Using Exploratory Focus Groups to Inform the Development of Targeted COPD Self-Management Education DVDs for Rural Patients

This exploratory study assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. A purposive, homogeneous sample of COPD patients participated in focus group interviews. Data from these interviews were referenced to edit a library of Rvision COPD self-management DVDs into a single condensed DVD containing only the most pertinent self-management topics. Patients reported a lack of knowledge and skill development related to purse lipped breathing, controlled coughing, and stress management; while medication management skills were found to be quite adequate. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs for self-management may lead to future use of educational technologies aimed at improving quality of life for these rural, hard to reach populations

Pubic Lice (Pthirus pubis): History, Biology and Treatment vs. Knowledge and Beliefs of US College Students

Pubic lice (Pthirus pubis) maintain a worldwide parasitic population infesting two to over 10 percent of human populations, continuing a presence that has been constant since early evidence 10,000 years ago. Outbreaks in the 1970s have been recorded, but incomplete records preclude description of a definitive population cycle. Current levels of infestation in a US college student population were investigated in this study. Knowledge and opinions of students were also recorded in an online survey administered to college students taking a basic health course at a mid-sized East Coast University. In a group of 817 students, 35 reported experience with pubic lice or other STD infection. Knowledge, beliefs, and treatment attitudes were examined for the 782 students who did not have experience with either pubic lice or STD infection. These students deemed antibiotics as a viable treatment for pubic lice infestation. They also indicated negative attitudes toward the use of pesticide crèmes, which are the most useful prescription. Symptoms and transmission myths in student answers are described. Publisher's version available at: http://www.mdpi.com/1660-4601/6/2

Association Between Health Literacy, Electronic Health Literacy, Disease-Specific Knowledge, and Health-Related Quality of Life Among Adults With Chronic Obstructive Pulmonary Disease: Cross-Sectional Study

Background: Despite the relatively high prevalence of low health literacy among individuals living with chronic obstructive pulmonary disease (COPD), limited empirical attention has been paid to the cognitive and health literacy–related skills that can uniquely influence patients’ health-related quality of life (HRQoL) outcomes. Objective: The aim of this study was to examine how health literacy, electronic health (eHealth) literacy, and COPD knowledge are associated with both generic and lung-specific HRQoL in people living with COPD. Methods: Adults from the COPD Foundation’s National Research Registry (n=174) completed a cross-sectional Web-based survey that assessed sociodemographic characteristics, comorbidity status, COPD knowledge, health literacy, eHealth literacy, and generic/lung-specific HRQoL. Hierarchical linear regression models were tested to examine the roles of health literacy and eHealth literacy on generic (model 1) and lung-specific (model 2) HRQoL, after accounting for socioeconomic and comorbidity covariates. Spearman rank correlations examined associations between ordinal HRQoL items and statistically significant hierarchical predictor variables. Results: After adjusting for confounding factors, health literacy, eHealth literacy, and COPD knowledge accounted for an additional 9% of variance in generic HRQoL (total adjusted R2=21%; F9,164=6.09, P<.001). Health literacy (b=.08, SE 0.02, 95% CI 0.04-0.12) was the only predictor positively associated with generic HRQoL (P<.001). Adding health literacy, eHealth literacy, and COPD knowledge as predictors explained an additional 7.40% of variance in lung-specific HRQoL (total adjusted R2=26.4%; F8,161=8.59, P<.001). Following adjustment for covariates, both health literacy (b=2.63, SE 0.84, 95% CI 0.96-4.29, P<.001) and eHealth literacy (b=1.41, SE 0.67, 95% CI 0.09-2.73, P<.001) were positively associated with lung-specific HRQoL. Health literacy was positively associated with most lung-specific HRQoL indicators (ie, cough frequency, chest tightness, activity limitation at home, confidence leaving home, sleep quality, and energy level), whereas eHealth literacy was positively associated with 5 of 8 (60%) lung-specific HRQoL indicators. Upon controlling for confounders, COPD knowledge (b=−.56, SE 0.29, 95% CI −1.22 to −0.004, P<.05) was inversely associated with lung-specific HRQoL. Conclusions: Health literacy, but not eHealth literacy, was positively associated with generic HRQoL. However, both health literacy and eHealth literacy were positively associated with lung-specific HRQoL, with higher COPD knowledge indicative of lower lung-specific HRQoL. These results confirm the importance of considering health and eHealth literacy levels when designing patient education programs for people living with COPD. Future research should explore the impact of delivering interventions aimed at improving eHealth and health literacy among patients with COPD, particularly when disease self-management goals are to enhance HRQoL

