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Background: The rates of annual visits for adult Medicaid enrollees to the emergency department (ED) are increasing. Many programs throughout the country are focused on engaging patients in the use of their primary care providers (PCP) rather than the ED for low acuity conditions. It is unclear, however, the proportion of patients who are willing to use primary care services rather than the ED if they are given the choice. Methods: Cross-sectional study of adult Medicaid enrollees (18 y and older) presenting to a large, urban, academic ED from June to August 2012 with a low acuity condition was performed. We excluded patients who did not have a PCP or active Medicaid insurance. Our primary goal was to determine the proportion of patients who prefer to use the ED, rather than their PCP clinic, if an appointment was immediately available. Our second goal was to understand why patients would prefer ED over PCP care. Results: A total of 150 patients agreed to complete the survey, and 95 (63.3%) met our inclusion criteria. Forty-three patients (45.3%) stated preferring to use their PCPs rather than the ED if an appointment was available at that time. Thirteen (48.1%) cited that the ED had more technology or specialty care services available when compared with their PCP's clinic, 8 (15.4%) were in significant pain, and 6 (11.5%) felt the care they received in the ED was better than what they would receive in their PCP clinic. Conclusions: Our study shows that a little less than half of adult Medicaid enrollees presenting to the ED with low acuity conditions would have preferred to use their PCP rather than the ED, if an appointment had been immediately available.

Despite prevention efforts of colleges and universities across the nation, there have been no substantial decreases in heavy episodic drinking among undergraduates over the past 2 decades.This study provides an update on correlates of heavy episodic drinking for a recent cohort of undergraduate college students.A cross-sectional survey design was utilized. Participants were randomly selected undergraduate students from a public 4-year university located in the Northeast.Heavy episodic drinking was associated with male gender, white race, having a family history of drug or alcohol abuse, smoking cigarettes, and using marijuana. Age, athlete status, completion of an alcohol education program, condom use, depression, anxiety, and financial stress were not associated. After controlling for gender and race, marijuana use and smoking cigarettes were found to increase predictability of heavy episodic drinking.Rates of heavy episodic drinking remain high but correlates may be shifting for this cohort of college students. Opportunities to address heavy episodic drinking concurrently with cigarette smoking and marijuana use should be explored.Qualitative research methods are needed to gain insight into reasons for heavy episodic drinking; information that could inform the creation of more effective programming. © 2014 Copyright © SHAPE America.

Empirical data support the benefits of physical activity for women who have been diagnosed with breast cancer. However, the experience of exercising during or after breast cancer treatment has not been fully documented. The purpose of the researchers in this study was to provide an in-depth description of women's experiences with exercising during or after their breast cancer treatments, specifically, their perceptions of the benefits they experienced as a result of participation in an individualized exercise program that included cardiovascular and resistance activities. Forty-five women who had been diagnosed with breast cancer within the previous two years were recruited from two oncology practices after electing to enroll in an exercise program. Data were collected between September 2006 and August 2007 through in-depth interviews at various stages in the exercise program and analyzed simultaneously using thematic analysis methods. Whether in treatment or post-treatment, women attributed psychological, physical, and social benefits to their participation in the exercise program. Participants credited the program with helping them to feel better, regain control over their bodies and their lives, manage their emotions, and prepare them to live healthfully going forward. These results provide insight into the specific ways women experience exercise during and after their breast cancer treatments.

Objective: To explore the psychosocial effects of living with polycystic ovary syndrome (PCOS) through the experiences of young women diagnosed with this endocrine disorder. Design: A qualitative, phenomenological methodology was used. Data were obtained through personal, semistructured interviews. Setting: College campuses in New England. Participants: A purposive sample of 12 young women with PCOS age 18 to 23 years. Results: The following themes emerged from analysis of participants' responses: concerns for older self, feeling physically inferior, coping with symptoms, patient-provider relationship, seeking useable information and support, and coming to terms with a chronic condition. Conclusions: Participants in this study faced numerous physical, social, and emotional challenges on a daily basis. As these young women gathered information relevant to their needs, sought and received social support, and maintained their daily routines to improve their health and appearance, they came to terms with this chronic condition. Based on participants' relayed experiences, it became evident that a need exists for health care practitioners to include psychosocial support in a comprehensive holistic plan for the treatment of PCOS in adolescents and young women in their early twenties. JOGNN, 40, 709-718; 2011. DOI: 10.1111/j.1552-6909.2011.01299.x

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.

