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Mental health care providers’ cultural responsiveness related to athletics is crucial to their clinical care provision for student-athletes on college campuses. However, little research has been conducted in applying a theoretical framework to explore providers’ intentions to provide culturally responsive clinical care to this specific student population. Understanding providers’ perceptions of student-athletes is integral in assuring clinical care provision that is responsive related to the culture of athletics. The purpose of this study was to test a conceptual model that adapted the Theory of Planned Behavior to explore the determinants of providers’ intention to be culturally responsive to the unique needs of collegiate student-athletes. For this study, cultural responsiveness was defined as the cumulative level of a provider’s self-efficacy related to communicating with student-athletes, empathy specific to student-athletes, positive attitudes toward the culture of athletics, and knowledge related to the culture of athletics. Data were collected using an online survey method, and the responses from 153 participants were analyzed using multiple regression analysis. The results indicated that all survey scales were stable and reliable on which to base our data analysis results. Additionally, results suggested that the adapted TPB can be a useful framework in predicting mental health care providers’ intention to be culturally responsive to student-athletes’ unique needs. Implications for research are discussed.

Introduction: A permanent drug donation box (“drop-box”) is one strategy implemented in communities across the United States to reduce the availability of excess controlled medications, including prescription opioids, for diversion. The objective of this study was to examine correlates of the diffusion and implementation of drop-boxes in North Carolina.Methods: We assessed the number and location of drop-boxes implemented in North Carolina. Cox proportional hazards models were used to examine covariates associated with drop-box implementation in NC counties (n?=?100) between 2007 and 2016.Results: There were 311 drop-boxes implemented in 91 (out of 100) counties. Most drop-boxes were in law enforcement agencies (78.8%) and a growing number were in pharmacies (14.5%). Counties with a higher percentage of whites, more educated residents, a substance abuse prevention coalition, higher rates of controlled medications dispensed and prescription opioid overdose, and that were Appalachian were more likely to be early adopters. Rural counties were less likely to have a drop-box. In the multivariate model, only higher rate of controlled medicines dispensed was significant.Conclusions: A growing number of drop-boxes are being implemented in law enforcement offices and pharmacies. Given that communities with higher rates of controlled medication dispensing likely have the highest need for disposal opportunities, it is promising that they are early adopters of drop-boxes. Future research should assess the effectiveness of drop-boxes as they become more widespread in a variety of locations.

Purpose: The purpose of this study was to quantify the performance of organizations’ worksite health promotion (WHP) activities against the benchmarking criteria included in the Well Workplace Checklist (WWC). Design: The Wellness Council of America (WELCOA) developed a tool to assess WHP with its 100-item WWC, which represents WELCOA’s 7 performance benchmarks. Setting: Workplaces. Participants: This study includes a convenience sample of organizations who completed the checklist from 2008 to 2015. The sample size was 4643 entries from US organizations. Measures: The WWC includes demographic questions, general questions about WHP programs, and scales to measure the performance against the WELCOA 7 benchmarks. Analysis: Descriptive analyses of WWC items were completed separately for each year of the study period. Results: The majority of the organizations represented each year were multisite, multishift, medium- to large-sized companies mostly in the services industry. Despite yearly changes in participating organizations, results across the WELCOA 7 benchmark scores were consistent year to year. Across all years, benchmarks that organizations performed the lowest were senior-level support, data collection, and programming; wellness teams and supportive environments were the highest scoring benchmarks. Conclusion: In an era marked with economic swings and health-care reform, it appears that organizations are staying consistent in their performance across these benchmarks. The WWC could be useful for organizations, practitioners, and researchers in assessing the quality of WHP programs.

