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African American (AA) women have the highest rate of obesity in the United States. To date, there are mixed findings on AA women’s perception on obesity and their perceived changes in health behaviors over time that may have contributed to obesity. Therefore, the aims of this current qualitative descriptive study were to explore: 1) AA women’s perception on obesity and perceived changes in health behaviors related to obesity through their reflection on life; 2) AA women’s perceived facilitators and barriers to maintaining healthy behaviors; and 3) AA women’s suggestions for future health promotion programs to manage obesity. Semi-structured interviews with open-ended questions were conducted with 21 AA women. Luborsky’s method for thematic analysis was used to analyze data. Three main themes with subthemes were identified. First main theme was the AA culture that served as a facilitator and barrier to maintaining healthy lifestyle from childhood to young adulthood. Second main theme was gradual changes in their healthy lifestyle due to social and physical environment from young adulthood to middle adulthood. Third main theme was AA women’s various suggestions for future health promotion programs. This study found obesity to be a multifactorial phenomenon that is a result of complex interaction of culture, environment, and social networks. Therefore, clinicians need to address the issue of obesity from a holistic perspective for AA women to actively engage with their primary health care. Future health promotion programs should incorporate culturally tailored lifestyle components and increase knowledge on healthy lifestyle against obesity through community-based programs.

As enrollments and class sizes in postsecondary institutions have increased, instructors have sought automated means to identify students who are at risk of failing a course. This identification must be performed early enough in the term to allow instructors to assist those students before they fall irreparably behind. In this sense, this dissertation proposes early identification methods of at-risk students and characterizes behaviors of such students. The first part of this work describes a modeling methodology that predicts student final exam scores in the third week of the term by using different sets of easy-to-collect data including student clicker responses, prerequisite course grades, online quiz scores, and assignment grades. The work uses different machine learning techniques, trained on one term of a course, to predict outcomes in subsequent terms. This allowed making predictions across terms in a natural setting (different final exams, minor changes to course content). We applied this modeling technique to five different courses across the computer science curriculum, taught by three different instructors at two different institutions. The results show consistent performance across multiple courses in a curriculum, and across multiple institutions. Also, prerequisite course grades and clicker responses are more predictive than online quiz and assignment grades. The second part of the work is to understand what factors contribute to those students' difficulties. If we were able to better understand the characteristics of such students, we may be better able to help those students. This work examines the characteristics of lower- and higher-performing students through interviews with students from an introductory computing class. We identify a number of relevant areas of student behavior including how they approach their exam studies, how they approach completing programming assignments, whether they sought help after identifying misunderstandings, how and from whom they sought help, and how they reflected on assignments after submitting them. Particular behaviors within each area are coded and differences between groups of students are identified.This dissertation ends with stating some future work of automating the identification process for general public and crafting effective student intervention frameworks.

A Concept Inventory (CI) is an assessment to measure student conceptual understanding of a particular topic. This article presents the results of a CI for basic data structures (BDSI) that has been previously shown to have strong evidence for validity. The goal of this work is to help researchers or instructors who administer the BDSI in their own courses to better understand their results. In support of this goal, we discuss our findings for each question of the CI using data gathered from 1,963 students across seven institutions.

Understanding COVID-19 vaccine hesitancy among Medicare beneficiaries is critical for increasing COVID-19 vaccine uptake in the US. This study aimed to estimate and compare the vaccine hesitancy rate among community-dwelling Medicare beneficiaries with and without cancer history, also to investigate factors associated with vaccine hesitancy during the first four months after COVID-19 vaccine became available. We used population-based, cross-sectional data on 3,034 community-living Medicare beneficiaries from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Supplement. Sample weights were applied to account for the complex survey design with results generalizable to 16.4 million Medicare beneficiaries. Weighted multivariable logistic regression model was conducted to investigate the association between cancer history and vaccine hesitancy adjusting for covariates. A total of 39.6% were hesitant about getting COVID-19 vaccine. Those with cancer history were significantly less likely to be hesitant to get vaccinated than those without cancer history (adjusted odds ratio = 0.80, 95% confidence interval: 0.64, 0.99, p = .050). The most common reason for being hesitant to get COVID-19 vaccine was that the vaccine could have side effects or was viewed as not safe (19.2%), followed by not trusting what government says about vaccine (11.4%). Those with cancer history were more likely to report ongoing health conditions, lack of recommendation from a doctor, and doctor recommending against COVID-19 vaccination as reasons for not getting the vaccine compared to participants without cancer history. Increasing the confidence and knowledge about vaccine benefits among high-risk and more hesitant individuals are urgently needed to increase the vaccine uptake.

