The objective of this investigation was to examine the extent to which ecstasy use is associated with the occurrence of problem violent behaviors in a sample of African American female adolescent detainees and to determine if differences, if any, could be observed between users and non-users. Participants were 749 self-described African American females drawn from a sample of 2260 juveniles. The level of severity and variation between self-reported use of ecstasy before present incarceration and problem violent behaviors were examined using an independent sample t-test to compare the mean scores against those of non-ecstasy users. The mean age of study participants was 14.8 years (SD = 1.23). Results of the Independent t-test revealed respondents who reported using Ecstasy were significantly more likely to indicate having carried a razor, switchblade, or gun to use it (t=2.60, p=0.009) and using a weapon such as a club, knife, or gun to get something from someone's business (t=3.49, p=0.001). These findings may be used to inform the development of health preventive interventions for at-risk female adolescent juvenile offenders to reduce risk practices associated with MDMA use while incarcerated.
COVID-19 has been pervasive on college campuses. However, there is limited understanding about the impact of COVID-19 on college students at the outset of the epidemic in the U.S. This study examined a national sample of college students’ COVID-19 experiences in spring 2020, a time in which there were few studies with robust samples. COVID-19-related questions were added to two national college health surveys: the American College Health Association-National College Health Assessment III and Healthy Minds Study. Surveys were administered at 14 colleges/universities with 18,764 total respondents between March-May 2020. The sample was weighted to account for non-response, and descriptive statistics were calculated. Results indicated that one-third of students had to change living situations due to COVID-19, and two-thirds had more financial stress. Of those who sought mental healthcare, over 60% found it more difficult to access. Approximately 41% witnessed discriminatory behavior due to perceived race/ethnicity, while 5.5% experienced it personally. Most respondents adhered to recommended personal protective behaviors, but a substantial number were not consistently compliant. Students generally believed their institution’s administration and faculty were supportive. These findings demonstrate that COVID-19 negatively affected students in multi-faceted ways at the beginning of the epidemic.Institutions of higher education are critical locales for health promotion efforts to improve students’ wellbeing, and college students are an important priority population for ongoing research. These results have implications for better understanding the immediate impact of COVID-19 on college students while also providing insights and lessons learned for future public health emergencies.
Human trafficking disproportionately affects foreign-born individuals in the United States, yet identification and prevention remain fragmented across sectors. This critical review synthesizes literature published between 2014 and 2024 to analyze multilevel barriers through the Social Ecological Model (SEM) and to clarify the underutilized role of Health Education Specialists (HES, including CHES/MCHES) in anti-trafficking efforts. Searches across PubMed, EBSCO, Google Scholar, and targeted gray literature identified recurring barriers: inconsistent and culturally nonresponsive screening, limited provider training, fragmented referral and data systems, and policy environments that deter disclosure among immigrants and refugees. We mapped Health Education Specialist Practice Analysis III (HESPA III) Areas of Responsibility aligned with the National Human Trafficking Training and Technical Assistance Center (NHTTAC) Core competencies to examine conceptual alignment and practical implementation opportunities. Findings reveal substantial alignment – HES competencies in assessment, communication, implementation, leadership/management, evaluation, research, and advocacy correspond directly to NHTTAC’s expectations for trauma- and survivor-informed, culturally responsive practice. Integrating HES across SEM levels can strengthen upstream prevention, improve culturally and linguistically concordant outreach, standardize cross-sector referral pathways, and advance policy and data standards that enhance identification and continuity of care for foreign-born survivors. By naming and mobilizing this prevention-oriented workforce, health systems can shift from reactive case processing to coordinated, community-grounded strategies that better support individuals experiencing or at risk of trafficking.
Regular physical activity in children reduces the risk of chronic diseases later in life. Economically disadvantaged children are particularly at risk for physical inactivity and related chronic health conditions, making them a priority population for intervention. Wearable activity trackers may boost children's moderate to vigorous activity (MVPA). Objective This study examined if wearing an activity tracker watch (ATW) increased MVPA and step count in 34 economically disadvantaged children (8–11yrs) during a 7-week after-school program. Design A counterbalanced, within-subject design and Wilcoxon signed-rank tests compared MVPA and step count between weeks with and without ATWs. Mann-Whitney U and Kruskal-Wallis tests explored the impact of sex, BMI, and age on these differences. Results When participants wore ATWs, MVPA (median = 10.7 min, IQR = 8.7–12.6) was higher than when ATWs were not worn (median = 9.2 min, IQR = 7.4–13.4), Z = −3.67, p < .001, r = .63. Step count was also higher in the ATW condition (median = 1,268 steps, IQR = 1,164–1,613) compared to the ACC condition (median = 1,096 steps, IQR = 895–1,429), Z = −3.72, p < .001, r = .64. No significant differences were found by BMI category, age, or sex. Conclusions Despite modest absolute increases, the presence of an activity tracker during an after-school physical activity program was associated with higher MVPA and step counts, indicating that tracker reactivity may modestly enhance activity during structured programs in low-resource settings.
