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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.

As unpaid family caregiving of older adults becomes increasingly prevalent, it is imperative to understand how family caregivers are socialized and how they understand the caregiving role. This PRISMA-ScR-based scoping review examines the published literature between 1995-2019 on the socialization of potential and current unpaid family caregivers of older adults. Of 4,599 publications identified, 47 were included. Three perspectives of socialization were identified: (1) role acculturation; (2) role negotiation and identification; and (3) specialized role learning. The findings show how socialization involves different contexts (e.g., cultures), imperatives for action (e.g., circumstances), socialization agents (e.g., family), processes (e.g., modeling), and internal (e.g., normalization) and external (e.g., identification) consequences for caregivers. Future research could fruitfully explore how caregivers manage key turning points within the socialization process, disengage from the caregiving role, and negotiate the socialization and individualization processes within diverse cultural and funding contexts., (C)2021Sage Publications

To achieve healthy communities, addressing food insecurity (FI) is critical. This study describes a unique food distribution program combining a mobile Summer Food Service Program (SFSP) for children with a mobile pantry for adults. A survey (n = 153) of participants at six locations in New Haven Connecticut revealed that 36% reported FI and 76% were first-time pantry users. Three- quarters participated in SNAP, WIC, or both, and two-thirds had children who were fed by SFSP. Major federal programs do not eliminate FI, therefore local voluntary organizations are essential partners to address the food crisis caused by the COVID-19 pandemic.

The disproportionate impact of coronavirus disease 2019 (COVID-19) on African American communities necessitates an increased focus on the intersectional roles of racism, stigma, and other social determinants of health in influencing disease and mortality risk. The Weathering Framework is applied to demonstrate the dynamic interrelationships between these factors and to conceptualize COVID-19 as a stressful life event that will have profound health implications over the life course for African Americans. Recommendations for population health research, interventions and policies aimed at reducing COVID-19 incidence and mortality, and mitigation of the long-term impacts of the pandemic on communities of color are discussed.

"Photovoice for Social Justice, the latest volume in Sage's Qualitative Research Methods Series, helps readers in the health and social sciences learn the foundations and applications of this exciting qualitative method. Authors Jean M. Breny and Shannon L. McMorrow approach photovoice as not only a community-based participatory research method, but as a method for social justice, centering community participants, organizations, and policy makers at the heart of this research method. Special topics relating to social justice include a focus on ethics and working with marginalized communities, sensitive concerns during data collection, and presenting the work to communities and policymakers, as well as academics. Written for students and researchers new to photovoice, this brief text takes readers from the process of conceptualizing and implementing a photovoice study to analyzing data and finally presenting the results of the study. The book concludes with suggestions for future iterations of photovoice, including web based resources and digital storytelling. The authors take into account the realities of photovoice as a method by providing practical, applied tools including sample consent forms, presentations, recruitment flyers, and photo-taking tips. Using Photovoice for Social Justice, new and experienced researchers can design, implement, and analyze their photovoice projects" --

The pandemic of respiratory disease spreading from person-to-person, named “coronavirus disease 2019” (abbreviated “COVID-19”), presents a public health emergency of international concern. This pandemic is occurring during renewed attention to the persistent issue of police brutality against Blacks in the United States. Protests have ensued to highlight perceived and observed injustice against minorities, particularly Black people. Concerns arise that these protests may complicate efforts to adhere to social distancing and increase risks of COVID-19 exposure among Black persons, who are already disproportionality affected by COVID-19 outcomes due to systemic barriers within the healthcare system and society. This article discusses police brutality against Blacks in the United States and subsequent protests, considerations for social distancing and racial disparities in health during COVID-19, and the need for policies to ensure fair and equitable enforcement of social distancing mandates. We also discuss the need for policies to improve access to COVID-19 testing, diagnosis, and management among underserved and minority communities. © 2020 Taylor & Francis Group, LLC.