Chinese immigrants in the US are disproportionately affected by gestational diabetes mellitus (GDM) and type 2 diabetes (T2D). The aims of this study were to describe their physical activity (PA) and sedentary behaviors (SB) patterns and to identify determinates of objectively-measured PA and SB among Chinese immigrants in the US with prior GDM. We conducted a cross-sectional study among 106 Chinese immigrants with prior GDM across the US. PA and SB were measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess knowledge and risk perceptions as well as cultural and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed. Only 27% of participants met the PA guidelines. The median duration of moderate–vigorous-intensity PA (MVPA) per week was 79 (IQR 38–151) minutes. Participants had an average of 9.2 ± 1.4 h of sedentary time per day. Living with parents (who may provide family support) was associated with more MVPA minutes per week, more steps per day, and a greater likelihood of meeting PA guidelines. Higher levels of acculturative stress were associated with fewer MVPA minutes per week. Being employed and having a lower BMI were associated with more SB. Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing family support. Different strategies are needed to decrease SB among this population.

Adolescents and sexual minority men (SMM) are high priority groups in the United Nations’ 2021 − 2016 goals for HIV prevention and viral load suppression. Interventions aimed at optimizing HIV prevention, testing and viral load suppression for adolescents must also attend to the intersectional realities influencing key sub-populations of SMM. Consequently, there is not a robust evidence-base to guide researchers and program partners on optimal approaches to implementing interventions with adolescent SMM. Using a multiple case study design, we integrated the Implementation Research Logic Model with components of the Consolidated Framework for Implementation Research and applied it as a framework for a comparative description of ten HIV related interventions implemented across five countries (Ghana, Kenya, Nigeria, Tanzania and United States). Using self-reported qualitative survey data of project principal investigators, we identified 17 of the most influential implementation determinants as well as a range of 17 strategies that were used in 90 instances to support intervention implementation. We highlight lessons learned in the implementation research process and provide recommendations for researchers considering future HIV implementation science studies with adolescent SMM.

Background: Women with prior gestational diabetes (GD) have times the risk of developing type 2 diabetes (T2D) as women without prior GD. Chinese immigrants in the US are disproportionately affected by GD and T2D. Physical activity (PA) is a modifiable lifestyle strategy to reduce the risk of T2D. The aim of this study was to identify health beliefs, cultural, and psychosocial determinants of objectively-measured PA among Chinese immigrants in the US with prior GD. Methods: We conducted a cross-sectional study among 1Chinese immigrants with prior GD (6 months to 5 years postpartum) across the US, recruited primarily via WeChat. PA was measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess health beliefs, cultural, and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed to identify factors associated with PA levels. Results: The mean age of participants was 34.3±3.7 years, and mean body mass index was 21.7±2.6 kg/m2. Mean daily steps were 5912±2139. Only 28% met the PA guidelines of ≥150 minutes of moderate- to vigorous- physical activity (MVPA) per week. The duration of MVPA per week was 86 [IQR 39- 152] minutes. Participants had an average of 9.2±1.4 hours of sedentary time per day, which was about 64.7±7.8% of the total wear time. In the final adjusted model, participants who had higher acculturative stress [-0.25 (SE=0.14) , p=.006], were not living with parents [-0.21 (SE=0.22) , p=.020], had no knowledge of PA guidelines [-0.18 (SE=0.17) , p=.039], and had an annual household income of < $60K [-0.21 (SE=0.23) , p=.025] were had fewer MVPA minutes per week. Conclusion and implication: Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing knowledge of PA guidelines. The findings from this study will inform the development of culturally-sensitive interventions. Disclosure S.Huang: None. G.I.Ash: None. S.Nam: None. S.Jeon: None. E.Mcmahon: None. R.Whittemore: None. Funding Connecticut Nurses’ Foundation Scholarship Award

