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Background: In this study, we explore how a health education course may play a role in pre-service teachers' perceptions in teaching and integrating health education activities to nurture K-8 students' health literacy., Methods: We used mixed methods to examine the effect of a health education course in a teacher education program. Of 55 pre-service teachers, 41voluntarily participated in the study. Quantitative data were obtained through an online questionnaire administered to participants at the beginning and end of the course. We conducted 6 focus groups at the end of the course., Results: The inferential analysis from a series of analysis of variance with repeated measures revealed significant differences in health knowledge (F = 113.39, p < .01, η 2  = 0.74), preparedness (F = 104.74, p < .01, η 2  = 0.73), attitudes (F = 15.02, p < .01, η 2  = 0.28), and beliefs (F = 8.87, p < .01, η 2  = 0.19) between time points. Qualitative data led to the conclusion that where one health education course is insufficient, such a course is the first step into future curriculum development and implementation., Conclusion: One health education course might be beneficial for general education teachers to increase their knowledge and preparation to teaching school health. On-going training is needed for program success., (© 2020, American School Health Association.)

Effective campaigns are desperately needed to combat the serious social problem of teen pregnancy. However, public health campaigns are most often noted for failures, rather than successes. One reason for a campaign failing to have the intended effect is lack of theoretical guidance at the formative evaluation stage. The study reported here is a theoretically-based formative evaluation with inner city teens. Six focus groups were conducted to determine knowledge, attitudes, beliefs, and recommendations for effective campaigns to deter teen pregnancy. The results indicate that campaign messages need to combat positive attitudes toward pregnancy, negative attitudes toward birth control, the perception of personal invulnerability, and emphasize the negative consequences of sexual intercourse. This study's findings also suggest that campaigns with these messages need to start at an early age in order to effectively prevent teen pregnancy.

Patients are increasingly involved in cancer treatment decisions and yet little research has explored factors that may affect patient attitudes and beliefs about their therapeutic choices. This paper examines psychosocial factors (e.g., attitudes, social support), provider-related factors (e.g., communication, trust), and treatment considerations in a prospective study of a sample of non-metastatic breast cancer patients eligible for chemotherapy and/or hormonal therapy (BQUAL cohort). The data come from a multisite cohort study of white, black, Hispanic, and Asian non-metastatic breast cancer patients recruited in New York City, Northern California, and Detroit, Michigan. Baseline surveys were conducted over the telephone between 2006 and 2010 among a total of 1,145 women. Most participants were white (69 %), had more than a high school education (76 %), and were diagnosed with stage I disease (51 %). The majority of women reported discussing chemotherapy and hormonal therapy with their doctor (90 and 83 %, respectively); these discussions primarily took place with medical oncologists. Nearly a quarter of women reported that the treatment decision was difficult, and the majority were accompanied to the doctor (76 %) and involved a friend or family member in making the decision (54 %). Positive considerations (e.g., beliefs about treatment reducing risk of recurrence) were important in making treatment decisions. Participants preferred a shared decision-making style, but results suggested that there is room for improvement in terms of actual patient's involvement in making the decision and provider communication, particularly among black patients. Patients 65 years and older reported fewer provider discussions of chemotherapy, poorer patient-provider communication, higher rates of being assisted by family members in making the decision, and more negative attitudes and beliefs toward treatment.

The objectives of the project were (1) to determine the extent to which HIV-positive persons living in Michigan were aware of and understood Michigan's criminal HIV exposure law, (2) to examine whether awareness of the law was associated with seropositive status disclosure to prospective sex partners, and, (3) to examine whether awareness of the law was associated with potential negative effects of the law on persons living with HIV (PLWH) including heightened HIV-related stigma, perceived societal hostility toward PLWH, and perceived need to conceal one's HIV infection. The study design was cross-sectional. A statewide sample of 384 PLWH in Michigan completed anonymous pen and paper surveys in 1 of 25 data collection sessions. A majority of participants were aware of Michigan's HIV exposure law. Awareness of the law was not associated with increased seropositive status disclosure to all prospective sex partners, decreased HIV transmission risk behavior, or increased perceived responsibility for HIV transmission prevention. However, awareness of the law was significantly associated with disclosure to a greater proportion of sex partners prior to respondents' first sexual interaction with that partner. Awareness of the law was not associated with increased HIV-related stigma, perceived societal hostility toward PLWH, or decreased comfort with seropositive status disclosure. Evidence of an effect of Michigan's HIV exposure law on seropositive status disclosure was mixed. Further research is needed to examine the various forms of HIV exposure laws among diverse groups of persons living with or at increased risk of acquiring HIV.

