[show abstract][hide abstract] ABSTRACT: Firearms injuries place a unique burden on America in terms of lives lost (31,000/year), disability (70,000 nonfatal injuries/year), and economic costs ($174 billion in 2010). The purpose of this study was to examine psychiatric residency directors' perceptions of firearm access issues of the mentally ill. In late Fall 2012 and early Spring of 2013, a three-wave mailing was used to survey the membership of the American Association of Directors of Psychiatric Residency Training (N = 129). Due to the homogenous small sample size descriptive statistics were calculated to describe the responses. A total of 72 (56 %) directors responded. Almost 1 in 4 (23.6 %) thought that access to firearms by the seriously mentally ill should not be prohibited. The majority (91.7 %) supported closing the background check loophole. The majority (54.2 %) also believed that singling out the mentally ill as a group of "banned purchasers" adds to the stigma of the mentally ill (54.2 %) but a plurality (44.4 %) did not believe reporting the mentally ill to authorities would result in the mentally ill avoiding treatment. The current method of reducing access by the mentally ill to firearms is perceived by psychiatric residency directors as ineffective and burdensome to the mentally ill.
Journal of Community Health 09/2013; · 1.28 Impact Factor
[show abstract][hide abstract] ABSTRACT: Abstract Objective: This multisite study assessed college student's perceptions and practices regarding carrying concealed handguns on campus. Participants: Undergraduate students from 15 public midwestern universities were surveyed (N = 1,800). Methods: Faculty members distributed the questionnaire to students in general education classes or classes broadly representative of undergraduate students. Results: Useable questionnaires were returned by 1,649 students (92%). The majority (78%) of students was not supportive of concealed handguns on campuses, and 78% claimed that they would not obtain a permit to carry a handgun on campus, if it were legal. Those who perceived more disadvantages to carrying handguns on campus were females, who did not own firearms, did not have a firearm in the home growing up, and were not concerned with becoming a victim of crime. Conclusions: The majority of students was not supportive of concealed handguns on campus and claimed that they would not feel safer if students and faculty carried concealed handguns.
Journal of American College Health 07/2013; 61(5):243-53. · 1.45 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). METHODS: The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N = 750). A valid and reliable survey instrument was developed and a 3-wave postal mailing procedure was used to maximize the return rate (57%). RESULTS: Most school nurses (86.4%) reported that they did not have a protocol in their schools to respond to an incident of ADV. The majority of nurses reported that in the past 2 years, training to assist victims of ADV had not been provided to personnel in their schools (88.1%) and their schools did not conduct periodic student surveys that include questions on teen dating abuse behaviors (71.5%). Nurses who had a school protocol for responding to an incident of ADV perceived significantly fewer barriers to assisting victims of ADV and assisted more victims. Over half (55.3%) of high school nurses reported assisting a victim of ADV in the past 2 years. CONCLUSION: Nurses appear to need more training in ADV. In addition, nurses found a number of barriers (eg, lack of training on ADV, lack of time, and lack of private space) to assisting student victims of ADV. Schools need to establish a means for assessing the status of ADV in their student population. Schools also need to provide in-service education for school personnel regarding prevention, assessment, and interdiction of ADV.
Journal of School Health 02/2013; 83(2):127-136. · 1.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Racial/ethnic minorities are 1.5 to 2.0 times more likely than whites to have most of the major chronic diseases. Chronic diseases are also more common in the poor than the nonpoor and this association is frequently mediated by race/ethnicity. Specifically, children are disproportionately affected by racial/ethnic health disparities. Between 1960 and 2005 the percentage of children with a chronic disease in the United States almost quadrupled with racial/ethnic minority youth having higher likelihood for these diseases. The most common major chronic diseases of youth in the United States are asthma, diabetes mellitus, obesity, hypertension, dental disease, attention-deficit/hyperactivity disorder, mental illness, cancers, sickle-cell anemia, cystic fibrosis, and a variety of genetic and other birth defects. This review will focus on the psychosocial rather than biological factors that play important roles in the etiology and subsequent solutions to these health disparities because they should be avoidable and they are inherently unjust. Finally, this review examines access to health services by focusing on health insurance and dental insurance coverage and access to school health services.
BioMed research international. 01/2013; 2013:787616.