Background: Despite the multitude of available resources, family caregivers of those with chronic disease continually underutilize support services to cope with the demands of caregiving. Several studies have linked self-identification as a caregiver to the increased likelihood of support service use. Purpose: The present study reviewed the literature related to the development of family caregiver identity. Methods: After a systematic process to locate literature was completed, content analysis was conducted to determine major themes related to the development of caregiving identity. Results: Findings suggest that there are multiple factors related to the development of family caregiver identity, including role engulfment and reversal, loss of shared identity, family obligation and gender norming, extension of the former role, and development of a master identity. Discussion: Considering the role of identity in human behavior, health professionals can address the underutilization of support services by family caregivers of those with chronic disease by understanding the influences on the development of caregiver identity. Translation to Health Education Practice: This literature review will assist health educators in addressing the underutilization of support services by family caregivers of those with chronic disease.

Answers as to whether sexually-oriented music lyrics influence adolescent sexual initiation are unclear. The purpose of this study was to develop a reliable and valid instrument based on the Theory of Reasoned Action to enable researchers to predict the influence of sexually-oriented music lyrics on early sexual initiation among African-American adolescents (AAas). Participants (n =185) resided in rural and urban areas in the southeastern U.S. The final instrument had a Cronbach‘s alpha of .846. While further development work is needed, the survey is in a promising state. Additional psychometric work will prove the predictive ability and worth of the instrument.

Dietary supplements may improve sport performance in adults. However, this has not been established in children. The aim of this study was to assess self-reported or parental-reported dietary supplement use to enhance sports performance among the child subset of the National Health Interview Survey (NHIS) dataset and determine national population estimates for that use. NHIS 2007 Child Alternative Medicine files containing records for children aged 10 years, indicating some increase in use with higher age categories (p < .001). Most were US born and reported living with both parents. Parents and children report child use of a wide variety of herbal and vitamin/mineral supplements to improve sports performance. Usage could be predicted by age, gender, and level of education but less likely by parent-based demographics.

The National Commission for Health Education Credentialing, Inc. (NCHEC) implemented an advanced-level credential to designate the Master Certified Health Education Specialist (MCHES). The initial certification phase was a six-month Experience Documentation Opportunity (EDO) for current CHES who had been active for five continuous years (certified on or before October 1, 2005). Eligible applicants were invited to submit an advanced-level practice documentation application from October 15, 2010 through April 15, 2011. The application included instructions to submit both an experience self-appraisal and testament of practice from an outside recommender.

The CDC reports that over half of all sports-related injuries each year occur among youth athletes. Because these injuries can have implications on current and future health, prevention of such incidents is vital. Healthcare practitioners are in a unique position to not only offer treatment, but also to educate and advocate for injury prevention at multiple community levels. This article summarizes the current statistics on youth sports injuries while examining the healthcare practitioner’s role in injury prevention. The social ecology model is used as a framework to demonstrate how practitioners may advocate at both the micro- and macro-levels within a community.

Objective: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. Methods: Telephone interviews were conducted with 71 individuals at 21 institutions. Results: Common challenges included inconsistent enforcement, mixed messages received by students, and students’ attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.

Doctors of Chiropractic (DCs) perform health promotion as part of routine practice. In addition, the regulating body for chiropractic educational institutions has a standard in place on the teaching of this subject matter in all accredited colleges. The largest chiropractic professional organization in the U.S. (the American Chiropractic Association) and the Association of Chiropractic Colleges also have position statements supportive of prevention and health promotion as part of practice. However, very little is known as to whether practicing chiropractors have the aptitude, willingness, competence or the infrastructure to appropriately address primary preventive issues with patients. Additionally, little is known regarding attitudes and beliefs among DC’s in different regions of the country and whether demographic and cultural norms will affect the ability to meet the accrediting agency’s charge. This study applies the Ecological Theory of health promotion to design a survey of attitudes, beliefs and practices of chiropractors in Alabama. Results indicate that although some health promotion practices are performed, many recommended screenings or procedures are not. In addition, though most clinicians agreed that public health measures should be a part of practice, in many cases they reported they did not perform them routinely. Further education and investigation are needed as to how chiropractors can be more involved in prevention and promotion of health as part of routine practice, including removal of actual and perceived barriers to this practice.

