Dissertations / Theses on the topic 'Young adults' health'

In this qualitative descriptive study seven homeless young adults in a northern town in Alaska were interviewed for the purpose of finding out how they cared for their health. The common barriers experienced by the participants in caring for their health were identified as hunger, absence of shelter, inattention to health, and the act of asking for help. Common facilitators described by the participants were access to food, resources, support system, and goals. Based on the findings nurses understanding the effects of hunger, lack of sleep, lack of support, and the stress of being homeless will be better able to assess the needs of homeless young adults. Findings support increased knowledge of resources in the community of practice and the culture associated with homelessness to facilitate the young homeless adults' health care and support them in their endeavors to secure a better future. Building a relationship with resource agencies within the nurse's community will enable the nurse to seek the assistance homeless young adults require for meeting their basic needs.

Thesis (Ph.D.)--Indiana University, Dept. of Applied Health Science, 2006.
Source: Dissertation Abstracts International, Volume: 67-04, Section: B, page: 1953. Advisers: Michael Reece; Stephanie Sanders. "Title from dissertation home page (viewed June 19, 2007)."

Abstract The aim of this epidemiological study was to investigate the oral health situation and associated factors among a group of Finnish healthy males born in the early 1990s. A pilot study was carried out in two garrisons of the Finnish Defence Forces in July 2010 to evaluate and time the various parts of the protocol (n = 256 men and women). In the main study, oral health of 13,564 men and 255 women who entered the military service in 2011 was screened for restorative treatment need (DT), dental history (DMFT) and periodontal status (CPI and BOP). In this cross-sectional study, a representative sample of the entire group of draftees in 2011 was achieved by examining all conscripts in 15 out of 20 garrisons and every fifth conscript in alphabetical order randomising the subjects in the five largest garrisons. Also 8,539 men answered a questionnaire covering their smoking and snuffing habits and alcohol use as well as other behaviour and background factors. BOP was available on 6,596 conscripts. The findings suggested stagnation in the improvement or even deterioration of the caries status in young healthy males. Among the study group of young male adults, caries burden was polarised, mainly due to primary caries. Prevalence of smoking was alarmingly high (39.6%). Smoking significantly increased the odds for restorative treatment need, high BOP or high CPI and was associated with other behaviour related to poor health. Snuffing and alcohol use were not associated with caries prevalence, BOP and CPI in the study group. The importance of the place of residence to caries experience was evident, but the impact decreased when health behaviours were included in the statistical analyses. Sociodemographic factors were associated with oral health among young men. In conclusion, health behaviour of young Finnish males does not support good oral health, and therefore caries control continues to be a challenge. Both health behaviours and environmental factors are associated with oral health, which should be considered in oral health promotion
Tiivistelmä Tämän epidemiologisen tutkimuksen tavoitteena oli tutkia 1990-luvulla syntyneiden perusterveiden suomalaisten nuorten miesten suun terveyden tilannetta ja siihen vaikuttavia taustatekijöitä. Pilottitutkimuksessa heinäkuussa 2010 testattiin tutkimusprotokolla ja arvioitiin sen soveltuvuus epidemiologiseen tutkimukseen. Pilottitutkimus tehtiin kahdessa Puolustusvoimien varuskunnassa, ja siihen osallistui yhteensä 256 varusmiestä Epidemiologinen tutkimus tehtiin tammikuussa ja heinäkuussa 2011 kahdessakymmenessä varuskunnassa. Kliininen tarkastus tehtiin kaikille alokkaille lukuun ottamatta viittä suurinta varuskuntaa, joissa tutkimukseen valittiin joka viides alokas. Tutkimukseen osallistui yhteensä 13 564 miestä ja 255 naista. Heiltä selvitettiin korjaavan hoidon tarve (DT) ja hoidon historia (DMFT) sekä korkein parodontaalisen hoidon tarve indeksihampaista (CPI). Ikenien vuotoindeksi (BOP) mitattiin 6 596 varusmieheltä. Kliinisen tarkastuksen lisäksi 8 539 varusmiestä vastasi kyselyyn, jolla selvitettiin muun muassa heidän tupakointi-, nuuskaus- ja alkoholinkäyttötottumuksiaan sekä muuta terveyskäyttäytymistä ja sosioekonomisia ja -demografisia taustatietoja. Tulosten perusteella suomalaisten nuorten miesten kariologinen tilanne ei ole enää parantunut vaan jopa hieman huonontunut aiempiin tutkimuksiin verrattuna. Karieskertymä on polarisoitunut tutkimusjoukossa, ja suurin osa löydöksistä oli uusia kariesleesioita. Varusmiehistä jopa 39,6 % tupakoi päivittäin. Tupakoinnin ja lisääntyneen kariologisen ja parodontaalisen hoidon tarpeen sekä huonon terveyskäyttäytymisen välillä havaittiin yhteys. Nuuskaaminen ja alkoholin käyttö eivät vaikuttaneet todettuun kariologisen ja parodontaalisen hoidon tarpeeseen tässä tutkimuksessa. Varusmiehen asuinpaikka vaikutti kariologisen hoidon tarpeeseen, mutta vaikutus väheni, kun terveyskäyttäytyminen otettiin analyyseihin mukaan. Myös varusmiehen omalla sekä hänen vanhempiensa koulutustaustalla oli vaikutusta nuorten miesten suun terveyteen. Tutkimuksen perusteella voidaan sanoa, että suomalaisten nuorten miesten terveyskäyttäytyminen ei tue hyvää suun terveyttä, jonka takia karieksen hallinta tulee olemaan haastavaa myös tulevaisuudessa. Sekä terveyskäyttäytyminen että ympäristö vaikututtavat suun terveyteen, mikä on tärkeä pitää mielessä terveyden edistämistyössä

Background: Health Care Transition (HCT) describes the purposeful, planned movement of adolescents from child to adult-orientated care. The purpose of this phenomenological study is to uncover the meaning of transition to adult centered care as experienced by Young Adults with Cerebral Palsy (YA-CP) through the research question: What are the lived experiences of young adults with cerebral palsy transitioning from pediatric to adult healthcare? Method: 6 females and 3 males, aged 19 -25 years of age, who identified as carrying the diagnosis of cerebral palsy without cognitive impairment were interviewed. Giorgi's (1985) method for analysis of phenomenology was the framework for the study and guided the phenomenological reduction. Results: The lived experiences of YA-CPs transition to adult health care, expressed from the data is expert novices with evidence and experience based expectations, negotiating new systems (effective/ineffective) interdependently (parents and provider support) accepting less than was expected. Conclusions: More information and support is needed for the YA-CP during transition to ensure a well-organized move to appropriate adult-oriented health care that is considerate of the lifelong impact of the disorder. Nursing's role as advocate, mentor and guide can optimize the individual's response to the transition process.