The Health Education Research Experience (HERE) program metadata dataset

Undergraduate subject pools are prevalent across disciplines in the United States. The Health Education Research Experience (HERE) Program was the first known course-based subject pool entirely managed and conducted online for online students enrolled in an introductory health education/health promotion course. The program was conducted within five semesters from Spring 2012 through Summer 2013. The HERE Program encompassed 13 studies embedded in two sections of an undergraduate online course at the University of Florida. The studies were all related to course topics and current research topics in health education/promotion (as identified through the Healthy People 2020 Framework). The topics ranged from the relatively less sensitive health aspects of college life (i.e., technology use) to studies assessing more sensitive health topics (i.e., intimate partner violence and sexual assault). In alignment with a best practice in survey design, the HERE Program's survey instruments included one metadata item embedded in each survey to identify which devices students used to complete the surveys. Understanding which devices students used for survey completion has ramifications for survey designers and survey researchers. In contrast to the relative uniformity of pen and paper surveys and control of the survey completion environment, online surveys may not look identical across personal devices and may be completed in increasingly varied environments. All studies, study procedures and protocols, and metadata collection procedures were approved by the university's Institutional Review Board. The data presented here were extracted from each survey's data files and aggregated. The aggregated metadata are available through Mendeley Data in a.csv file for widespread access. Descriptive statistics are presented in tables. The data provided in this article will benefit researchers interested in survey methodology, questionnaire design, modes of survey collection, and survey metadata. The data are hosted in the following Mendeley Data repository: https://data.mendeley.com/datasets/ht9jmd3cdt/2

Facebook Groups on Chronic Obstructive Pulmonary Disease: Social Media Content Analysis

Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD); however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available on COPD-related Facebook Groups, as well as the communication (self-disclosures, social support) and engagement (agreement, emotional reaction) strategies used by members to facilitate these resources. Two researchers independently searched the “Groups� category using the terms “COPD�, “emphysema�, and “chronic bronchitis�. Twenty-six closed (n = 23) and public (n = 3) COPD Facebook Groups were identified with 87,082 total members. The vast majority of Group members belonged to closed (n = 84,684; 97.25%) as compared to open (n = 2398; 2.75%) groups. Medications were the most commonly addressed self-management topic (n = 48; 26.7%). While overall engagement with wall posts was low, the number of “likes� (an indicator of agreement) was significantly greater for wall posts that demonstrated social support as compared to posts that did not (p < 0.001). Findings from this study showed that COPD Facebook group members share specific disease-related experiences and request information about select self-management topics. This information can be used to improve the quality of self-management support provided to members of popular COPD Facebook groups

Natural Observation of Alcohol Price and Promotions at Bars: Implications for Alcohol Misuse Prevention

Alcohol misuse among young adults remains a primary public health concern given the wide range of short- and longterm physical, social, and societal consequences of the behavior. On-premise drinking establishments, which allow alcohol consumption on site (i.e., bars), are frequent locations for young adult alcohol use. Risks for alcohol misuse within the bar setting are key factors to identify for prevention. Notably, alcohol price and promotions are associated with alcohol consumption among young adults. This study sought to develop and pilot test an observational protocol to assess the alcohol environment at on-premise drinking establishments. Following qualitative exploration of salient risk factors in these settings through focus groups with young adults, an observational tool was adapted and tested in a feasibility study. The refined tool was then pilot tested with two independent data collectors conducting natural observation at 13 establishments in the downtown nightlife district of a small, southeastern city. High interrater reliability was noted. Descriptive summary statistics of bar characteristics demonstrate low alcohol prices with variability across types of alcohol (e.g., beer, wine, and liquor), greater numbers of alcohol promotions inside rather than outside the building, and higher rates of manual versus electronic age verification procedures. Observational assessment of alcohol price and marketing at on-premise drinking establishments as described in this study is needed to inform prevention policy and programs to reduce harms associated with young adult alcohol misuse

An Experiment Assessing Punitive versus Wellness Framing of a Tobacco-Free Campus Policy on Students’ Perceived Level of University Support