Community-based participatory research (CBPR) is a collaborative methodology that uniquely involves stakeholders in all stages of the research process. CBPR has been widely utilized in the field of public health, but not widely employed with college populations. This study utilized CBPR methods within a college community to gain insight into excessive alcohol consumption. Six student researchers planned and carried out a rigorous qualitative study at a public university in the Northeast region of the United States. A total of 48 undergraduate participants were recruited for focus groups that were facilitated by two student researchers, and transcribed and analyzed using thematic analysis methods. Students' reasons for drinking alcohol were focused within the themes of inclusion, habitual default, and the student development process. Social media, strict policy/enforcement, and student's desire to avoid responsibility led to increased risk and consequences related to drinking. Students recommended late night transportation and a Good Samaritan policy as strategies to improve student safety. This study led to student advocacy and policy change directed at improving student's health and safety and demonstrated that CBPR methods show promise for engaging students and producing meaningful data.

Depression and anxiety are increasingly prevalent on college campuses; however, few studies have explored these disorders among graduate students. Purpose of this study was to examine prevalence, correlates and predictors of depression and anxiety among graduate students. This cross-sectional study used secondary data (N=4477) collected as part of the Healthy Minds Study. The Patient Health Questionnaire (PHQ) was used as the screening instrument. Multiple logistic regression examined the effect of demographic and social variables on the outcome of screening positive. Results showed 14.0% screened positive for depression, 9.5% for anxiety, 19.1% for either, and 4.4% for both. Depression correlates included: race/ethnicity, nationality, living situation, relationship status and finances growing up. Anxiety correlates included: sex, nationality, sexual orientation, and current finances. Validated predictors for depression were relationship status and finances growing up. Validated predictor for anxiety was identifying as lesbian, gay, bisexual, transgender or queer (LGBTQ), while being male and international status were protective. These findings suggest depression and anxiety are as prevalent among graduates as undergraduates and provide insight into the social and demographic influences of screening positive. Health educators can use these findings to inform policy and programming for graduate students that will provide an appropriate combination of services.

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.

A wheelchair basketball showcase was hosted at a state university in New England. Student surveys revealed that the event had a positive effect on students’ views of both individuals with disabilities and adapted sports. Using Allport’s (1954) contact theory as a lens, the author demonstrates how the event met the four positive features that Allport believed should be present in order to reduce negative feelings toward another group: (a) equal status between the groups, (b) common goals, (c) intergroup cooperation and (d) the support of authorities. This exploratory study argues that adapted sports can be an effective method to positively impact stereotypical views of people with disabilities.Subscribe to PALAESTRA

Research on college substance use and mental illness is limited and inconsistent. Measures of substance use, and anxiety and depressive symptoms, were completed by 1,316 undergraduates within a major drug transportation corridor. Hierarchical linear regressions were used to test associations between anxious and depressive symptoms and substance use (i.e., alcohol, cannabis, tobacco, cocaine, other amphetamines, sedatives, hallucinogens, and designer drugs). Depressive symptoms were associated with use of cannabis, tobacco, amphetamines, cocaine, sedatives, and hallucinogens. Anxiety symptoms were unrelated to substance use. These findings support the need for education and prevention at universities, emphasizing tobacco, cannabis, and certain “harder” drugs.

Market-based approaches to addressing racial disparities have essentially re-commodified Blackness. Utilizing Hartford, which contains the largest percentage of Blacks per capita in Connecticut, this article examines market-based approaches to address racial disparities while discussing Blackness as an enduring commodity that is tied to private sector profit. The study argues that market based approaches incentivize punitive approaches to social problems associated with Blackness. The study concludes by suggesting that addressing disparities utilizing markets requires reimagining policy incentives to focus on prevention and treatment of social problems associated with Blackness. Failure to reimagine policy incentives serves to commodify Blackness whereby industries benefit from the continuity of disparities rather than the elimination of disparities.

This original study examines the reluctance of oppressed populations to publicly criticize the recognized performance shortcomings of leaders who are members of their identity group. Using critical race theory (CRT), this article utilizes three case examples of Black American leadership that present evidence of what the authors identify as Historical Persecution Reaction Complex (HPRC). HPRC describes four elemental arguments reflecting an oppressed identity group's attempt to protect itself from perceived further social marginalization, limit the exacerbation of oppression, and to preserve the identity group's leadership gains in the larger society by supporting leadership despite recognized shortcomings in the leadership. Although asserting HPRC operates as a functional reaction to oppression by serving both as an act of cohesion and resistance to oppressive structures, the authors suggest that HPRC is paradoxically detrimental to oppressed identity groups due to maintaining substandard leadership.