Obesity is becoming an increasing health concern for young adults. There have been numerous studies on the potential predictors of obesity. However, few studies have researched the predictors of obesity in young adults. Guided by the health belief model, this quantitative cross sectional study investigated the potential predictors of obesity in young adults. The 2011 Behavioral Risk Factor Surveillance System was used to gather data on the potential predictors of obesity, including physical activity, health care coverage, excessive alcohol consumption, and demographic characteristics on 1,511 young adults, aged 18-34 years, who were living in New York State. Data were analyzed using a combination Pearson correlation and multiple regression analyses. The findings on physical activity were statistically significant and revealed that physical activity had the strongest association to young adult obesity. The study provides information for public health professionals that can be used to develop more effective obesity interventions targeting young adults. The implications for positive social change include improving young adult health through the reduction of obesity rates and the promotion of physical activity.

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged 18 to 26 from the northeastern region of New Jersey who were currently engaged in the use of tobacco products participated in open-ended interviews. Research questions were designed to investigate young adults' views and perceptions regarding cigarette use and to explore information regarding how smoking-related communication received from family members influenced young adults' decision to smoke. The theory of planned behavior and social learning theory provided the theoretical underpinnings and consistent themes by young adults from the study. Van Manen's data analysis strategy demonstrated thematic reports from young adults that behaviors, habits, attitudes, communications, including verbal and nonverbal cues and practices are learned from their parental figures in the home environment. Recommendations for future research include exploring young adults from other geographical locations regarding their perspectives toward tobacco use. This study may promote positive social change for the public and health practitioners by providing insight on family interactions regarding smoking behaviors for young adults..

Transitioned perinatally HIV-infected patients may be at increased risk for poor outcomes, yet the impact of transition and of transition programs on health are not well understood. This research examined: (1) post-transition mortality, (2) engagement in adult HIV care, (3) transition experiences, and clinical and sociodemographic influences, including transition program exposure. Data were collected from patients who had transitioned from a Florida pediatric clinic to adult HIV care between January 2003 and September 2012. Post-transition mortality and care engagement were assessed in a retrospective analysis of medical record data. Fisher exact and Kruskal-Wallis tests were used for significance testing. Risk ratios (RRs) were calculated to assess strength of associations. Stratified analysis controlled for confounding. Transition experiences were examined in a mixed-methods study, with qualitative data from a computer-assisted survey subjected to thematic analysis. Of 51 transitioned patients, nine (18%) had died by May 2014, five (56%) in the first post-transition year. Of 42 survivors, 33 were eligible; 27 (82%) provided consent. Post-transition mortality was high, particularly in those severely immunosuppressed (CD4 count <100/mm3; RR =6.0, 95% CI =1.88-19.19 [P=.005]) at transition. When controlled for CD4 count, employment was associated with decreased (adjusted RR= 0.19; 95% CI=0.04-0.88 [P=.02]), and high school non-completion with increased (adjusted RR= 3.0; 95% CI=1.37-6.40 [P=.07]) mortality risk. The number of kept HIV appointments decreased from last pre-transition (Median = 5, IQR 4-6) to first post-transition (Median = 2, IQR 1-10; P=.002) year; the proportion of poorly engaged increased from 3% to 35% (P=.006), with no significant changes between first and second post-transition years. Non-Hispanic black and low-income participants were less likely to be regularly engaged in adult HIV care one year post-transition. Transition program exposure did not significantly affect mortality or care engagement. Most of 27 received transition services, but 59% had trouble doing well in adult care. Needs for patient-centered care, with caring, personal patient-provider relationships and accessible HIV care, characterized post-transition experiences. This research suggested that transitioned perinatally HIV-infected young adults are at risk for poor health outcomes. Systematic programs using a socio-ecological framework to include multi-level interventions and post-transition support may improve outcomes.

Background: Obesity has emerged as a major public health problem across the globe. Unfortunately, all the efforts, to date, to treat obesity have limited success. Despite the increased publicity on health and economic consequences, its prevalence continues to rise, even in countries that were previously battling under-nutrition. The annual weight gain which may lead to obesity if it remains uncontrolled, is small, averaging 0.7-1.0kg/year. Aiming to halt this small weight gain could be a solution towards combating the obesity epidemic and thus reduce its prevalence. One of the critical life stages where weight gain occurs is the transition between adolescence and young adulthood and especially evident in those attending higher education in the US. There is very limited data from the UK on the magnitude of weight gain in this population. This thesis aimed to explore the weight changes occurring during that life-stage, identify factors affecting those weight changes, explore weight gain prevention data and design and test interventions aiming to prevent any weight gain. Methods: Several studies were carried out during this PhD programme in order to answer all the research questions. Three systematic reviews were employed to examine 1) weight changes in young adulthood, 2) weight gain prevention studies in young adulthood and 3) the effect of calorie-labelling on calories purchased as an anti-obesity measure. A pilot study was carried out to test and explore methodologies for collecting data from young adults on lifestyle and lifestyle changes. A qualitative study was carried out to supplement the data from the pilot study on the importance of any weight changes for young adults. A prospective cross-sectional study was carried out to examine the weight changes and lifestyle changes occurring during the first year of studies in young adults. An interrupted time-series study was carried out to test the hypothesis that calorie-labelling might have an effect on preventing weight gain in young adults. A cross-sectional study was carried out to test the effect of calorie-labelling on sales and choices in independent catering facilities where young adults represent a significant proportion of the customers. Lastly, a randomised trial was carried out to test the hypothesis than on-line programmes based on two different behavioural theories could help young adults to avoid any unwanted weight gain. Results: The systematic literature review of weight changes in young adults identified 27 studies reporting a mean weight increase of 0.7-3.75kg in those attending higher education. The pilot study examining methodologies and weight changes in young adults attending higher education in the UK found a weight increase between 0.5-5.5kg by 56% of the participants and the best recruitment method to be the on-line method compared to mail or in-person recruitment. The prospective study that looked at weight changes among first-year students attending a large university in the UK found a weight change of 1.8kg in a 9-month period. Baseline weight explained 48% of the variation observed in weight changes. Despite the belief that physical activity or consumption of fruit and vegetables is linked to weight management, neither of these protected against weight gain. The literature review on weight gain prevention studies among young adults, identified twelve studies (five of those conducted in higher education settings). Six of the studies found an effect on preventing weight gain or maintaining weight. No specific techniques were identified to be more effective as the studies that found an effect followed similar techniques with those that did not. The systematic review and meta-analysis on the effect of calorie-labelling on calories chosen/purchased identified seven studies. Overall, there was no effect of calorie-labelling on calories chosen/purchased, however customers noticing the calorie-labels, reduced the calories chosen/purchased by 124.5kcal. Students are generally supportive of the presence of calorie information in a range of products and settings including alcohol products. In the time-interrupted study which was conducted over two years, young adults that were exposed to calorie information did not gain the expected weight observed in young adults in the same setting in the year prior to the implementation of calorie-labelling. The cross-sectional study conducted in an independent catering outlet examined the effect of calorie-labelling on sales of products. Prominent calorie-labelling led to substantial reduction in sales of all labelled products but mostly among those that were high calorie products. The randomised controlled trial led to weight loss among those who were randomised to the intervention groups while those in the control group gained the anticipated weight over a 9-month period. Conclusion: Young adults in the UK gain weight when starting higher education. The weight-gain is similar to that observed in young adults in higher education in other countries but higher than the weight gain observed in the general population. Interventions based on different behavioural models were all successful at abolishing this weight–gain. Applying these interventions in a larger scale or making them part of future public health policies could be a significant step towards halting the obesity epidemic.