There has been debate as to whether smoking should be allowed in addiction treatment centers as part of recovery programming. A prior study at one facility assessed health promotion needs and found 80% of inpatients were smokers or tobacco users. This is four times the national average. This study assessed predictors of length of stay at a faith-based, inpatient facility in Alabama and included tobacco use as a possible predictor of success. Other potential predictors such as basic demographics, drugs of choice, intravenous drug use, parental marital status, and education levels were also tested. Among the 290 participants completing the survey (100%), 83% were males, most were white, mean age was 33 years, and ages ranged from 18-61. Eighty percent used tobacco, and cocaine use was the most common drug for which patients were under treatment. Although approximately one third of patients completed the entire 52 week program, older patients tended to stay longer in the program and those court-ordered were more likely to complete the program as well. Marijuana use predicted longer stays compared to other drugs of choice, and tobacco use was a borderline significant predictor of length of stay (p=0.05), with users less likely to stay as long. Continued tobacco use did not enhance participants’ length of stay. Modifying program delivery by taking into consideration such factors as age of patients and drugs of choice, and considering a tobacco-free policy are issues that the facility may wish to address. Further studies could include assessment of mandated tobacco cessation and its effects on successful length of stay.

Doctors of chiropractic (DCs) see approximately 10% of the US population in a given year making them among the most visited practitioners outside of conventional medicine for general health problems and especially back and neck conditions.1,2 In addition, one of the fastest growing areas of specialty treatment is in the area of sports injury. Today, most professional teams, the US Olympic Team, and many college or high school sports programs have a DC either on staff or available to treat athletes as part of the sports medicine team.3,4 There are also specialty programs for training of DCs in the area of sports medicine as well as pediatric care.5

Gambling is an important public health concern. To better understand gambling behavior, we conducted a classroom-based survey that assessed the role of the theory of planned behavior (TPB; i.e., intentions, subjective norms, perceived behavioral control, and attitudes) in past-year gambling and gambling frequency among college students. Results from this research support the utility of the TPB to explain gambling behavior in this population. Specifically, in TPB models to predict gambling behavior, friend and family subjective norms and perceived behavioral control predicted past-year gambling, and friend and family subjective norms, attitudes, and perceived behavioral control predicted gambling frequency. Intention to gamble mediated these relationships. These findings suggest that college-based responsible gambling efforts should consider targeting misperceptions of approval regarding gambling behavior (i.e., subjective norms), personal approval of gambling behavior (i.e., attitudes), and perceived behavioral control to better manage gambling behavior in various situations.

Health educators have much to be excited about if the debate and legislation on healthcare continues to focus on prevention. The potential of resources and jobs would be a boon for the profession not to mention further legitimacy for practitioners. Without question health education advocacy efforts helped in some respects to push the prevention agenda but was it enough and was it at the right time? This article seeks to discuss advocacy in health education in the political, program and practice arenas and calls for advocacy as a health education skill to be more ingrained into the fabric of the profession.

Objective: Doctors of chiropractic (DCs) provide health educational and promotion efforts in the communities they serve by counseling patients at the individual level. This article outlines a method and model in which DCs can effectively serve as public health advocates within their community. Discussion: The social ecological model of health education and health promotion serves as an excellent template for taking into account every antecedent to disease within a community and how to prevent it through health promotion. A step-by-step guide to getting the DC involved in the community can be centered on this model, with the DC serving as a health advocate for his or her community. Resources are provided to assist in this process. Conclusion: The DC can and should engage his or her community in areas that are conducive to health through involvement and advocacy roles where these are suitable. A community's health can be enhanced with greater health care provider involvement, and DCs need to consider themselves a part of this process.