[show abstract][hide abstract] ABSTRACT: —Background: Several professional medical societies advocate for firearm safety counseling with pa-tients. Little is known about Emergency Physicians' prac-tices and perceptions of firearm safety counseling. Objective: To assess Emergency Physicians' beliefs regard-ing firearm control and their confidence in counseling pa-tients on firearm safety. Methods: A national random sample (n = 500) of the members of the American College of Emergency Physicians was sent a valid and reliable ques-tionnaire on firearm safety counseling. Results: Of the 278 (56.8%) responding physicians, those who were non-white and those who were not members of the National Rifle Asso-ciation (NRA) perceived firearm violence to be more of a problem than white physicians and those who were mem-bers of the NRA. The majority did not believe that patients would view them as a good source of information on firearm safety (63.3%) or that patients would accept them providing anticipatory firearm safety guidance (56.5%). The majority of the Emergency Department physicians did not believe firearm safety counseling would impact firearm-related ho-micides (75.2%) or suicides (70%). Conclusions: The vast majority of Emergency Physicians had never been formally trained regarding firearm safety counseling, did not believe patients would see them as credible sources, and did not be-lieve that anticipatory guidance on firearm safety would have any impact. These data may help inform Emergency Medicine residency programs on the training needs of residents regarding anticipatory guidance on firearm safety. Ó 2013 Elsevier Inc.
Journal of Emergency Medicine 01/2013; 27(1):1-10. · 1.33 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: HIV/AIDS is one of the leading causes of illness and death in the United States with individuals between the ages of 13 and 19 years being especially vulnerable for infection. The purpose of this study was to examine the attitudes, perceptions, and instructional practices of high school health teachers toward teaching HIV prevention. METHODS: A total of 800 surveys were sent to a national random sample of high school health teachers and 50% responded. RESULTS: There was almost complete agreement (99%) among respondents that HIV prevention instruction is needed. The factors that emerged as significantly influencing the attitudes and perceptions of high school health teachers about teaching HIV prevention were related to teacher preparation, training, and years of experience teaching health education. A state mandate requiring HIV prevention instruction was significantly associated with higher teacher efficacy expectations and more perceived benefits, but did not have a significant influence in relation to practices in the classroom. Characteristics of high school health teachers that were significantly related to attitudes, perceptions, and instructional practices included the instructor's age, sex, and race/ethnicity. CONCLUSIONS: High school health teachers who reported the least experience teaching health education had the least supportive attitudes, perceived the most barriers, and had the lowest efficacy and outcome expectations related to teaching about HIV prevention. Whereas these findings support the importance of teacher preparation and training, they also suggest that more recent college graduates may not be fully prepared to provide effective instruction in HIV prevention.
Journal of School Health 11/2012; 82(11):514-521. · 1.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: The presence of firearms in an environment significantly increases firearm trauma. So far, four states have passed legislation permitting the carrying of concealed handguns on university campuses and several other states are considering such legislation. The purpose of this study to assess the perceptions and practices of college faculty regarding support for carrying concealed handguns on their campuses. A valid and reliable questionnaire was sent to a random sample of 1,125 faculty at 15 randomly selected state universities in five Great Lakes states. A two wave postal mailing in the Spring of 2012 was conducted to help ensure an adequate response rate. A total of 791 (70 %) of the faculty responded. The vast majority felt safe on their campuses (98 %) and were not supportive of people carrying concealed handguns on their campuses (94 %). Seven of the eight potential disadvantages of carrying concealed handguns on campus were supported by the majority of faculty members. Those who were significantly more likely to perceive there to be disadvantages to carrying concealed handguns on campus were: those who did not own a firearm (OR = 4.89), Democrats (OR = 4.52) or Independents (OR = 2.25), Asians (OR = 2.49), and females (OR = 1.51). The vast majority of faculty felt safe on their campuses and perceived that carrying concealed handguns on campuses create more risks than benefits to the campus environment. Aggressive efforts are needed to help maintain the uniquely safe environment of college campuses.