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open heart surgery can influence young adults' attitudes and behaviors towards adopting a heart healthy lifestyle. The theory of health belief model and the theory of reasoned action were used in guiding this research. A quantitative design involving observation and administration of surveys was used. A survey with questions about participants' lifestyle practices was administered prior to observation of open heart surgery and 3 or more months afterwards. A total number of 179 young adults at baseline were considered eligible for the study. Ages of the research participants were between 18 and 35 years old. The t test and ANOVA results showed no significant differences between baseline and follow up data with regards to changes in behaviors of young adult students towards adopting a heart healthy lifestyle. The study concluded that observing live heart surgery did not significantly change behaviors of the students in adopting a heart healthy lifestyle. In order to achieve the desired changes in attitudes and behavior of students, looking into other evidence based options and pursuing those that can influence and motivate young adult students to adopt a heart healthy lifestyle can be a positive social change.

Thesis (Ph. D.) -- University of Maryland, College Park, 2006.
Thesis research directed by: Counseling and Personnel Services. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.

Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2006.
Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the School of Public Health." Discipline: Public Health; Department/School: Public Health.

This dissertation examines the health insurance status of young adults during the transition to adulthood. In a series of three essays, I analyze what happens as young adults reach important milestones and the effects of public policies. The first essay is a descriptive study on how insurance status changes after reaching age 19 and graduating from college. The likelihood of becoming uninsured rises sharply once turning age 19 and then peaks at age 23. While the proportion uninsured also increases following college graduation, this increase disappears after one year. The second essay analyzes the effect of a dependent age law in New Jersey, which allowed dependent coverage for young adults up to age 30 and did not require full-time student status. Pennsylvania did not pass a law and was used as a control state. Among 19-to-22-year olds, there was a rise in health insurance coverage in New Jersey relative to Pennsylvania. There also was a negative effect on college enrollment in New Jersey relative to Pennsylvania. The final essay considers other unintended consequences of dependent age laws. Using a national dataset, I estimate that there were no clear effects on decisions related to living arrangements, marriage, and full-time employment.

Health is a multidimensional, holistic, concept integrating physical and mental health. In childhood, the most common cause of physical disability is Cerebral Palsy (CP). For individuals with CP, health and well-being is impacted by the complex interactions among their physical impairments, activity, participation and environmental barriers. Although CP is considered non-progressive, secondary conditions (pain and fatigue) and their functional consequences have been found to worsen as the individual with CP ages. While preliminary evidence shows that many of the physical impairments (pain, fatigue, depression) reported in adults with CP begin during late adolescence, there is little information about the role personal and environmental factors, impairments, activity limitations, and participation restrictions have on health and well-being of young adults with CP.

To understand the health and well-being of young adults with CP, the International Classification of Functioning, Disability and Health (ICF), a World Health Organization framework, guided the selection of survey instruments for this study. Surveys were sent to 610 young adults (18-30 years) with CP. 95 surveys were returned, 55 were self-reported and 40 were completed by proxies. Increasing severity of impairment was associated with decreased participation in daily activities and social roles, while loss of ambulatory ability, pain, fatigue, depression, and activity level did not differ by severity of impairment. Environmental barriers restricted the level of participation only for the self-report participants. Health status was decreased in those who self-reported increased pain, fatigue, and depression; offset by emotional support. Life satisfaction was decreased by depression and poor health; offset by emotional support.

Addressing the physical impairments, activity limitations, participation restrictions, personal factors and environmental barriers impacting young adults with CP requires coordinated efforts among the medical, educational and vocational systems. These efforts need to begin early with appropriate assessment and treatment of impairments, provision of assistive technologies and augmentative communication, and adaptation of the environment to facilitate participation in activities and social roles. The health and well-being in young adults with CP can also be improved with enhanced emotional support beyond the family unit through peer support groups, mentors, and other adult role models.

Lyme disease is the most prevalent arthropod-borne (tick) disease in North America. The disease is more prevalent in some Eastern and Central states than in Western states. The general problem is that, in southern California especially in Los Angeles County, both patients and practitioners fail to recognize the disease, resulting in misdiagnosis and delayed treatment. Consequently, the patient may develop the long-term, chronic Lyme disease (CLD). The purpose of this phenomenological study was to explore the impact of CLD on the health-promoting behaviors of ethnically diverse young adults from similar educational and socioeconomic backgrounds based on their lived experiences. The geographical focus of this study was restricted to Los Angeles County, California, because researchers have demonstrated a general lack of awareness of CLD as well as a gap when it comes to representing CLD clients from diverse ethical and socio-economic groupings. Data were collected from face-to-face semistructured interviews of 9 participants, based on the health belief model constructs on an ethnically diverse group of young adults clinically diagnosed with CLD. Data were coded and explored for themes. Key results of the study include the existence of excellent health prior to CLD, marked declined in health status because of the disease not being recognized or properly treated, and the use of various modalities of treatment including conventional antibiotic treatment and complementary and alternative treatments to combat the disease. Social implications of this study include increased awareness of physicians and the community in the Los Angeles County of Lyme Disease as an emerging epidemic, development of preventive measures against this disease, and generation of rich data and propositions regarding CLD for further research.

Background and Purpose: According to the Canadian Community Health Survey conducted in 2000-1, 12% of Canadians reported experiencing an unmet health need compared to four percent in 1994-5. There is growing reason to investigate the increasing number of Canadians reporting unmet health needs, particularly among young adults (between 18 and 30 years of age) who access health services less frequently than any other age group. In particular, the growing population of Chinese living in Canada present unanswered questions regarding the health needs of Chinese young adults. The purpose of this study was to examine: 1) if Chinese young adults who primarily speak Chinese experience more unmet health needs when compared to English-speaking Chinese young adults and, if there are, 2) the reasons why Chinese young adults have unmet health needs. Methods: A mixed methods approach was taken; in-depth interviews (n=8) with Chinese young adults were used to complement and explain findings from a secondary analysis of a larger cross-sectional survey of the primary health care seeking behaviours of Chinese-, English-, and Punjabi-speaking Canadians. Findings: Fifty-eight Chinese young adults participated in the primary health care survey; ten percent (n=6) reported having an unmet health need related to the availability and accessibility of health care. Language preference was not found to be associated with unmet health needs. Close to two out of three young adults reported seeing a physician in the past year. Twenty-four percent reported accessing health care outside of Canada. In-depth interviews revealed that Chinese young adults had unmet needs due to the lack of a primary care provider and not accessing preventive care. Acculturation and health behaviour was found to be more predictive of unmet health care needs than language.