Mental health has become an increasingly important public health issue on college campuses. The current study examined depression, anxiety, and perceptions of institutional support for graduate and undergraduate students. Results show that undergraduate students have higher levels of depression (M = 12.5, SD = 5.98) and anxiety (M = 14.0, SD = 5.15) compared to graduate students (M = 10.03, SD = 5.05; M = 11.6, SD = 5.35, respectively). There are differences in perceptions of institutional support for undergraduate and graduate students. Undergraduate students report lower levels of perceived organizational support for health (M = 97, SD = 8.13) and organizational trust (M = 11.26, SD = 3.58) compared to graduate students (M = 28.14, SD = 8.35; M = 12.58, SD = 3.59, respectively). For perceptions of organizational diversity, undergraduate students report higher levels (M = 18.14, SD = 4.18 for undergraduate students versus M = 17.84, SD – 4.52 for graduate students). Results are also provided for students by year in school. Linear regression was done to understand how depression and anxiety is associated with institutional perceptions. As perceptions of institutional support for mental health and organizational trust go up, depression and anxiety rates go down. As perceptions of institutional support for diversity go up, depression and anxiety also go up. Institutions of higher education should provide targeted mental health programming by year in school. Institutions should also work to improve campus climate to improve mental health.
The COVID-19 pandemic represented an unprecedented challenge for the public health community. This challenge shed light on a host of social and cultural threats facing our nation. The purpose of this commentary is to examine three of these threats within the context of public health. Specifically, individualism, apathy, and polarization are presented through selected examples to advance knowledge for public health practice.
Self-management of chronic diseases is important for all age groups, especially for college students as they develop and transition to adulthood, increasing their prevalence of chronic disease risk factors. Inconvenience, lack of access, and cost may be barriers for their participation in chronic disease self-management programs. This study explored self- management knowledge and skills of a small group of college students attending a free, six-week long, telehealth-based, chronic disease self-management program led by a provider Leader and a college-aged lay Leader. Topics ranged from disease and medication management to patient-provider communication. Participants met once per week for two hours via telehealth, received a companion textbook, and were instructed through slide shows and interactive activities. The Partners in Health Scale was used to assess participant-reported, self-management knowledge and skill levels before and after the program. Participants reported significantly better knowledge and self-management of their chronic disease pre- to post-program for understanding conditions and treatments, patient-provider communication, physical activity level regulation, and symptom tracking. Results of this exploratory study suggest that telehealth-based chronic disease self-management programs for students at colleges and universities can be a clinically effective part of a support program for those whose academic and extracurricular participation are affected by their chronic condition. It is recommended that larger and more comprehensive studies be conducted in the future to confirm the current findings. Nonetheless, there is potential utility for telehealth-based chronic disease self-management program options as part of disease management programming to improve participant knowledge and self-management skill building.
School-based interventions support children’s holistic well-being by promoting mental health, fostering resilience, and enhancing social, academic, and physical development. This systematic review aimed to synthesize current evidence-based research on school mental health promotion interventions. Another objective is to analyze the reported outcomes of interventions to review current policies and available resources. A comprehensive search within MEDLINE (PubMed), CINAHL (EBSCO), and Google Scholar was conducted using different combinations of keywords “school-based”, “intervention”, “mental health”, “evidence-based”, “theory” and “promotion” by using the Boolean operators “AND” and “OR”. Studies were included from December 1, 2017, to October 31, 2024, study design (randomized control trials), age ≤ 18, all genders, and English language. Studies were excluded based on inception year, age ≥ 18 years, study designs other than mentioned above, and non-English language. Quality assessment was performed with the Joanna Briggs Institute (JBI) critical appraisal tool for randomized controlled trials. A total of 24 studies were included, identifying a total of 32 evidence-based mental health interventions. These school-based mental health promotion interventions utilized combined frameworks (n=7), cognitive behavioral therapy (n=5), mindfulness theory (n=3), mental health literacy (n=3), diathesis-stress model (n=3), WHO-approved FRIENDS program (n=2), social cognitive theory(n=1). A combination of programs and frameworks were utilized in 5 out of 24 studies. School-based interventions effectively reduce depression, anxiety, and psychosocial challenges in youth, promoting well-being. More rigorous research is needed to enhance evidence-based interventions, consider contextual influences, and evaluate broader societal benefits of empowering children in mental health prevention.
