Health changes in Hispanic older adults in a Spanish arthritis self -management education program

Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants' general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. ^ Results indicated the participants' health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants' health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. ^ The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants' health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants' health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits. ^

A worksite nutrition education program increased firefighters' knowledge and resulted in healthier attitudes toward fad diets

The effectiveness of a worksite nutrition education program to improve firefighters' knowledge and weight management strategies was evaluated. One hundred fifty Miami-Dade Fire Rescue workers recruited for the study were randomly assigned to an intervention or a control group. The intervention group attended four 30-minute worksite nutrition education sessions. A nutrition knowledge test completed by both groups before and after the intervention showed no significant differences between groups for pre-intervention nutrition knowledge. The post-intervention increase in nutrition knowledge was significantly greater (p < 0.001) for the intervention group (16.8% ± 8.2) compared to the control group (4% ± 8.9). No significant pre-intervention difference was found between the groups' predilection toward a ketogenic diet. A statistically significant (p < 0.01) reduction was seen in the intervention group's willingness (0.57 ± 1.06) to use this diet compared to the control group (0.02 ± 0.99). Results indicate that worksite nutrition education can improve firefighters' knowledge and weight reduction strategies. ^

An investigation of the relationships between selected characteristics and leadership outcomes of Athletic Training Education Program directors

There is currently no evidence describing what characteristics make an Athletic Training Program Director (PD) an effective leader. An influx of accredited programs resulted in a rapid increase in the demand for PDs, yet training and preparation for these positions has failed to evolve. Although Certified Athletic Trainers (ATs) are trained in specific content areas, they may not always be prepared for the administrative and leadership responsibilities associated with the role of PD (Leone, 2008). This dissertation examined the relationships between selected characteristics and leadership outcomes of Athletic Training Program Directors. Each PD participants (n=27) completed a demographic questionnaire to obtain the leader's academic preparation, accreditation experience and leadership training history. Each participant also completed the Multifactor Leadership Questionnaire (MLQ) to obtain leadership styles, behaviors, and outcomes. Overall, the PDs reported utilizing transformational leadership most often and passive avoidant leadership least often. There was no significant difference between PDs with master's and doctorate degrees on overall leadership outcome. However, participants with a doctorate degree scored significantly different on the effectiveness component of the leadership outcome compared with participants with a master's degree. Those participants who have completed academic coursework on leadership scored significantly different on the leadership outcome compared to those who have not completed academic coursework on leadership. Findings from this study indicate that changes to the current requirements for the role of PD may be warranted. Consideration should be given to increasing the minimum degree requirement and requiring academic coursework on leadership. Future research may be useful in determining specific degree guidelines and types and amounts of leadership training that would be beneficial to Athletic Training PDs.

Leadership Styles, Behaviors, and Outcomes of Athletic Training Education Program Directors

Context: With the increase in athletic training education programs, the demand for a highly qualified faculty member to serve as program director (PD) and fill the multiple roles and responsibilities of the position has increased. A successful PD must possess leadership skills crucial for the evolving academic environment. Research suggests that educational leaders must provide both transactional and transformational leadership if athletic trainers are to secure a legitimate place as healthcare providers. Objective: To describe the leadership styles and behaviors of athletic training education PDs and to describe the associations between leadership style, behavior, outcome, and experience. Design: We will utilize a survey design to identify the leadership styles, behaviors, outcomes, and experiences of athletic training education PDs. Setting: On-line questionnaire. Participants: The population of this study will be limited to the academic PDs of the 360 accredited entry-level athletic training education programs in the United States. Intervention: The investigation will utilize the Multifactor Leadership Questionnaire (MLQ). The MLQ is a validated tool composed of 45 items that identify and measure key leadership and effectiveness behaviors shown to be strongly linked with both individual and organizational success. In addition to the leader, it is recommended that all persons working above, below, and directly at the same organizational level as the leader rate the leader. Raters evaluate how frequently, or to what degree, they have observed the leader engage in 32 specific behaviors. Main Outcome Measure(s): Statistical analysis will be utilized to describe the associations between leadership styles, behaviors, outcomes, and experiences.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and nutrition education on nutrition and health outcomes of HIV+ individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. ^ SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. ^ Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.^

Advanced Placement and American education: A Foucauldian analysis of the Advanced Placement Program of the college board

Advanced Placement is a series of courses and tests designed to determine mastery over introductory college material. It has become part of the American educational system. The changing conception of AP was examined using critical theory to determine what led to a view of continual success. The study utilized David Armstrong's variation of Michel Foucault's critical theory to construct an analytical framework. Black and Ubbes' data gathering techniques and Braun and Clark's data analysis were utilized as the analytical framework. Data included 1135 documents: 641 journal articles, 421 newspaper articles and 82 government documents. ^ The study revealed three historical ruptures correlated to three themes containing subthemes. The first rupture was the Sputnik launch in 1958. Its correlated theme was AP leading to school reform with subthemes of AP as reform for able students and AP's gaining of acceptance from secondary schools and higher education. The second rupture was the Nation at Risk report published in 1983. Its correlated theme was AP's shift in emphasis from the exam to the course with the subthemes of AP as a course, a shift in AP's target population, using AP courses to promote equity, and AP courses modifying curricula. The passage of the No Child Left Behind Act of 2001 was the third rupture. Its correlated theme was AP as a means to narrow the achievement gap with the subthemes of AP as a college preparatory program and the shifting of AP to an open access program. ^ The themes revealed a perception that progressively integrated the program into American education. The AP program changed emphasis from tests to curriculum, and is seen as the nation's premier academic program to promote reform and prepare students for college. It has become a major source of income for the College Board. In effect, AP has become an agent of privatization, spurring other private entities into competition for government funding. The change and growth of the program over the past 57 years resulted in a deep integration into American education. As such the program remains an intrinsic part of the system and continues to evolve within American education. ^

Advanced Placement and American Education: A Foucauldian Analysis of the Advanced Placement Program of the College Board

Advanced Placement is a series of courses and tests designed to determine mastery over introductory college material. It has become part of the American educational system. The changing conception of AP was examined using critical theory to determine what led to a view of continual success. The study utilized David Armstrong’s variation of Michel Foucault’s critical theory to construct an analytical framework. Black and Ubbes’ data gathering techniques and Braun and Clark’s data analysis were utilized as the analytical framework. Data included 1135 documents: 641 journal articles, 421 newspaper articles and 82 government documents. The study revealed three historical ruptures correlated to three themes containing subthemes. The first rupture was the Sputnik launch in 1958. Its correlated theme was AP leading to school reform with subthemes of AP as reform for able students and AP’s gaining of acceptance from secondary schools and higher education. The second rupture was the Nation at Risk report published in 1983. Its correlated theme was AP’s shift in emphasis from the exam to the course with the subthemes of AP as a course, a shift in AP’s target population, using AP courses to promote equity, and AP courses modifying curricula. The passage of the No Child Left Behind Act of 2001 was the third rupture. Its correlated theme was AP as a means to narrow the achievement gap with the subthemes of AP as a college preparatory program and the shifting of AP to an open access program. The themes revealed a perception that progressively integrated the program into American education. The AP program changed emphasis from tests to curriculum, and is seen as the nation’s premier academic program to promote reform and prepare students for college. It has become a major source of income for the College Board. In effect, AP has become an agent of privatization, spurring other private entities into competition for government funding. The change and growth of the program over the past 57 years resulted in a deep integration into American education. As such the program remains an intrinsic part of the system and continues to evolve within American education.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and Nutrition Education on Nutrition and Health Outcomes of HIV+ Individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.