BACKGROUND: Personal health records (PHRs) are tools that allow individuals to access, share and manage their health information online. PHRs have received considerable interest and investment in recent years, because they are thought to have the potential to promote patient self-management and greater involvement in their own care. Despite apparent public interest and a proliferation of available options, adoption rates remain low. There is a gap in our understanding as to why people are choosing to use or not use PHRs, and what different populations of users might want from such a tool. In particular, young adults could be a potential group to target with preventative strategies using a PHR, since technology is much more integrated in their everyday life.OBJECTIVE: This qualitative descriptive study therefore aimed to explore the views and expectations of young healthy adults about using an online personal health record. METHODS: Four focus groups were conducted with a total of 29 participants (18-34 years old) from a community setting in Montreal, Canada. Interviews were transcribed and analyzed with inductive thematic analysis. RESULTS: With respect to how young adults viewed PHRs, three broad themes were identified: perceived advantages to using a PHR; future PHR users; and concerns about PHRs. In terms of what they themselves expected from using a PHR, different themes were elaborated: characteristics of an “ideal” PHR; using the PHR for preventative health; taking more control over their health; and making the PHR worthwhile. A conceptual framework of factors influencing expectations of PHR use in this population is proposed.CONCLUSION: The findings suggest that what young adults perceive as benefits of a PHR may not be the same things that motivate them to actually use a PHR. The results emphasize the fact that more research is needed to understand the expectations and anticipated use of different populations in designing a patient-centered tool. The proposed framework can be used as a basis and tested in future research on PHR adoption.
CONTEXTE: Les dossiers de santé personnels (DSP) sont des outils qui permettent aux individus d'accéder, de partager et de gérer l'information sur leur santé en ligne. Ils ont obtenu beaucoup d'intérêt et des investissements considérables ces dernières années puisqu'on considère que les DSP ont le potentiel de promouvoir une plus grande implication des patients dans la gestion de leurs propres soins. Malgré l'intérêt public apparent et une prolifération des options, les taux d'adoption des DSP restent faibles. Notre compréhension des raisons pour lesquelles les gens choisissent d'utiliser ou non les DSP et de ce que les différentes populations d'utilisateurs pourraient vouloir d'un tel outil est limitée. En particulier, les jeunes adultes pourraient être un bon groupe à cibler en ce qui concerne les possibilités de prévention avec un DSP puisque la technologie est beaucoup plus intégrée dans leur vie quotidienne.OBJECTIF: Cette étude qualitative descriptive vise donc à explorer les points de vue et les attentes des jeunes adultes en bonne santé à propos de l'utilisation d'un dossier de santé personnel. METHODES: Quatre tables rondes ont été menées avec un total de 29 participants (18-34 ans) dans un milieu communautaire de Montréal, au Canada. Les entrevues ont été transcrites et ensuite analysées avec la méthode d'analyse thématique inductive. RÉSULTATS: En ce qui concerne ce que les jeunes adultes pensent à propos des DSP, trois grands thèmes ont été identifiés: les avantages perçus, les futurs utilisateurs et les préoccupations au sujet des DSP. En terme de ce qu'eux-mêmes attendaient d'un DSP, différents thèmes ont été élaborés: les caractéristiques d'un DSP «idéal»; la contribution des DSP à la santé préventive en prenant plus de contrôle sur leur santé, et l'aspect pratique des DSP. Un cadre conceptuel des facteurs ayant une influence sur les attentes des participants à propos des DSP est proposé. CONCLUSION: Les résultats suggèrent que ce que les jeunes adultes perçoivent comme avantages d'un DSP ne sont pas les mêmes choses qui les motivent à se servir d'une PHR. Cela souligne l'importance de comprendre l'utilisation prévue et les attentes des populations d'utilisateurs spécifiques dans la conception d'un outil centré sur le patient. Le cadre proposé peut constituer une base pour de plus amples recherches sur l'adoption des DSP.

Chronic insomnia is a highly prevalent disorder in general and young adult populations, and contributes a significant economic burden on society. Previous studies have shown healthcare utilization (HCU) is significantly higher for people with insomnia than people without insomnia. One limitation with previous research is accurate measurement of HCU in people with insomnia is difficult due to a high co-morbidity of medical and mental health problems as well as varying operational definitions of insomnia. Assessing HCU in people with insomnia can be improved by applying research diagnostic criteria (RDC) for insomnia, using a population with low rates of co-morbid medical/mental health problems, and measuring HCU with subjective, objective, and predictive methods. The current study found young adults with chronic insomnia had greater HCU than normal sleepers, specifically on number of medications, and chronic disease score (CDS) estimates of total healthcare costs, outpatient costs, and predicted number of primary care visits. The presence of a medical and/or mental health problem acted as a moderating variable between chronic insomnia and HCU. Simple effects testing found young adults with chronic insomnia and a medical/mental health problem had the greatest HCU followed by normal sleepers with a medical/mental health problem, chronic insomnia, and normal sleepers. Exploratory analyses found young adults with chronic insomnia had a greater likelihood of emergency room visits and overnight hospital admissions. More efforts for early identification and intervention of insomnia are necessary to help reduce costs associated with chronic insomnia co-morbid with medical and/or mental health problems.

The objective of this thesis was to assess the acceptance of an online-questionnaire in a survey of young adults in southern Germany. The online-questionnaire was implemented in a study of respiratory diseases. Each of 280 subjects, aged 18 to 20 years, was assigned randomly to one of two groups who responded using (1) a paper-based questionnaire and (2) an otherwise identical questionnaire that was to be completed on the Internet. This group also received a copy of the printed questionnaire. Only eight subjects made use of the online-questionnaire, and the remainder of the respondents used the paper-based instrument. The major reason given for not using the online-questionnaire was that subjects considered it too time-consuming (39.7%). Additionally, 27.0% of the subjects did not have access to the Internet at home. In conclusion, the acceptance of an Internet-based questionnaire by adolescents with an Internet coverage of about 60% may still be low.

Background: There is considerable evidence that physicians lack sufficient training in facilitating transition from pediatric to adult care systems for adolescents and young adults (A/YA). While several primary care residency programs have introduced health care transition (HCT) curricula in recent years, there are few studies that assess the effectiveness of HCT teaching models. Purpose: To assess the impact of a residency education program that uses electronic health records (EHR) and other methods to teach residents how to prepare A/YA for transition to adult care. Methods: In a mixed methods, quasi-experimental research design, quantitative methods were used to measure change in knowledge, confidence and experience among 67 Pediatrics and Med-Peds residents who participated in the program. All residents and a comparison group were invited to complete a 35-item pre/post-survey; a retrospective chart review provided documentation of age-specific HCT preparation tasks completed by residents during well visits for A/YA aged 12-21. Descriptive and correlational analyses were conducted to compare differences between resident and control test scores for 5 outcome variables, and to measure resident utilization of the HCT tool in the EHR. Using the Reach Effectiveness-Adoption Implementation Maintenance (RE-AIM) evaluation model as a guide, semi-structured interviews were conducted concurrently with residents and faculty to assess program acceptability, feasibility, and other important attributes. Interviews were transcribed and analyzed using a constant comparative, iterative process. Results: Survey results showed residents (11 matched pairs) scored significantly higher than controls (13 matched pairs) in 2 of 5 outcomes: exposure to HCT learning activities (p=.0005) and confidence in providing primary care for YSHCN (p=.0377). Overall utilization of the EHR tool among 51 residents was 52.8% (57 of 108 patient visits). In interviews conducted with 16 residents and 6 faculty, both groups said that HCT training is a highly relevant need. Residents said they had little knowledge or experience in HCT prior to the intervention but felt more confident in their abilities afterwards. The HCT tool in the EHR was the only intervention element among multiple modalities that reached all study participants, with more than 80% of residents interviewed reporting they used the HCT tool "usually" or "always." Factors that influenced program adoption included accessibility of educational materials, ease of use, time constraints, patient age and health condition, and attending physicians' enforcement of the protocol. Conclusion: This study contributes to the body of knowledge concerning HCT by increasing our understanding of ways to effectively educate residents about transition preparation. Results show a positive intervention effect on selected dimensions of resident knowledge, confidence, and practice in HCT, highlighting program strengths and weaknesses. The program is distinctive in educating residents to prepare all A/YA for HCT, as recommended by major medical associations for pediatric and adult care physicians, and in its use of the EHR as a primary teaching tool, a consideration for reducing time-intensive didactic instruction. It provides a model that can be adapted by other residency and provider training programs, and suggests a need to integrate acquisition of health care self-management skills more broadly in child and adolescent health preventive care tools and policies.

