships between public health agencies and park and recreation departments, focused on measurable outcomes, may increase benefits to the health of youth in a community.

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.1 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, self-esteem, and self-efficacy to take medications).

This paper explores narrative literature as a means of inquiry into the sense of self in depression. Described as a disease, an identity and a way of life, depression is influenced by both internal and external factors. Although brain research has provided new insight into the relationship between neurotransmitter function and depression, the symptoms are experienced by individuals whose lives are intertwined with historical and sociocultural interpretations of illness and its manifestations. At the intersection of science and the humanities, narratives aid in the interpretation of lived experiences, provide a window to that experience, and a public medium that engages writers and readers as they interpret the world. Engaging narratives to interpret both experience and medical jargon may reveal for both those experiencing depression and those engaged in their care, a way of mediating that experience. Narratives can help dissect and thus illuminate the official language of medicine and psychiatry and the personal language of depression. Such a window can enhance the opportunities for empathy and care.

Women of childbearing age who misuse opioids are a particularly vulnerable population, and their barriers to treatment are unique because of their caregiver roles. Research on treatment for opioid use generally draws from urban and rural areas. This study fills a gap in research that focuses on barriers and motivators to opioid treatment in suburban areas. The aim of this study was to give voice to suburban pregnant women and mothers caring for children while using opioids. Ethnographic methods were used for recruitment, and 58 in-depth interviews were analyzed using a modified grounded theory approach. Barriers to medication-assisted treatment (MAT) included stigma, staff attitudes, and perceptions the women had about MAT treatment. Barriers associated with all types of treatment included structural factors and access difficulties. Relationships with partners, friends, family, and providers could be barriers as well as motivators, depending on the social context of the women's situation. Our findings suggest increasing treatment-seeking motivators for mothers and pregnant women by identifying lack of resources, more empathetic consideration of social environments, and implementing structural changes to overcome barriers. Findings provide a contemporary understanding of how suburban landscapes affect mothers' treatment-seeking for opioid dependence and suggest the need for more focus on emotional and structural resources rather than strict surveillance of women with opioid dependence who are pregnant or caring for children. Copyright © 2021 Boeri, Lamonica, Turner, Parker, Murphy and Boccone.

Background and Objectives: This study investigated the behavioral and psychological correlates of strength and balance training (SBT) participation among older African Americans. Research Design and Methods: A cross-sectional survey of 90 older African Americans (M = 66.7 ± 8.7 years; 70% female) was conducted to assess correlates of intention to undertake SBT exercises and the number of days that they currently engage in SBT. The Theory of Planned Behavior (TPB) and the threat appraisal of the Protection Motivation Theory (PMT) were used as frameworks for the analyses. Results: The intention to do SBT exercises was positively associated with favorable attitudes and subjective norm, knowledge about the benefits of SBT, and hours worked per week. The frequency of SBT participation was significantly correlated with behavioral intention, high fear of falling, and a low score on the kinesiophobia scale. Discussion and Implications: This study demonstrated the utility of the TPB and PMT's threat appraisal construct in modeling intention and number of days of SBT participation among African American older adults. The study affirmed the link between intention and behavior and between knowledge of the benefits of SBT and intention. Fear of falling's positive association with days of SBT suggests that respondents' saw SBT's efficacy in reducing falls. The unique contributions of this study are the inclusions of kinesiophobia as a correlate and multiple threat appraisals in the PMT. Health promotion interventions should consider the interrelationship among these constructs. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.