BACKGROUND: Opioid overdoses are primarily discussed by the pharmacological properties of the drugs used. Research shows that other factors such as the social/physical environment and the mental/emotional states can have an impact on overdose events. Ataiants and colleagues (2020) used Zinberg's "drug, set, and setting" framework to identify circumstances surrounding overdose experiences of street-involved women in Philadelphia. The aim of this paper is to extend their analysis to a diverse sample of suburban women who experienced overdoses., METHODS: The mixed-methods design consisted of ethnographic fieldwork, in-depth interviews, and brief surveys with 32 suburban women who use opioids. Inductive theoretical reasoning and constant comparative analysis facilitated themes emerging within the "drug, set, and setting" framework., RESULTS: Eighteen out of 32 women identified "drug" as the primary factor involved in their overdose events. Major themes were an inability to identify the synthetic opioid fentanyl, lack of knowledge or control over how much to use, poly-substance use, and an insufficient understanding of risks. Eleven out of 32 women linked "set" to their overdose experiences. Themes included emotional trauma, such as death of a child, child custody issues, and mental health conditions, such as depression. Six out of 32 women associated "setting" with one of their overdose experiences. Themes were related to being with friends or partners that used, and having recently been released from treatment or incarceration., CONCLUSION: Findings show similar themes found among an urban sample, adding insight on the need for effective overdose interventions targeted for suburban populations. The opioid crisis is not confined to the cities, and neither should services aimed at addressing opioid overdose. The knowledge provided here can help policy makers support female-centered harm reduction services not only in urban areas but also in the suburbs. Copyright © 2020. Published by Elsevier B.V.

Founded in 1950, the Society for Public Health Education (SOPHE) provides leadership to the health education profession and promotes the health of all people through six strategic commitments: developing and promoting standards for professional preparation and credentialing of community and school health educators; stimulating research on the theory, practice, and teaching of health education; supporting elimination of health disparities and the achievement of health equity; providing continuing education of the health education workforce; advocating for policy and legislation affecting public health and health promotion; and supporting a network of local chapters. This article describes how SOPHE has pursued these strategic commitments during the past 70 years and discusses challenges that will influence the future of SOPHE and the contours of the research and practice agendas of the field going forward. © 2020 Society for Public Health Education.

BACKGROUND: Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities. PURPOSE: The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids. METHODOLOGICAL ORIENTATION: The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings. SAMPLE: The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years. CONCLUSIONS: Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses. IMPLICATIONS FOR PRACTICE: Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons. Copyright © 2020 American Association of Nurse Practitioners.

Background: Non-motor symptoms (NMS) are common in Parkinson's disease (PD), but their relationships to nigrostriatal degeneration remain largely unexplored. Methods: We evaluated 18 NMS scores covering 5 major domains in relation to concurrent and future dopamine transporter (DAT) imaging in 344 PD patients from the Parkinson's Progression and Markers Initiative (PPMI). We standardized NMS assessments into z-scores for side-by-side comparisons. Patients underwent sequential DaTSCAN imaging at enrollment and at months 12, 24, and 48. Specific binding ratios (SBR) were calculated using the occipital lobe reference region. We evaluated the association of striatal DAT binding at the four time points with each baseline NMS using mixed-effects regression models. Results: Multiple baseline NMS were significantly associated with DAT binding at baseline and at follow-up scans. REM sleep behavior disorder (RBD) symptoms showed the strongest association – mean striatal SBR declined with increasing RBD symptom z-score (average of time-point-specific slopes per unit change in z-score: βAVG = −0.083, SE = 0.017; p < 0.0001). In addition, striatal DAT binding was linearly associated with increasing baseline z-scores: positively for the memory (βAVG=0.055, SE = 0.022; p = 0.01) and visuospatial (βAVG=0.044, SE = 0.020; p = 0.03) cognitive domains, and negatively for total anxiety (βAVG= −0.059, SE = 0.018; p = 0.001). Striatal DAT binding showed curvilinear associations with odor identification, verbal discrimination recognition, and autonomic dysfunction z-scores (p = 0.001, p = 0.0009, and p = 0.0002, respectively). Other NMS were not associated with DAT binding. Conclusions: Multiple NMS, RBD symptoms in particular, are associated with nigrostriatal dopaminergic changes in early PD. © 2020 Elsevier Ltd

Health education and promotion researchers and practitioners are committed to eliminating health disparities, and the Society for Public Health Education (SOPHE) has continuously supported this effort through its journals, professional development, annual conferences, and advocacy. The COVID-19 pandemic elucidated inequities directly caused by racism and other social determinants of health. In order to achieve health equity, we need to become antiracist in our research, practice, and advocacy work by standing united against racist policies and practices. I invite us all to heed the call to action on these five points: place racism on the agenda, practice cultural humility, claim your privilege and eliminate microaggressions, utilize strategies that promote inclusion and equity, and embrace your inner leader and activist. Just as SOPHE as an organization pivoted its annual conference from on ground to virtual in March 2020, so can we be innovative and brave as professionals to face the hard work and dedication needed to become antiracist., (C)2020Sage Publications