As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, 95% of the time. Additionally, gender and race were explored in relationship to adherence to radiation treatment and follow-up appointments. Demographic data were first extracted from the Cancer Registry of a Midwestern Hospital. Then radiation appointments and follow-up appointments were examined for each patient, in paper and/or computerized charts, to determine adherence rates. McNemar's test was used to compare young adults and older adult oncology patients' adherence rates, and Chi-square analysis was used to explore gender and race in relationship to adherence. Results indicated a lower adherence rate to follow-up appointments for younger adults as compared to older adults, with older adults adhering 3 -½ times more than younger adults. Gender was also related to follow-up appointment adherence, with males adhering better than females. This study contributes to positive social change by increasing the knowledge base of healthcare providers on adherence rates of young adult patients and reducing the dollars spent on treatment for re occurrences.

As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.

The Health Belief Model was used to study HIV/AIDS beliefs of 419, 18 to 24 year old, never married, sexually active, heterosexual college students and predict their AIDS preventive behaviors from a larger sample of 662 college students. The structural properties of the scales used were evaluated using confirmatory factor analysis. Recent preventive behaviors were predicted in a LISREL Structural Equation Modeling analysis.

Feedback representing a performer's success for a given response has long been considered a critical factor in motor learning. Numerous studies of learning from augmented feedback have produced ambiguous guidelines for frequency design-some have recommended minimal feedback, whereas others have advocated more extensive feedback. Due to conflicting opinions regarding the frequency of Knowledge of Results, this study aimed to identify how young and old adults retain motor skills when two different frequency schedules of augmented feedback, everytrial and bandwidth are provided in acquisition. The participants performed a ballistic lever movement pattern involving four different target locations in a 1-day retention test. Behavioral outcomes and kinematic movement patterns were analyzed from two groups, young adults (20-30 years) and old adults (above 71 years) from a previously completed experiment. Results revealed that in both the age groups, bandwidth feedback promoted motor learning as compared to every-trial feedback. Further, bandwidth feedback promoted slower movements with longer durations as compared to an every-trial feedback schedule. Additionally, no significant interaction of age with any of the feedback conditions was found, suggesting that the effects of augmented feedback on motor learning are similar in young and old adults.

Suicidal behavior, including suicide attempt, may result from maladaptive explanatory patterns for past negative life events, in which a person attributes the causes of stressors to internal, stable and global factors. Conversely, an optimistic explanatory style involves perceiving negative life events as external, transient and specific, and may be related to reduced suicide risk. We examined the association between attributional style and lifetime suicide attempts in 135 college students, covarying age, race and ethnicity. Participants provided informed consent and completed an online survey. An optimistic explanatory style was associated with reduced risk of suicide attempt; this effect persisted in a model controlling for hopelessness and depressive symptoms. The manner in which an individual interprets negative life events may buffer against suicidal behavior. Therapeutic strategies to promote an optimistic explanatory style may be successful in the prevention of suicide.

ObjectiveWe examined the self-reported preparedness of hospitalized adolescents and young adults (AYA) for transition from pediatric to adult-oriented health care with regard to: 1) previous health care transition (HCT) preparation, 2) Self-Determination Theory (SDT) constructs of health self-management autonomy and competence, and 3) their perception of medical knowledge, attitudes, and concerns.MethodsFrom 2013 to 2015, 139 hospitalized patients aged 15 to 21 years completed a 40-item survey on HCT preparation, attitudes, concerns, and perception of knowledge adapted in part from validated questionnaires of the Department of Health and Human Services, Maternal and Child Health Bureau, and SDT Treatment Self-Regulation Study.ResultsFewer than 40% of all respondents endorsed previous HCT preparation such as providers discussing taking responsibility for their health, transitioning to adult providers, and only 20% had discussed future health insurance needs. Of our AYA population, 84% had 1 or more special health care needs. Older patients, female patients, and those with increased HCT preparation scores had increased autonomous motivation, positive attitudes toward transition, yet also increased transition concerns. Higher autonomous motivation and perceived competence correlated with increased perception of knowledge (P = .002, < .001 respectively) and more positive attitudes toward transition planning (P < .001, .054 respectively). Multivariate regression analysis revealed those with increased HCT preparation and those with increased perceived competence had increased perception of knowledge (β = .25, P = .005 and β = .35, P < .001).ConclusionsOur findings suggest that hospitalized AYA received limited education and preparation regarding key elements of HCT to adult-oriented health care. Moreover, those previously exposed to transition preparation efforts were more likely to have motivation and a sense of competence in HCT skills.

Electronic cigarettes (e-cigarettes) are deemed to be safer than tobacco cigarettes because they do not contain a number of toxicants and carcinogens that are present in tobacco cigarettes. However, their long-term health effects are unknown. Despite concerns surrounding this, there has been a rapid market penetration of e-cigarettes worldwide. South Africa has no legislation which specifically controls the marketing, sale and use of e-cigarettes and concerns have been raised over the increasing use of e-cigarettes by youth, who are often attracted to these novel products. This study is one of the first studies to explore the knowledge and perceptions of ecigarettes in South Africa. A qualitative approach was used to explore young adults’ perceptions, attitudes and behaviour related to e-cigarettes and assess the factors that shape those perceptions. The sources from which the participants accessed e-cigarette-related information were also explored. The study was conducted at the University of Cape Town and participants were registered male and female students at the university. Focus group discussions and individual interviews were used to collect data and thematic analysis approach was used to analyse the data. The results show that participants generally perceived e-cigarettes as healthier than tobacco cigarettes despite showing limited knowledge of the chemical constituents of e-cigarette liquid. Rather, the majority of the participants felt e-cigarettes were safer because of the pleasant smell. A pleasant smell from e-cigarettes was associated with health and the unpleasant smell was associated with danger. E-cigarettes were also viewed as a symbol of social status. The study recommends that e-cigarette awareness should be increased, and e-cigarettes should be regulated as tobacco products to alter the perception that they are safe.