Background and Objective: Some evidence has suggested a significant decrease in physical activity (PA) during college, putting students at a higher risk of health issues. The purpose of this study was to test Gourlan and colleagues’ (2019) two-step Theory of Planned Behavior (TPB) intervention on TPB variables and PA behavior in college students. Design: Undergraduate students (n = 63, 46 females) were assigned to one of four conditions: motivational intervention, volitional intervention, volitional plus motivational intervention, and control. The motivational intervention aimed to increase participants’ attitudes, subjective norm, and perceived behavioral control. The volitional intervention educated participant on the infrastructures available to use for PA and then asked participants to create an action plan for engaging in PA. Subjective PA and the TPB constructs were measured at baseline, mid-intervention (week 4), and post-intervention (week 7). Results: Despite no significant differences between conditions, the volitional intervention appeared to be effective at maintaining or increasing attitudes, subjective norms, intentions, and perceived strenuous PA in already active college students. Interestingly, we observed that students were underestimating their PA when compared to objective data. Discussion and Conclusions: This study offers preliminary evidence regarding the volitional intervention, and provides researchers with guidelines for future research. College students who meet the recommended PA guidelines tend to underestimate their PA. Future research investigating the efficacy of the two-step TBD intervention should focus on less active populations.
Background. Many students in urban public schools are unaware that they need prescription glasses or have access to them, which can potentially compromise their academic performance. Methods. A longitudinal, retrospective, matched cohort design was employed over a three-year period. A two-way mixed analysis of variance was used to examine differences in English/language arts (ELA) and mathematics scores between students who received glasses and their matched pairs over a three-year period. Results. A total of 162 students from an urban school district in the Midwest were included in the study. There was no statistically significant interaction between receiving glasses and time on either the ELA or math standardized test scores, indicating that providing glasses to students allows them to perform at the same academic level as their matched pair, when performing at the same rate at baseline. Discussion. The school-based eye care program helps students maintain their academic performance as they matriculate through school, keeping them on pace with their peers who do not require corrective vision.
Background: Understanding college students’ attitudes, beliefs, and behaviors related to the COVID-19 pandemic is important for public health and health promotion efforts on university campuses, as well as to inform decisions and practices of administrators. The purpose of this study was to extend existing research by investigating some COVID-related variables that have yet to be clearly studied, and by examining how student responses varied by age, sex, and race. Methods: University students (N=2764) attending five universities in Florida, Louisiana, Missouri, North Carolina, and Virginia completed an online anonymous survey between October and December, 2021. Survey items addressed personal COVID-19 history, perceptions of severity and susceptibility, engagement in COVID-19 preventing behaviors, COVID-19 vaccination status, and attitudes about COVID-related university policies. Results: More than half of students (63.1%) had not contracted COVID-19 at the time of data collection, but most (96.4%) knew someone who had. Over two-thirds of the sample (67.9%) had been vaccinated at the time of survey completion. Survey responses varied significantly by gender, age, and race/ethnicity, with female, older, and African American students expressing greater concern, more often engaging in COVID-preventing behaviors, getting vaccinated against the virus, and supporting college policies regarding mandated face masks and COVID-19 vaccination. Conclusion: This study highlights significant variations in college students’ attitudes and behaviors towards COVID-19, influenced by demographic factors such as age, sex, and race
Background: While dietetics has a long history of interprofessional education (IPE), there is little evidence of IPE activities done with Health Studies students. Objective: This article describes the feasibility, strengths, and challenges of using an electronic medical record (EHR) in an IPE health promotion experience. Design/Results: Three assignments used EHR to simulate a smoking cessation client, collaborate and document patient care, and a self-reflection debriefing. A thematic analysis of assignment #1 revealed differences in patient care provided by Health Studies students compared to Nutrition students. Students generally performed well on the rubric for Assignment #2, which was the documentation of virtual teaching using either ADIME or SOAP notes (based on the student’s profession). Nutrition students, having more experience with narrative note writing, were notably more advanced. A thematic analysis of Assignment #3, a reflection paper about the IPE experience, resulted in five themes describing students’ appreciation for the importance of IPEC and skill development. Discussion: The results demonstrate that this innovative IPE teaching strategy is timely and promotes collaboration and team communication which may lead to improved education, teamwork and ultimately improved patient outcomes. The use of an online mock EHR platform to teach IPEC was determined to be feasible with these students. Conclusions: An online EHR platform to support interprofessional education between future dietitians and healthcare administrators was feasible. Students provided evidence of competence in IPE collaborations in smoking cessation care. The results of this study have future implications for IPE tobacco cessation health education and patient outcomes.