The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students’ perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course to three message conditions in an online survey: control (no message), wellness (emphasizing promoting health and quitting support), and punitive (emphasizing consequences for violating the policy). The dependent variable was perceived organizational support. We selected items previously shown to be relevant for college students (alpha = 0.92 in our data). Given significant non-normality, we used non-parametric Kruskal-Wallis tests with pairwise comparisons to examine differences in perceived organizational support across the three conditions. We examined results by smoking status and if the participant correctly reported the message they received. We found no significant difference in perceived organizational support among students exposed to different tobacco-free campus policy announcements (p = 0.75). We also found no significant difference among smokers (p = 0.66). However, among smokers who correctly reported the message they received, we found significantly lower perceived university support (p = 0.01). Messages about tobacco-free campus policies should focus on the role of policy in supporting a healthy environment instead of punitive enforcement. Campus administrators should use caution when using message frames focusing on consequences of violating newly adopted policies.ECU Open Access Publishing Support Fun

Measuring Workplace Discrimination among Sexual and Gender Minority Workers

As inequities in health for sexual and gender minority (SGM; eg, lesbian, gay, bisexual, and transgender [LGBT]) populations become increasingly well documented, it is important to investigate causes of inequities to inform intervention work. One area of importance is in employment discrimination, as there are limited or no protections against sexual orientation and gender identity discrimination in approximately half of US states. We sought to assess the internal consistency and validity of a brief, adapted scale to measure SGM workplace discrimination. Methods: We modified an existing workplace age discrimination scale to assess SGM workplace discrimination. We assessed internal consistency, criterion validity, construct validity, and conducted a confirmatory factor analysis. Data came from a convenience sample of employed, SGM-identified adults (N = 124) attending a pride festival in Durham, NC, in September 2016. Results: The 5-item scale was significantly associated with poorer health, greater internalized homonegativity, reporting workplace bullying, SGM isolation, gender expression discrimination, and having filed a formal complaint of workplace discrimination. The scale had a single factor solution. Conclusions: This 5-item scale may be useful in efficiently documenting and addressing SGM workplace discrimination; it assesses material forms of discrimination (eg, pay and job tasks assigned) against SGM employees.ECU Open Access Publishing Support Fun

Best Practices in Honors Pedagogy: Teaching Innovation and Community Engagement through Design Thinking

Honors colleges aim to provide unique first-year experiences that promote life skills and emphasize process over product in an interdisciplinary setting that builds community. A two-semester, five-semester-hour course sequence with colloquia tackles these challenges by introducing an entrepreneurial mindset that pushes students toward innovative understanding and building of community. The first iteration includes an introduction to design thinking; identification of wicked problems; collection of data using immersion experiences, interviews, and literature review; and experiments (n = 35) in project-based entrepreneurial methodologies using Lean LaunchPad. The second iteration involves assessment, applied qualitative analysis, out-of-class learning, and peer mentoring. Results provide a framework for developing innovative thinking, an entrepreneurial mindset, and community engagement among first-year students—a design that, the authors conclude, has not only developed in students specific, non-academic skills (such as resiliency and creative self-confidence) but effectively doubled the size (as mandated by the university) of the first-year class. Implications for future iterations are considered, calling for strengthening administrative support, increasing academic/community partnership, and sustaining funding beyond the first year

Does Gender Minority Professional Experience Impact Employment Discrimination? Two Résumé Experiments

We sought to examine perceived gender identity, perceived co-worker discomfort, and salary recommendations for youth counselors with transgender-related work experience. In two experiments conducted in 2016 and 2017, we randomized participants to view 1 of 2 résumés with varying work experience at a camp for transgender youth or a generic youth camp. Study 1 participants were 274 adult festivalgoers at a lesbian, gay, bisexual, and transgender pride festival. Study 2 participants were 296 employed, heterosexual adults aged 35-60 from an online survey panel. In Study 1, viewing the résumé with transgender experience resulted in a statistically significantly higher likelihood of reporting the applicant was gender minority than cisgender (adjusted odds ratio = 3.76, 95% confidence interval [1.32, 10.72],   p = .01), higher but not a statistically significant level of co-worker discomfort (aOR = 1.39, 95% CI [0.83, 2.32], p = .22), and, although not statistically significant, a $2,605 higher salary (95$604, - $5,814], p = .11). In Study 2, we found a statistically significantly greater likelihood of reporting the applicant was gender minority than cisgender (OR = 2.56, 95$1,374 higher salary (95% CI [-$1,931,$4,679], p = .41). Our results indicate the potential for stigma by association for professionals working with marginalized groups and suggest potential pathways through which employment discrimination may exacerbate existing inequities for gender minority people