Objective Identify if constructs from the Eating and Appraisal Due to Emotions and Stress Model, including Emotion and Stress Related Eating, Appraisal of Ability and Resources to Cope, and Appraisal of Outside Influ-ences and Stressors, were related to overweight and obesity. Design Data were collected from a cross-sectional study using the Eating and Appraisal Due to Emotions and Stress Questionnaire. Subjects/Setting Convenience sample from a southeastern public university, including staff and faculty (n=822) with ages ranging from 18 to 83 years and 55.8% of the sample being overweight or obese. Statistical analysis performed Total sum scores were given to each construct and converted to quartiles. Lower quartiles represented higher stress- or emotion-related eating and more compromised appraisal skills or resources to cope. X2 Analyses were used to identify variables associated with overweight and obesity. Forward stepwise logistic regression (n=783) was used to identify the independent association of each significant variable with overweight and obesity. Results A model including race, sex, life stage, and job category as covariates, with a cumulative R2 of 0.075 was produced. Emotion- and Stress-Related Eating remained in the model during stepwise regression producing a cumulative R2=0.265. Individuals scoring in the lowest quartiles for Emotion- and Stress-Related Eating were 13.38 times more likely to be overweight or obese, compared with individuals scoring in the highest quartiles. Conclusions The Eating and Appraisal Due to Emotions and Stress Model construct of Emotion- and Stress-Re-lated Eating as measured by the Eating and Appraisal Due to Emotions and Stress Questionnaire can be used to assess nontraditional factors that contribute to overweight and obesity.

This article highlights three noteworthy distance education program approaches to the delivery of health education courses. Insights into The University of Alabama Masters in Health Studies, now in its second decade delivering a complete degree program via distance technologies, will be shared as well as Texas A&M University's efforts at both graduate and undergraduate health education distance offerings, and lastly, the evolution of the Health Education and Promotion Network (HEPNetwork), the first profession wide opportunity for health educators to gain educational credit by distance. Each program will be discussed, followed by a thoughtful discourse on the challenges each program faced.

The purpose of this study was to measure influences of college athlete alcohol consumption through application of the Social Ecology Model of health behaviors. A nonrandom sample (n=230) of college athletes from an NCAA institution was surveyed regarding alcohol use and influences on consumption. The most significant social ecological predictors of alcohol consumption were personal beliefs, perceptions of teammates use, and perceptions of overall campus use. Alcohol rules of coaches and athletic departments had no impact on athletes' alcohol behavior. Identifying the ecological influences of college athlete alcohol use assists in the development of appropriate intervention and prevention programs.

Managing diabetes requires a motivated client and skilled health care provider." clients adhere to diabetes management recommendations is challenging. The transtheoretical model may be valuable in achieving success in diabetes management. Health care providers who are informed about the behavior change process and stage specific interventions may be well equipped to facilitate positive and lasting behavior changes. The purpose of this paper is to describe the transtheoretical model and to discuss strategies for applying it to diabetes management. Utilizing stage-matched strategies may be beneficial in motivating clients with diabetes to adhere to recommendations.

Objective To develop and validate the Eating and Appraisal Due to Emotions and Stress (EADES) Questionnaire that was created to measure how one uses food to cope with stress and emotions. Design Data were collected from a cross-sectional study using the EADES Questionnaire. Subjects/setting Convenience sample (response rate 22%) from a southeastern public university, including staff and faculty (n=854) with ages ranging from 18 to 83 years and a mean body mass index of 27.3 &#x00B1 6.4. Statistical analysis performed Exploratory factor analysis was completed on 54 items that were originally meant to describe constructs from the Transactional Model of Stress and Coping. Reliability of scales was estimated using Cronbach’s a. Total sum scores were given to each factor. Pearson correlation coefficients assessed linear associations between factors. Results Three factors accounting for 43.5% of the variance were retained with a total Cronbach’s a = .949. The factors did not represent the theoretical constructs from the Transactional Model of Stress and Coping as anticipated. A new model was created, including Emotion- and Stress-Related Eating, Appraisal of Resources and Ability to Cope, Appraisal of Outside Stressors and Influences with Cronbach’s a being .949, .869, and .652, respectively. These factors were significantly correlated with one another. Conclusions The EADES model provides a viable conceptual model to help explain variables that may contribute to overeating, whereas the EADES Questionnaire provides a measurement tool for evaluating these variables that have not traditionally been explored in weight management efforts.