Aim: To examine healthcare provider knowledge, beliefs, and practices regarding exercise during pregnancy using a cross-sectional 31-question pen and paper survey., Methods: Ninety-three practicing healthcare providers, M.D. (n = 45) and D.O. (n = 14) physicians and certified nurse midwives (C.N.M., n = 34), from hospitals and birth centers around Michigan participated in this study. Descriptive characteristic data, provider knowledge, beliefs, and practices regarding exercise during pregnancy, common exercise restrictions given to pregnant patients, and provider awareness of current American College of Obstetricians and Gynecologists (ACOG) exercise and pregnancy guidelines were collected. Descriptive statistics and chi-square analyses were completed., Results: Overall, 99% of respondents believed that exercise during pregnancy is beneficial, 64% of all respondents believed that maternal exercise heart rate should not exceed 140 beats per minute (bpm), and 60% of M.D.s and 86% of D.O.s were not familiar with the 1994 ACOG guidelines for exercise and pregnancy (p < 0.05)., Conclusions: Although the providers' beliefs about exercise during pregnancy were positive, not all were aware of or followed current ACOG recommendations. Different strategies for dissemination of current research may be warranted.

This paper presents the rationale and findings of a feasibility and process study of the Kin Keeper(SM) Cancer Prevention Intervention. An observational cohort study design was implemented with African-American women in synergistic female family relationships. Community health workers (CHWs) from two Michigan public health programs recruited women to serve as 'kin keepers' who in turn recruited their female family members. In total, 161 kin keepers and female family members were sampled. Trained CHWs led kin keepers and family members in learning about breast cancer. Data methods included baseline and post-training administration of a breast cancer literacy assessment, post-training focus groups and review of personal action plans. To validate the feasibility of the process, a linear mixed-effects regression with 97% power was identified and differences in pre-post scores were detected at 5% significance level. Adjusting for family random effects, breast cancer literacy scores increased for all participants recruited (P-value = 0.0004) suggesting that the process was feasible. Analysis of focus groups and action plans indicated that participants valued the instruction and planned to act upon it. This experience with kin keepers and their families offers encouragement that the theoretical model and its community-based delivery can continue to enhance scholarship dedicated to ameliorating health care disparities.

Background: The demand for integrative medicine care is increasing rapidly among patient consumers, yet the integrative medicine model is not the norm in clinical practice, nor is this approach a focus in traditional medical schools. Furthermore, patient well-being and satisfaction outcomes within an integrative care model are not common in the literature., Objectives: The purpose of this paper is to offer a summary of a model of integrative medicine patient care and its evaluation and outcomes from the University of Michigan Integrative Medicine Clinic., Methods: Using three tools to evaluate patient outcomes and satisfaction, statistically significant outcomes were noted. The SF-12 showed positive change in the physical component score, the Holistic Health Questionnaire showed improvements in all of the subscales of body, mind, and spirit, and a unique Integrative Medicine Patient Satisfaction Tool suggested high satisfaction with an integrative approach to care., Conclusions: Findings, limitations, and implications are discussed.

This paper describes the development and psychometric evaluation of an instrument designed to assess medical students' comfort with a range of sociocultural issues and intercultural experiences. Each survey item obliged students to reflect on their own sociocultural identities and academic status in relation to others', and to judge how comfortable they would be interacting across perceived boundaries based on sociocultural identity and academic status. More than 90% of University of Michigan first-year medical students (n=153) completed the survey just before classes began. Principal components analysis of the survey's 26 items identified 7 interpretable factors or subscales; the Cronbach alpha reliability coefficients for the 7 subscales and the total scale ranged from .73 to .92. T-tests were used to investigate differences in average ratings among student subgroups (based on gender and ethnicity). To assess the magnitude of the effect of the differences between groups, effect size was computed for each of the means comparisons. Psychometric analyses indicated that this survey was both reliable and valid for assessing students' cultural attitudes. Further, analyses by gender and ethnic subgroup identified meaningful ratings differences in men's and women's reported comfort levels. Our findings suggest that this instrument is useful for assessing students' openness to developing cultural awareness and competence. Educators at other medical schools may find this instrument useful as a needs assessment tool for planning educational programs designed to increase students' cultural competence.