Thesis (MCur)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Hypertension is on the increase among patients as found on the Routine Monthly Report (RMR) at Kayamandi Clinic. The staggering figures showed that the number of patients with hypertension between January 2009 until December 2009 was 5 754. It was further identified on the Routine Monthly Report (RMR) statistics that, more and more young adults between 18 and 40 years who are visiting the clinic for other health problems are diagnosed with hypertension and its complications. The incident rate of these young adults ranges between 151 and 340 per month. It is very alarming that some of them who are diagnosed with hypertension never return for further follow-up visits and are at risk of debilitating complications which are preventable in later life. The objectives of this study were to determine the knowledge young adult patients have of: • hypertension • the management of hypertension • the complications of hypertension. The study adopted a descriptive, exploratory design with a quantitative approach. The research question determines the research design or approach. In this case a broad overview is necessary of the knowledge young adults at Kayamandi Clinic have on the topic of hypertension. This then serves as a platform for further in-depth studies on this phenomenon. A yes/no scale was used to collect data. The questionnaire was designed in such a way that the participants could understand all the questions. The layout of the questionnaire was easy and the questions were straightforward. The questionnaires were written in English, Xhosa and Afrikaans. After the translation of the questionnaires, a second person scrutinized it for the correctness of the Xhosa translation. An interpreter assisted with the questionnaire in the Xhosa speaking community at the time of data collection, where a language barrier was anticipated. The Cronbach’s alpha test was used to test the reliability of the questionnaire. Informed consent was obtained from each participant. Permission was obtained from the University of Stellenbosch via the Health Research Ethical Committee ((HREC). Permission was also obtained from the Director: Department of Health, Western Cape Province and the authorities of the Cape Wine lands district. A statistician from the University of Stellenbosch was consulted regarding the data analysis and the interpretation of the data. Data was articulated in the form of frequency tables and histograms. The Spearman test was used to determine the correlation between variables. 10% of the participants used in the pilot study were from Cloetesville Clinic and 21% of the participants used for the main study were from Kayamandi Clinic, that is n=210 participants. The results of the study showed that for the n=172 participants that partook in the study, there was a correlation between complications and hypertension but no correlation on lifestyle management. Statistical associations were determined by using the Spearman test on a 95% confidence interval between various variables. The normal descriptive statistical analysis was completed. The implication of the results of this study is that high blood pressure can affect young and old people. Recommendations consist of on going health promotion and continuous education that include both old and young people.
AFRIKAANSE OPSOMMING: Hipertensie is aan die toeneem onder die pasiënte soos gevind in die maandelikse roetine-verslag.Die skokkende syfers soos gerapporteer in die maandelikse roetine-verslag,wys dat die aantal pasiënte met hipertensie by Kayamandi-kliniek van Januarie 2009 tot Desember 2009 was 5 754. Dit is verder geidentifiseer in die maandelikse roetine-verslag dat al hoe meer jong mense tussen die ouderdomsgroep van 18 to 40 jaar oud wat die kliniek vir ander siektetoestande besoek, met hipertensie en verwante komplikasies gediagnoseer word. Die voorkomssyfer van jongmense met hipertensie wissel tussen 151 tot 340 per maand. Dit is sorgwekkend dat sommige van die pasiënte nadat hulle met hipertensie gediagnoseer is, nie terugkeer na die kliniek vir verdere opvolgbesoeke nie en daardeur blootgestel word aan uitmêrgelende komplikasies in hul latere leeftyd wat voorkombaar is. Die doelwitte van die studie is om jong volwasse pasiënte se kennis vas te stel ten opsigte van: • hipertensie • die behandeling van hipertensie • die komplikasies van hipertensie. Die studie neem die vorm van ʼn beskrywende, verkennende ontwerp met ʼn kwantitatiewe benadering aan. Die navorsingsvraag bepaal die navorsingsontwerp of benaderring. In hierdie geval is ʼn breë oorsig nodig van die kennis van jong volwassenes by Kayamandi-kliniek oor die onderwerp aangaande hipertensie. Dit dien dan as basis vir verdere indringende studies rakende hierdie fenomeen. ʼn Ja/nee skaal is gebruik om data te versamel. Die vraelys is ontwerp op ʼn manier sodat die deelnemers dit kan verstaan. Die uitleg van die vraelys is eenvoudig en die vrae maklik. Die vraelys is geskryf in Engels,Xhosa en Afrikaans.Na die vertaling van die vraelys,is dit deur ʼn tweede person wat ook Xhosa magtig is nagegaan om die korrektheid van die vraelys te verseker. ʼn Tolk het gehelp met die vraelys ten tye van data-insamelling in die Xhosa- sprekende gemeenskap, waar taal ʼn moontlike probleem kon wees. Die Cronbach alpha- toets was gedoen om die betroubaarheid van die vraelys te toets. Ingeligte toestemming was verkry van elke deelnemer. Toestemming was verkry van die Universiteit deur middel van die Gesondheids Navorsings Etiese Kommitee (GNEK). Toestemming was ook verkry van die Direkteur: Departement van Gesondheid, Wes Kaap Provinsie en die owerhede van die Kaap Wynland streek. ʼn Statistiekus van die Universiteit van Stellenbosch was geraadpleeg aangaande die data analise. Data was geartikuleer in die vorm van frekwensies in tabelle en histogramme. Die Spearman-toets is gebruik om die korrelasie tussen variante vas te stel .10% van die deelnemers wat vir die loodprojek gebruik is, is van Cloetesville-kliniek. 21% van die deelnemers wat vir die hoofstudie gebruik is, is van die Kayamandi-kliniek , dus ʼn total van n=210 deelnemers. Die studie het bewys dat vir n=172 deelnemers wat aan die studie deelgeneem het, daar ʼn korrelasie tussen die komplikasies en die hipertensie toestand is, maar geen korrelasie met leefstylgewoontes is gevind nie. Statistiese assosiasies is bepaal deur gebruik te maak van die Spearman-toets op ʼn 95%-interval tussen verskeie variante. Die normale, beskrywende statistiese analise is voltooi. Die implikasie van die resultate van die studie, is dat hoë bloeddruk jonk en ouer mense affekteer. Aanbevelings dui op aanhoudende gesondheids promosies en voortdurende opvoeding wat jonk en ouer persone insluit.