Journal of Community Health 10/2012; · 1.28 Impact Factor
[show abstract][hide abstract] ABSTRACT: INTRODUCTION: The purpose of this study was to determine the perceived likelihood of emergency nurses reporting to work during an avian influenza outbreak, to consider options if nurses decided not to report work, and to explore Protection Motivation Theory constructs as predictors of reporting to work. METHODS: A descriptive, nonexperimental, cross-sectional survey of emergency nurses within the United States. RESULTS: A total of 332 nurses (46%) responded. Most emergency nurses (84%) reported they would report to work (1 in 6 would not). The likelihood of reporting to work differed by education level, nurses' avian influenza information sources, and nurses who had family living with them. Of the nurses who decided not to report to work, the majority were willing to provide health information (90%), administer vaccinations (82%), and triage (74%) neighbors/friends from home. One third of nurses had not attended a disaster-preparedness drill within the past year. Only 20% identified formal training while on the job as a source of avian influenza information. A third of emergency nurses would be worried about getting an avian influenza vaccination because of potential adverse effects. Protection Motivation Theory accounted for almost 40% of the variance of likelihood to report to work, with response costs being the largest predictor. DISCUSSION: Disaster drills, avian influenza job training, and vaccination education are necessary to prepare emergency nurses for an outbreak. The findings support emergency nurses' willingness to work from home if they are unable to report to work. This finding is new and may have implications for disaster planning, staffing, and ED operations.
Journal of emergency nursing: JEN: official publication of the Emergency Department Nurses Association 10/2012; · 0.36 Impact Factor
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: This study aimed to gauge state legislators' level of support for evidence-based obesity reduction policies. METHODS: A list of 17 potential obesity reduction measures was sent via a valid and reliable survey questionnaire to a random sample of 800 state legislators from all 50 United States in 2011. Legislators were asked to rate their support for each measure on a three-point Likert-type scale. RESULTS: There were 250 questionnaires returned. Chi-square tests revealed no significant differences between respondents and non-respondents by sex, political affiliation, or chamber designation. Respondents were approximately evenly split between Republicans (n=117) and Democrats (n=122). Overall, public school and community-based measures were supported at approximately the same levels. Linear regression revealed that political affiliation, race, and perceiving obesity as a serious societal problem were significant predictors of legislator support for obesity reduction policies. Legislator body mass index, level of education, and geographic location were not significant predictors of support. CONCLUSIONS: Public health advocates interested in promoting obesity prevention legislation at the state level are most likely to find support among non-white female Democratic legislators regardless of their BMI who perceive obesity to be a serious societal problem.
[show abstract][hide abstract] ABSTRACT: Adolescent dating violence (ADV) is a significant public health problem that, according to various estimates, affects 9% to 34% of adolescents in the United States. Schools can play an important role in preventing ADV. However, little is known about school personnel's practices and perceptions regarding ADV. This study assessed high school counselors' knowledge, training, perceptions, and practices on dealing with ADV incidents.
A national random sample (n = 550) of high school counselors who were members of the American School Counselors Association were sent a valid and reliable questionnaire on ADV. A 3-wave mailing procedure was used to increase the response rate, which was 58%. Statistically significant differences (P < .05) were calculated by using t tests, χ(2) tests, analysis of variance, and logistic regression.
A majority of the school counselors reported that they did not have a protocol in their schools to respond to an incident of ADV (81.3%). Additionally, the majority (90%) of counselors reported that in the past 2 years, training to assist survivors of teen dating abuse has not been provided to personnel in their schools, their school did not conduct periodic student surveys that include questions on teen dating abuse behaviors (83%), and their school did not have a committee that meets periodically to address health and safety issues that include teen dating abuse (76%).
The results of this study indicate that schools do not find ADV a high-priority issue to be addressed in their student populations.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to assess the prevalence of sexting among sixth through twelfth grade students and its correlations with other risk behaviors. The survey was conducted in 35 different schools in a midwestern state. Overall, 17% of students engaged in sexting, which varied significantly by age (3% of 12-year-olds to 32% of 18-year-olds). Adjusted odds ratios found statistically significant correlations between sexting and sexual behaviors, substance use behaviors, emotional health behaviors, and time spent texting. Sexting should be addressed by parents, teachers, and mental health professionals who interact with adolescents.
American Journal of Sexuality Education 01/2012; 7(1):1-15.
[show abstract][hide abstract] ABSTRACT: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between health and learning, and specific school system practices for assisting students were also examined.
A 4-page questionnaire was sent to a national random sample of public school superintendents using a 4-wave postal mailing.
Only 19% of school districts assessed the health insurance status of students. School districts' assistance in helping enroll students in health insurance was assessed using Stages of Change theory; 36% of superintendents' school districts were in the action or maintenance stages. The schools most often made health insurance materials available to parents (53%). The perceived benefits identified by more than 80% of superintendents were to keep students healthier, reduce the number of students with untreated health problems, reduce school absenteeism, and improvement of students' attention/concentration during school. The 2 most common perceived barriers identified by at least 50% of superintendents were not having enough staff or financial resources.