African Americans watch more television than any other race, with African American teens watching 7 hours and 55 minutes per day compared to 6 hours and 33 minutes viewed by total U.S. teens. It is hypothesized that exposure to television content may impact health behavior. The purpose of this review is to discuss what is known about the exposure of African American adolescents to sexual content presented in black-themed television programming.

Compared to non-athletes, college athletes consume more alcohol and report higher rates of alcohol-related consequences such as DUI, unsafe sexual practices, and criminal behavior. This poses major problems for the integrity of college athletics, athletic department personnel, and health educators who work to reduce destructive alcohol behaviors on campus. To understand why current alcohol education is ineffective, it is necessary to examine the ecology of this behavior. This article examines alcohol use among college athletes using the Social Ecology Model to determine what most influences this behavior. A proposed ecological model specific to alcohol use among college athletes is discussed.

Background: Employers seek to minimize business costs by creating conditions of employment. Relying on the presumably negative effects of smoking on variables such as workers’ compensation claims, absenteeism and physical fitness scores, they seek a rational basis for requirements that employees refrain from smoking. No research has been found on police officer smoking rates relating to physical fitness, and the resulting economic variables of workers’ compensation claims and absenteeism rates. Aims: To compare police officer non-smoker and smoker physical fitness, absenteeism rates and workers’ compensation claims. Methods: The sample included 514 officers of a metropolitan police department. A physical fitness test was ad- ministered. Smoking status, yearly absenteeism rates and workers’ compensation claims were collected. Results: Male smokers were significantly older than non-smokers. An analysis of covariance controlling for sex and age indicated that smokers had significantly (P = 0.05) lower fitness scores in sit and reach flexibility, sit-ups endurance, bench press strength and bicycle ergometer cardiovascular endurance. When neither age nor sex was controlled in males, a similar trend continued. However, in females only the sit and reach and sit-up tests demonstrated statistically significant differences. Fat percentage, step-test scores, absenteeism rates and workers’ compensation claims were not statistically different. Conclusion: These data do not provide a rational basis for the requirement that officers refrain from smoking when considering body fat and the economic savings of lower absenteeism rates and workers’ compensation. To some extent, smoking policies can be justified by officers’ physical fitness but there are age, gender and test protocol considerations.

This study sought to predict the use of dietary supplements marketed to enhance athletic performance among 1,737 adolescent athletes. An anonymous, paper-and-pencil, self-report survey was administered to the participants. Grade level, participation in multiple sports, and scales representing attitudes, subjective norms, and intention were all significant predictors of current dietary supplement use. The results of this study allow for the development of more appropriate prevention and intervention strategies that can target specific groups of adolescent athletes. The authors recommend that attitudes of adolescent athletes be addressed in interventions and that salient others be included in program planning.

A new twist on an old problem. Sports supplements are hard to miss right now. In fact, never has the sports world been more enmeshed in media coverage and debate. Much of the emphasis is on male athletes, as it has been for decades. Males are clearly the largest population of users and live and play in a culture that supports use. That culture however is shifting over into the evolving but as yet undefined culture of the female athlete and cannot be ignored.

The University of North Carolina at Wilmington, in their efforts to develop a health education degree program, invited local health educators to a university-funded advisory forum. The goal was to provide local practitioners ownership in the development of the program, and elicit real world comments to aid in curriculum design. The insights gained reinforced the notion of including all stakeholders in any planning process. The following represents the process that took place and the subsequent curricular outcomes.