Available research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces.To examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics.We analyzed data from statewide random samples of California RNs (N=895).Increased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings.The findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.

Objective This cross-sectional study aimed to 1) explore the relationships among work-life balance (WLB), burnout, and empathy and 2) investigate the roles of the subtypes of burnout relating to WLB and empathy.Methods A total of 105 health care professionals from a general hospital in Seoul were assessed using the Maslach Burnout Inventory, Jefferson Scale of Physician Empathy, and a one-sentence-question on subjective WLB. Multiple questions on psychiatric problems, including sleep problems, anxiety, depressive symptom, and alcohol problems, were also included.Results In the mediation analyses, personal achievement was considered as a potential mediating variable between WLB and empathy. The direct effect (β=3.93, 95% CI: 1.21–6.64) and the indirect effect (β=1.95, 95% CI: 0.52–3.76) of WLB on empathy were also significant.Conclusion Interventions encouraging personal achievement may help mitigate burnout of health professionals.

Perceived racial discrimination is linked to unhealthy behaviors and stress-related morbidities. A compelling body of research indicates that perceived racial discrimination may contribute to health disparities among African Americans (AAs). The purposes of this study were to describe the study protocol including data collection procedures and study measures and to evaluate the feasibility and acceptability of intensive biobehavioral data collection using ecological momentary assessment (EMA), salivary biomarkers, and accelerometers over 7 days among middle-aged AAs with a goal of understanding the relationships between perceived racial discrimination and biobehavioral responses to stress. Twelve AA men and women participated in the feasibility/acceptability study. They completed surveys, anthropometrics, and received in-person training in EMA and saliva sample collection at baseline. Participants were asked to respond to the random prompt text message-based EMA five times a day, wear an accelerometer daily for 7 days, and to self-collect saliva samples four times a day for 4 consecutive days. The EMA surveys included perceived racial discrimination, affective states, lifestyle behaviors, and social and physical contexts. The mean EMA response rate was 82.8%. All participants collected saliva samples four times a day for 4 consecutive days. About 83% of participants wore the accelerometer on the hip 6 out of 7 days. Despite the perception that the intensive nature of assessments would result in high participant burden, the acceptability of the study procedures was uniformly favorable.

Chatter is one of the most critical problems that causes poor surface quality and restriction of machining efficiency. Spindle speed variation (SSV) is a well-known technique for suppression of regenerative chatter. However, in the authors’ understanding, the chatter suppression effect diminishes when the spindle speed difference between the present and previous cutting moments is small. Furthermore, the stability changes largely according to the spindle speed variation profile which changes with the set condition of SSV parameters, e.g., nominal spindle speed, variation period and variation amplitude. Therefore, SSV parameters should be adequately set to avoid this limitation and to exert its effect throughout the entire duration of cutting. However, there is no clear methodology to determine the optimal condition. This paper presents the characteristics of chatter growth during SSV focusing on the change of chatter frequency, which lead to novel indices to evaluate the chatter stability when cutting with SSV. To verify the validity of the indices, time-domain simulations and the cutting experiments with triangular spindle speed variation (TSSV) are carried out. The influence of SSV parameters on the chatter stability is investigated from the simulation and experimental results. The limitations of widely utilized SSV profiles are discussed., ファイル公開：2022-03-01