Most superintendents believed schools should play a role in helping students obtain health insurance, but the specific role was unclear. Three fourths of superintendents indicated overwhelmingly positive beliefs regarding the effects of health insurance status on students' health and academic outcomes. School personnel and public policy makers can use the results to support collaboration in getting students enrolled in health insurance.
Journal of School Health 12/2011; 81(12):756-63. · 1.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: To assess general pediatricians' screening practices for sleep-related issues and assess their knowledge on common sleep complaints in children, their perceived barriers to screening for sleep issues, and whether they have received training regarding sleep issues.
A national random sample (n = 700) of general pediatricians who were members of the American Academy of Pediatrics were sent a valid and reliable questionnaire on sleep problems in youth.
A total of 346 pediatricians (49%) responded. The vast majority (96%) indicated that they believed it was their job to counsel patients/guardians regarding sleep hygiene, yet few pediatricians (18%) had ever received formal training on sleep disorders. Those who did not screen for sleep problems spent significantly less time with each patient and perceived significantly more barriers to screening. Pediatricians who had received training about sleep disorders had significantly higher knowledge scores on sleep problems, perceived significantly fewer barriers to screening, and reported significantly higher confidence scores regarding counseling patients/guardians on sleep problems.
These findings support the need for formal education on sleep disorders for all pediatricians.
[show abstract][hide abstract] ABSTRACT: Psychiatric nurses should be uniquely positioned for helping to prevent firearm suicides and homicides among the mentally ill. This study assessed the prevalence of firearm injury prevention training in graduate psychiatric nursing training programs through a three-wave mail survey of program directors. Most (87%) of the directors reported that they had not seriously thought about providing firearm injury prevention training. Almost half (48%) reported they did not routinely screen patients for firearm ownership. In addition, most (66%) thought that the American Psychiatric Nurses Association (APNA) should provide curriculum guidelines regarding firearm injury prevention training. Leadership is needed by the APNA to help reduce firearm violence in the mentally ill.
Archives of psychiatric nursing 08/2011; 25(4):245-52. · 0.90 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to assess physician assistant training programs incorporation of firearm injury prevention training in their curricula. Also, content of such programs as well as perceived benefits and barriers of providing such training were explored.
A three-wave postal mailing of a 24-item questionnaire was sent to the population (n=145) of physician assistant program directors.
The majority (77%) of directors responded. The majority (81.3%) reported they had not seriously thought about providing such training (pre-contemplation). The three most important barriers to providing firearm injury prevention training were: lack of time, lack of faculty expertise on the topic, and lack of standardized teaching materials. Those programs that offered training averaged one-half hour. Yet, 77.7% thought that firearm injuries were a very large or large problem to the health and wellbeing of the U.S. population.
There is a paucity of professional training for physician assistants regarding firearm injury prevention. It appears unlikely that physician assistants are playing a role in helping to reduce one of the leading causes of death in the U.S., firearm trauma. The American Academy of Physician Assistants needs to take the lead in improving training in this area for physician assistants.
Physician Assistant training program directors should consider offering firearm injury prevention training to help reduce patient suicides and homicides.
Patient Education and Counseling 07/2011; 86(3):348-53. · 2.37 Impact Factor
[show abstract][hide abstract] ABSTRACT: Young people are likely to experience noise-induced hearing loss (NIHL), as the use of personal listening devices and other damaging factors (e.g., video games) increases. Little research has examined the role of school health personnel in the prevention and early identification of hearing impairment. A 32-item, valid and reliable survey was developed regarding elementary and middle school nurses' practices concerning hearing loss screening and prevention. The survey instrument was based on the Stages of Change theory and the Health Belief Model. A random sample of 800 nurses was obtained from The National Association of School Nurses. A two-wave mailing was used to achieve a 58% response rate. Forty eight percent indicated there were not many educational programs that addressed NIHL in students. Performing hearing screenings routinely can help identify those students at risk. School nurses need to become advocates for policies and programs that mandate hearing screenings and educational programs to help reduce hearing loss.