Ghana was the first country globally to receive about 600,000 Oxford-AstraZeneca vaccine doses from the WHO-backed Covax program in February 2021. Ghana’s initial plan was to vaccinate about two-thirds of its adult population by the end of October 2021. This necessitated the selection of vaccination centers across the country. This study analyzed vaccination centers location against other factors, including COVID-19 cases, population density, and poverty level to assess the efficiency of each center's location in Greater Accra Metropolitan Area (GAMA). Our study applied spatial-analytical techniques to access the spatial coterminous distribution of COVID-19 cases with vaccination centers within GAMA. Hotspot analysis of cases was performed using kernel density tool and compared to hotspots of vaccination centers. Nearest neighbor analysis and error differential ellipse were performed to access the spatial pattern of the distribution of COVID-19 vaccination centers within the GAMA. This study revealed three local clusters of COVID-19 cases in Tema East municipality, Ayawaso Central, and Ablekuma West; three vaccination hotspots, found in Ashaiman, Madina, and AyawasoCentral localities. COVID-19 case clusters are not coterminous with vaccination centers. The top three vaccination clusters were found in Ashiaman, Madina-La Nkwantanan, and Kpone-Katamanso which are inhabited by indigenous populations and also recorded the lowest COVID-19 cases. Tema East and Ayawaso East, which have the highest number of COVID-19 cases, recorded the lowest number of vaccination centers. We conclude that need-based allocation is lacking in the distribution of vaccination centers, which partly affects the equitable access and spatial distribution of COVID-19 vaccines.
The challenge healthcare faculty are encountering when discussing cannabis education with students is the effect that misperceptions, media influence, and lack of evidence can have regarding cannabis care. This article shares an innovative teaching strategy and qualitative results based on increasing intellectual humility using the Collective Rethinking Model. The instructional design of this study included three assignments: a role and responsibility analysis, a more nuanced conversation about cannabis, mental health, and athletes, and promoting student curiosity using a virtual cannabis field trip. Each assignment consisted of a cannabis-related activity followed by a written response (n=99). These responses were coded, and thematic analysis was confirmed by the research team. For the role and responsibility analysis assignment, themes reflected existing stigmas and a new awareness of evolving cannabis research. For the nuanced conversation assignment about cannabis, mental health, and athletes, the results identified three themes: concern for the ethics of the suspension, the need for more research regarding cannabis and PTSD care, and an increased awareness of the inconsistencies in drug policies from a global perspective. The last assignment designed to promote cannabis curiosity used a virtual cannabis field trip. It demonstrated curiosity across a broad spectrum of cannabis industry topics and issues. The results demonstrate today's healthcare students have curiosity about their potential role in cannabis care. The lessons learned from this study have implications for designing nursing and interprofessional health curricula that rigorously and creatively engage students in the practice of cannabis care, mental health promotion, ethics, regulation, and industry.
Purpose: Various factors related to the victim and perpetrator in sexual assault have been shown to affect people’s perceptions of the sexual assault. The purpose of this study was to fill a gap in the literature and analyze how age of the victim might influence perceptions of a sexual assault. Method: University students over the age of 18 (n=400) completed a paper and pencil survey to examine rape myth acceptance, ageism, and sexual assault classification after reading a hypothetical scenario in which the victim was either 21 or 65 years old. Results: Most participants classified the scenario as sexual assault regardless of condition, however, participants had higher odds of sexual assault classification when the victim was 65 compared to when she was 21, regardless of ageism scores. Conclusions: These findings can have implications within the legal system where incorrect decisions may be made due to bias.
The physical, mental, and professional impacts of the pandemic on healthcare and public health workers have been widely discussed in the media and the scientific literature, but what is known about health education specialists (HES) appears to be far less. To address this gap, a brief online survey including questions from the PHQ-9 Depression Questionnaire, General Anxiety Disorder Scale, Post Traumatic Stress Disorder Scale, Brief COPE, the Transtheoretical Model, and the Health Belief Model, was sent to certified (CHES®) and master certified (MCHES®) HES. Of the 11,743 successfully delivered, 1,480 (13%) were completed. The overwhelmingly female (89%), white (71.5%), non-Hispanic (86%), respondents reported being employed full-time (80.7%) and holding at least a master’s degree (77.7%). Though approximately half of participants reported at least some level of anxiety, worry, trouble sleeping, tiredness, poor appetite or overeating, trouble concentrating, depression, and/or little interest in doing things, the majority had not sought treatment. Not surprisingly, there was a significant correlation between those who reported a notable increase in COVID-19 work hours and those who felt nervous, anxious, or on edge over the last two weeks (r=8.5, p<.05). HES frequently turned to various forms of healthy and unhealthy coping mechanisms besides professional treatment. These findings are important both to document the impact of the ongoing COVID-19 pandemic on the HES workforce, as well as to highlight the ways employers can offer appropriate support to those needing mental health interventions.