Older adults display slower walking speeds, which could be attributed to an altered perception of optic flow (OF) speed. It has been previously demonstrated that older adults exhibit altered speed discriminations when exposed to expanding OFs. Whether these perceptual impairments explain slower and less context-adapted gait speeds in older adults remains unknown. The purpose of this study was to contrast speed discrimination thresholds and gait speed adaptations in young-old vs. younger adults. I also sought to determine whether speed discrimination and walking speed modulation abilities were related in older adults. Twelve young adults (23.0 ± 2.4 years) and twelve young-old adults (68.8 ± 4.4 years) participated in a speed discrimination experiment and two walking experiments. In the speed discrimination experiment, participants wore a head-mounted display (HMD) that displayed a virtual reality (VR) scenario depicting self-motion along a corridor. Participants were asked to choose which of two scenes that were played sequentially, moved faster. Speed discrimination thresholds were determined as the geometric mean of the last eight reversals. In the walking tasks, participants walked on a self-paced treadmill while wearing the HMD and viewing the VR scene showing OF speeds ranging from 0.25 to 2 times their comfortable speed. In the first walking paradigm, participants were instructed to walk the corridor distance of each test trial, which displayed different OF speeds, within the same time as during a preceding control trial that presented an OF matching their comfortable gait speed. In the second walking paradigm, participants were instructed to match their gait speed to the speed of the OF shown in the virtual environment. Walking speed modulation was measured as the slope between walking speed changes and OF speed changes (walking paradigm 1), and as the absolute error in walking speed with respect to the target speed (walking paradigm 2). Older adults showed larger speed discrimination thresholds, more attenuated slopes and larger errors in speed compared to their younger counterpart. Within the older group, speed discrimination thresholds were not significantly related to speed modulation abilities, as measured by the slopes and absolute errors in speed. These findings indicate that older age affects both the ability to perceive speed information from OF and to modulate walking speed in response to OF speed changes. It is suggested that poor visual motion perception may be one of the contributing factors leading to a mobility decline in older adults.
Les gens âgés ont une démarche plus lente, ce qui peut être attribué à une perception fautive de la vitesse du flux optique (FO). Il a déjà été démontré que les personnes âgées ont une capacité altérée à discriminer la vitesse de stimuli visuels décrivant des FO à différentes vitesses. On ne sait toujours pas si cette perception déficiente explique que leur vitesse de marche soit plus lente et que leur démarche soit moins adaptée aux demandes contextuelles. Le but de cette étude était de comparer le seuil de discrimination de la vitesse et l'adaptation de la vitesse de marche chez des jeunes personnes et des personnes âgées en bonne santé. J'ai aussi examiné la relation entre la perception de la vitesse et l'habilité à contrôler la vitesse de marche. Douze jeunes adultes (23.0 ± 2.4 ans) et douze adultes plus âgées (68.8 ± 4.4 ans) ont participé à une évaluation de la perception de la vitesse et à deux évaluations de la démarche. Lors de l'expérience de perception de la vitesse, les participants étaient en position assise et portaient un casque de réalité virtuelle illustrant leur déplacement le long d'un corridor à différentes vitesses. Ensuite, les participants devaient identifier laquelle des deux scènes présentées était la plus rapide. Les seuils de perception de la vitesse ont été mesurés par la moyenne géométrique des huit derniers changements de vitesse. Lors des tâches de marche, les participants marchaient sur un tapis roulant auto-rythmé en portant un casque de réalité virtuelle montrant des scènes présentées à des vitesses de FO variant de 0,25 à 2 fois leur vitesse de marche confortable. Lors du premier test de marche, les participants devaient marcher la longueur du corridor qui décrivaient des vitesses variées de FO (condition expérimentale) et ce, durant la même période de temps qu'un essai précédent illustrant un FO équivalant à leur vitesse confortable de marche (condition contrôle). Lors de la deuxième session, on a demandé aux participants de marcher à une vitesse équivalente à la vitesse du FO présentée dans l'environnement virtuel. La modulation de la vitesse de marche a été mesurée selon la pente entre les changements de vitesse de marche et les changements de vitesses du FO (premier test de marche) et avec les erreurs absolues de vitesse de marche par rapport à la vitesse cible (deuxième test de marche). Les adultes plus âgés ont démontré des seuils plus élevés de discrimination des vitesses, des pentes plus atténuées et de plus grandes marges d'erreurs de vitesse lorsque comparés aux jeunes adultes. Parmi le groupe plus âgé, les seuils de discrimination des vitesses n'étaient pas reliés de façon significative aux habiletés à moduler la vitesse de marche, tel que mesurés par les pentes et les erreurs de vitesse. Ces résultats indiquent que le vieillissement affecte autant l'habileté à percevoir les vitesses du FO que celle à moduler sa vitesse de marche en réponse aux changements de vitesse de FO. Ces observations suggèrent qu'une mauvaise perception de mouvements visuels pourrait être un des facteurs contribuant au déclin de la mobilité chez les personnes âgées.

This study bridges the gap in literature about the impact of extended family relationships on young adult depression and self-esteem. A sample of 304 undergraduate students between the ages of 18 and 21 at the University of Kentucky was recruited to complete an online survey about their immediate and extended family relationships and their mental health. The largest predictor of self-esteem and depression in early young adults is perceived social support from the family of origin, which is also moderately correlated with perceived support from extended family members. This indicates that extended family support collaborates with family of origin support to benefit self-esteem and depression levels. Depression also decreases through more positive interactions with extended family members. Males benefited less than females from extended family relationships, as evidenced by the result that closer extended kin relationships were the second largest predictor of more depressive symptoms in males. These findings inform therapists about effective ways of conducting therapy with college students and support the use of Bowen family systems therapy.

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) were used in combination as the theoretical foundation of this study. Data collection was done using an adapted version of the Health Information National Trends Survey (HINTS), the Condom Use Self Efficacy Scale (CUSES), and an adapted version of the Marin County (California) Health Department's Sexual Risk Survey. There were 128 eligible participants and analysis of the data showed that the internet was the primary source of both general health information (87.5%) and STD specific health information (75.8%). A multiple regression analysis showed that there was no statistically significant correlation between perceived susceptibility and health information seeking or sexual risk (p > .05). This can aid in positive social change by prompting additional research on the subject of STD prevention in young adults through the design and dissemination of tools for education that may reduce the rate of STDs or other health ailments.

Disparities in HIV disease continue to adversely affect Black and Hispanic populations in the United States. Racial and Ethnic Approaches to Community Health (REACH) 2010 in Broward County, Florida, used strategic communications to alert Black and Hispanic young adults of the serious threat and the choices they could make to prevent HIV infection. This study assessed the channels through which 18-39 year-old African American, Haitian, Afro-Caribbean, and Hispanic residents of 12 high AIDS-incidence ZIP-code areas obtained information about HIV/AIDS and which sources they found most helpful. In addition, this study examined how obtaining HIV/AIDS information was associated with histories of HIV testing and perceptions of risk. A secondary analysis of computer-assisted telephone interview (CATI) data sets was conducted for first-time respondents (N=7,843) in 2001-2003, 2005, and 2007. All ethnicities identified obtaining HIV/AIDS information most frequently from television public service announcements, talk shows, and programs and considered this source “most helpful.” Radio was mentioned second most frequently by Haitian respondents, but African Americans and Caribbean Islanders preferred print media: newspapers and magazines. Use of the Internet increased by 22.4% from 2001 to 2007, but very few respondents regarded the Internet as “most helpful.” African Americans, Hispanics, and Caribbean Islanders who obtained HIV information from family or friends were more likely to believe that they might become infected with HIV. Caribbean Islanders who obtained information from a church were less likely to believe they were at risk. Among African American, Caribbean, and Hispanic young adults, obtaining information from a doctor or health provider was the best predictor for reporting ever being tested for HIV. African Americans who heard about AIDS on radio stations “HOT 105” and “99 Jamz” were more likely to have been tested for HIV, as were Haitians who saw something about AIDS on a billboard or bus. Comprehensive HIV-prevention programs should incorporate culturally competent communications components to inform Black and Hispanic young adults of scientific advances in prevention, treatment, and medical care. Further research should examine how diverse ethnic groups in south Florida and elsewhere are accessing and responding to health-related information in the digital age.