The Journal of School Nursing 06/2011; 27(5):380-9. · 0.69 Impact Factor
[show abstract][hide abstract] ABSTRACT: In recent years, it has become commonplace for universities to hire part-time and non-tenure track faculty to save money. This study examined how commonly part-time faculty are used in health education and how they are used to meet program needs. The American Association of Health Education's 2009 "Directory of Institutions Offering Undergraduate and Graduate Degree Programs in Health Education" was used to send a three-wave mailing to programs that were not schools of public health (n = 215). Of the 125 departments (58%) that responded, those that used part-time faculty averaged 7.5 part-time faculty in the previous academic year, teaching on average a total of 10 classes per year. A plurality of departments (38%) were currently using more part-time faculty than 10 years ago and 33% perceived that the number of part-time faculty has resulted in decreases in the number of full-time positions. Although 77% of department chairs claimed they would prefer to replace all of their part-time faculty with one full-time tenure track faculty member. As colleges downsize, many health education programs are using more part-time faculty. Those faculty members who take part-time positions will likely be less involved in academic activities than their full-time peers. Thus, further research is needed on the effects of these changes on the quality of health education training and department productivity.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to examine the prevalence of anal intercourse and its associated risk behaviors in a sample of Midwestern, predominantly white rural adolescents. Most of the research on this activity has been local or regional studies, with urban East and West Coast racial and ethnic minority adolescents.
A surveillance questionnaire based on the Youth Risk Behavior Survey was distributed in 2009 to 820 rural middle and high school students in grades 6-12, across 2 rural counties in a Midwestern state. The school districts were stratified by grade level and a stratified random sample of schools (n = 17) was used. Data were analyzed using Fisher's exact test and multiple logistic regression.
A total of 778 (95%) students completed the survey. The rural adolescents were in grades 6-12, were primarily white (95%), and were evenly distributed by gender. Similar amounts of students had engaged in sexual intercourse (24%) and oral sex (23%). Seven percent reported engaging in anal sex (1.6% middle school, 10.9% high school). Multivariate logistic regression controlling for other risk behaviors found that 2 variables were associated with increased anal sexual activity: ever had sexual intercourse (adjusted odds ratios [AOR]= 14.5) and ever had oral sex (AOR = 6.0).
Anal sexual activity is a component of some rural adolescents' sexual experiences. These findings have important implications for sex education programs targeted to rural schools, where the typical high school classroom may have some students engaging in anal sex.
The Journal of Rural Health 03/2011; 27(2):196-204. · 1.44 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study examined the prevalence of oral sexual activity in rural Midwestern adolescents. We also examined the correlates of a series of risk behaviors with oral sexual activity.
A questionnaire based on the Youth Risk Behavior Surveillance System was distributed to 2121 rural middle and high school students in grades 6-12 across 5 rural counties in a Midwestern state. The schools within districts were stratified by grade level and a stratified random sample of schools was used (n = 49).
A total of 2000 (94%) students completed the survey. The rural adolescents were: male (51%), White (85%), with an average age of 14.7 years (SD = 1.9). Overall, one-fourth (26%) of the students had engaged in sexual intercourse (8% of middle school and 39% of high school students). Slightly more than one-fourth of the students (29%) had engaged in oral sex (9% of middle school and 44% of high school students). Logistic regression was used to calculate adjusted odds ratios and found 3 risk behaviors were statistically significantly associated with oral sexual behavior: ever having had sexual intercourse (16.6 times more likely to engage in oral sex), having drunk alcohol in the past 30 days (2.2 times more likely), and having smoked 1 or more cigarettes in the past 30 days (2.0 times more likely).
Oral sexual activity is an established component of many rural adolescents' sexual experiences. These findings have important implications for sex education programs targeted to rural adolescent youths.
Journal of School Health 03/2011; 81(3):159-65. · 1.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Public health professionals can maximize their effectiveness in reducing firearm trauma by seeking partners from law enforcement professionals. This study assessed sheriff's support for various types of firearm control measures and their firearm control advocacy activities. A 29 item valid and reliable survey was used for a three- wave mailing to a national random sample of 650 sheriffs. The majority (over 50%) of sheriffs supported 4 of 14 proposed firearm control policies. Almost 55% of responding sheriffs were members of the NRA and being a member of the NRA was significantly associated with less support for 12 of the 14 firearm control policies. The majority (>70%) of sheriffs did not participate in most firearm control advocacy activities. Sheriffs were found to be far less supportive of potentially important firearm control policies than what has been previously found for police chiefs. Thus, sheriffs may be less helpful than police chiefs as colleagues for public health campaigns to reduce firearm trauma.
Journal of Community Health 02/2011; 36(5):715-20. · 1.28 Impact Factor