Many people understand participating in physical activity (PA) can provide both physical and psychological benefits, yet a plethora of individuals remain inactive. Understanding these factors could prove vital in development of improved intervention strategies. The purpose of this study was to better understand the relationship between Body Mass Index (BMI) and motivation to participate in PA among undergraduate pre-health students. Participants completed an online survey. A cross-sectional research design was used to examine variables: Motivation, PA, and BMI. Correlations and ANOVAs were used to assess associations and variable differences established at p < 0.05. Multiple significant associations and gender-based group differences were found which illustrate males being primarily driven by intrinsic motives, while female data suggests high motivational drive in both intrinsic and extrinsic areas. Furthermore, among BMI categories, those classified as ‘normal’ reported significantly higher levels of appearance and ‘obese’ categories reported significantly higher levels of fitness motivation. Findings illustrate how the impact of both gender and BMI on PA motivation is shifting from traditional understanding. While educated individuals may be more eager to participate in PA, they may still lack the knowledge of how to properly apply PA principles to daily life. This study controlled possible internal motivation variables by exploring those who understand the benefits of PA, which is absent in the literature. Previous research indicates that BMI inversely effects affective response to exercise, which reduces sustained PA participation, however, the solution to this may not be more literacy-based education.
Given the central role of nurses in our healthcare system for quality medical care, patient safety and ensuring optimal patient outcomes, it is important to understand their career motivations and work-related concerns. While the profession has been in existence for centuries, exploring current career motivations and work-related concerns is a key aspect of keeping the profession staffed and satisfied. A cross-sectional online survey was conducted with a convenience sample of 211 Registered Nurses (RNs) in New York State. This study sought to identify the motivation to pursue a career in nursing, including a career as an RN, as well as current work-related concerns in their primary nursing position. Personal motivators (predominantly the desire to help others) ranked as the principal reason for choosing the profession (63.8%) among respondents. Employment motivators (including job security, benefits and monetary reasons) ranked second (28.2%), and Lifestyle motivators (including hours and schedules) ranked third (8.0%). Statistical analysis examined the associations between variables of interest. Results revealed consistency across subgroups of RNs for both career motivations and current work concerns. Analyses were conducted to determine whether nurse career motivations and current work concerns differ by: demographics; education and training; licensure and employment. In consideration of the current and worsening nursing shortage, nurse attrition and retention strategies were explored within the context of nurse motivations and concerns. Understanding the career motivations and work concerns of RNs can advise both academia and healthcare employers regarding recruitment and retention strategies to ensure proper staffing for these essential healthcare workers.
The Coronavirus disease (COVID-19) pandemic presented prevention, screening, and mitigation challenges for public and primary healthcare, including university athletics. During 2020-21, student-athletes at a medium-sized university were required to undergo a COVID-19 screening program [symptom screening/surveillance testing] as a condition of athletic participation.To determine the effectiveness of the screening program in identifying athletes in this population with a COVID-19 diagnosi, prior to every athletic encounter, all 334 student-athlete participants reported any COVID-19 symptoms to the athletic training staff, body temperature was measured, and participants from three teams were randomly selected for an additional anosmia screening. All participants were subject to COVID-19 surveillance testing. For each participant, results of each element of the screening and testing processes were recorded in their electronic medical record and cross-referenced with any positive COVID-19 medical diagnosis. From 2025 surveillance tests conducted, only 32 participants tested positive. Of those, 25 (78%) experienced and reported COVID-19 symptoms to the athletic trainer immediately before testing. Onlyseven (.035%) were captured as pre-symptomatic positive tests. One hundred ten athletes who experienced symptoms, however, did not participate in an athletic encounter that day but instead self-admitted to the university health center for testing. All 110 tested positive at the health center. Experiencing and reporting COVID-19 symptoms appeared effective, and COVID-19 surveillance testing appeared ineffective, as detection measures in this study. Due to the extensive and costly resources needed, the decision to continue to implement these processes in the future will be difficult.