Background: Agriculture is the most hazardous occupational industry for young adults. Young adults are engaging in agricultural work and interacting with common hazards, however, it is unknown how young adults are engaging with such hazards and whether administrative controls including workplace organizational factors and social influences in the workplace are associated with safe working practice. Methods: Workplace practices were examined among young adult agricultural workers (18-24). Workers responded to statements regarding their participation in six agricultural work areas, specific behaviors within each work area, risk-taking behaviors of parents, peers, and supervisors, and items about workplace organizational characteristics. A second study, conducted among swine facility workers in the Midwest, tested the effectiveness of an intervention that coupled behavioral theory with technology to increase the use of hearing protection in swine facilities. Results: Results from the cross-sectional, online survey indicated supervisor influence was more strongly associated with reported workplace behaviors than co-worker/peer or parent influence. Furthermore, organizational factors including number of hours worked each week and the presence of safety and health policies was associated with workplace behaviors Results from the intervention study suggest behavioral tracking is effective at increasing the use of hearing protection among young adult swine facility workers in the short term, however, changes in behavior are not maintained over time. Supplying hearing protection is a more effective tool in facilitating sustainable behavioral change. Conclusions: Results suggest interventions that address social and organizational factors of work to improve workplace behaviors among young adult agricultural workers should be tested.

Paralleling recent increased public awareness of transgender issues, gender nonconforming youth are coming out at increasingly earlier ages. It is important to understand the impact that family acceptance or family rejection has on the health outcomes of transgender young people, who are at increased risk of discrimination, prejudice, harassment, victimization, violence, and possible mental health issues and who are understudied. This understanding can be framed within the minority stress model and Carl Rogers' theory of self, which provide insight into how minority groups experience negative reactions from both society and an internalized sense of congruence. The purpose of this descriptive, cross-sectional, quantitative study was to measure the levels of negative health behaviors between transgender young adults who felt they had the support of their parents for their gender identity and those who did not. Data from 96 young transgender adults, between 18 and 25 years of age recruited through LGBT and transgender community organizations, were analyzed using correlation and logistic regression. Results showed significant relationships between the perception of parental support and suicidal ideation, number of suicide attempts, and illicit drug use. Findings from this study could contribute to positive social change by informing families, schools, health care providers, mental health practitioners, and policy makers about the significance of affirmative support for transgender youth. Quantifiable data regarding the impact of parental responses to a young person's gender identity could lead to the development of programs and policies leading to improved health outcomes for transgender youth.

Background: The smoking rate among young Alaska Native adults (ages 19-29) in Southeast Alaska is 70% as compared to the statewide adult smoking rate of 21%, the Alaska Native adult rate of 41%, and the overall young adult rate of 32%. Southeast Alaska Regional Health Consortium (SEARHC), the non-profit tribal health consortium serving Southeast Alaska, commissioned this research to inform development of a young adult-specific, social marketing-based smoking cessation intervention.

Methods: Using purposive sampling, 23 individuals were recruited for five focus groups and four individual interviews in Juneau, Alaska. Following a social marketing framework, the research assessed participant beliefs about the benefits and negative impacts of smoking, barriers to quitting, and preferred quit support methods, as well as participant reactions to particular anti-smoking advertisements and quit support methods.

Results: Almost all participants reported an interest in quitting smoking. Stress relief, boredom relief, relaxation, and oral satisfaction were the main benefits of smoking. Downsides to smoking included negative short-term health impacts, negative impacts on children in the extended family, and negative cosmetic impacts. Barriers to quitting included loss of listed benefits, addiction and habit, fatalism, and the high prevalence of smoking among family and friends. The preferred method of quitting was cold turkey (unassisted quitting), with very few participants reporting use of counseling or pharmacotherapy. Participants preferred high emotional level anti-smoking advertisements with either strongly negative emotional valence (e.g., fear and disgust) or strongly positive emotional valence (e.g., joy, happiness). Reaction to quit support methods was most favorable to texting support and a smart phone app, and most negative toward a smart phone video game. Reaction to counseling was strongly supportive among those who had tried it and largely but not totally negative among those who had not.

Conclusion: Young Alaska Native adults in Juneau who smoke are interested in quitting but prefer cold turkey to counseling and pharmacotherapy. They are more concerned about short-term than long-term health impacts, and they are sensitive to the impact of smoking on their appearance and on children in their extended family. Findings formed a foundation for a proposed social-marketing based intervention.

Despite the continual prevention efforts in the United States, an estimated 1 million people are infected with the human immunodeficiency virus (HIV) and 25% of them are unaware of their infection status. There are no national surveillance data available on the incidence or prevalence of HIV/AIDS in the transgender population; this absence of data is a matter for concern. Guided by the health behavior model and social cognitive theory, this study utilized a quantitative approach to examine the associations between HIV/AIDS-related knowledge, attitudes regarding HIV/AIDS and condoms, and condom use self-efficacy as predictors of condom use in African American transgender young adults--one of the most disenfranchised and marginalized groups at increased risk for HIV infection--in the District of Columbia. Descriptive statistics, multiple regression, and chi-square analyses were used to analyze the research questions. There was no statistically significant relationship found between the dependent and independent variables at last intercourse with a steady partner. However, there was a statistically significant relationship when predicting condom use in the last 30 days and last 6 months with a steady partner. There was a statistically significant relationship for predicting condom use at last intercourse and intercourse in the last 30 days among nonsteady partners. There was no statistically significant relationship found between the dependent and independent variables at intercourse in the last 6 months with nonsteady partners. The findings could inform public health practitioners to develop and implement programs targeting African American transgender populations; the findings could also reinforce the public health policies and practices in favor of this cohort.

Background: Social and health supports provided during young adulthood can have long lasting health implications. Racial and ethnic minorities will soon comprise the majority of this population in the US and are more likely to experience poverty with poor access to health services. Oral health has been identified as a health disparity for young adults in the general population as well as those living with HIV (YALWH). Identifying and addressing barriers to oral healthcare are important for the long-term improvement of overall health outcomes for YALWH.

Methods: This mixed methods cross-sectional study includes: 1) an in-person quantitative survey and a semi-structured qualitative interview of YALWH between the ages of 17 and 25 years of age, 2) an online and in person survey of general and pediatric dentists and clinical dental hygienists and 3) a focus group with dental clinic support staff of a hospital based dental clinic.

Results: YALWH expressed the importance of oral health in their lives; a clean mouth and straight white teeth impacts how they judge others and, they assume, how others judge them. Barriers to care identified across all study groups included dental insurance, HIV disclosure and dental fear.

Conclusions: Oral healthcare for YALWH can be affected by individual and systemic factors including provider communication skills, provider knowledge of HIV, limitations of healthcare delivery systems and the expectations of the individual patient. These factors are important considerations for health policy makers and oral health professionals in their efforts to address oral health disparities for YALWH.