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Health & Human Services.

How Does Patient Experience Predict Operating Margins and Cash-Flow Margins of U.S. For-Profit, Non-Profit, and Governmental Hospitals? Lihua Dishman, Central Michigan University

A longitudinal national study was completed in 2016 in response to United States hospitals' rising foci on improving patient experience (PX) as measured by the nationally standardized Hospital Consumer Assessment of Healthcare Providers and Systems survey. The quantitative study's period was 2009-2012, and its final sample encompassed 1,377 U.S. Medicare-certified inpatient acute-care hospitals (on average 62% were non-profit, 18.5% for-profit, and 19.5% governmental). Results of correlation analyses indicate that PX consistently had a statistically significant positive association with operating margins (OM) and cash-flow margins (CFM) respectively. Results of linear regression analyses indicate that hospitals delivering better PX reported higher OM and CFM consistently. Moderation analyses using fitted general linear modeling indicate that better PX improved all, governmental, and non-profit hospitals' OM and CFM, but results for for-profit hospitals were mixed. Furthermore, logistic regression analyses were performed to obtain predictive indications that may inform hospitals' governing boards, executive leaders, and financial managers. Results of logistic regression analyses indicate: PX was a better predictor of OM for non-profit than for for-profit and governmental hospitals, a better predictor of CFM for governmental than for for-profit and non-profit hospitals in 2009-2010, but an inconsistent predictor of CFM for non-profit and governmental hospitals in 2011-2012.

Neudextra: The New "Mommy's Little Helper Pill" Hits Long Term Care, Highlighting the Dangers of Prescribing Off-Label Drugs. Susan L. Bushinski, Eastern Michigan University

Off label prescribing is common practice amongst providers. According to Ruan and Kay (2016) the FDA maintains that a provider use excellent acumen and medical practice, following what is best for the patient. Treatment may include legally available pharmaceuticals, biologics and/or medical devices. The drug Neudextra, which has been prescribed to geriatric patients within Long Term Care, has been linked to increased falls, which is a quality indicator of care in both Acute Care and Long Term Care facilities, who are monitored by CMS, and studied through AHRQ (Rand, 2017). Off-labeled prescribed drugs such as Seroquel, Paxil, Singular, Metformin and Zyprexa have been controversial when used off-label as well (Stafford, 2008).

To meet the objective of informing providers of the risks of prescribing off-label pharmaceuticals, biologics and devices, twenty-five articles were reviewed for background, conditions contributing to the rise in incidence, screening and management strategies. Both Medline and CINAHL data bases were explored.

While much has been published on off-label prescribing, little has delved into the negative patient outcomes of this. I conclude that providers must be aware of the risks and benefits of off-label prescribing, and more research on its association with falls and other negative outcomes needs to be done.

Leadership Competency Gaps of Health Administration Graduates: What Does the Industry Tell Us? John W. Fick, Siena Heights University; Lihua Dishman, Katherine Adler, and Letha Williams, A.T. Still University

A mixed-method, cross-sectional national study was conducted recently in response to U.S. hospital CEOs' continued concerns for personnel shortages. The CEOs, credentialed as American College of Healthcare Executives Fellows (FACHE) and from across the U.S., were surveyed using a self-developed survey instrument, including quantitative and qualitative questions regarding the CEOs' seven demographic characteristics and 26 competencies established by the National Center for Healthcare Leadership and expected of healthcare leaders. Excluding incomplete responses, the final sample (n = 46) represented a 5% response rate. Descriptive and inferential statistical analyses of quantitative data were performed to examine respondents' demographic characteristics and health-administration graduates' 26 leadership competencies scored by the respondents (1-5 scale). Thematic analyses of qualitative data were performed to identify top competencies critical to the CEOs. Quantitative results indicate that FACHE credentialed U.S. hospital CEOs rated health-administration graduates' leadership competencies upon job-entry unfavorably in general (the five top-scored competencies were below 4: Information-Seeking, Information-Technology-Management, Performance-Measurement, Professionalism, and Self-Confidence). Qualitative results indicate that five most sought-after leadership competencies of health-administration graduates were Self-Development, Information-Seeking, Analytical-Thinking, Organizational-Awareness, and Accountability. The critical gaps in leadership-competency as possessed by health-administration graduates upon job-entry versus as expected by FACHE credentialed U.S. hospital CEOs lie in Self-Development and Organizational-Awareness.

Examining the Relationship among Hospitalist Continuing Education, Hospitalist Communication Competency, and Stroke Patient Outcomes.

Kathie Thomas, American Heart Association, A.T. Still University; Lihua Dishman and John Fick, A.T. Still University

Studies of effective continuing education (CE) often related to individual knowledge base, behavior, and patient outcomes (Sampath, Dietze, Toth, Cannon, and Breslan, 2012). Physician communication helps improve patient outcomes (O'Hagan, 2014). Nevertheless, understanding is limited regarding the interactions among CE, communication competency, and stroke patient outcomes. This study utilized a mixed methods research design to investigate the relationship among the three constructs and three main empirical findings emerged. First, hospitalists' CE in communication had a statistically significant negative relationship with readmission rates. Second, CE in communication improved hospitalists' communication competencies. Finally, hospitalists' improved communication competency improved stroke patients' outcomes including readmission rate, mortality rate, disability rate, treatment related complication rate, and average length of stay. The study's descriptive and empirical results imply that CE in communication may improve collaboration and teamwork among hospitalists, and better hospitalist-patient communication may also help to reduce medical errors. The summary discussion of the study results and the implications for practitioners collectively facilitated the identification of several recommendations for practitioners, including leadership development of hospitalists, engagement and retention of hospitalists, engagement of patients and their families, and enhancement of medical curricula. Finally, this study facilitated the identification of several opportunities for future research.

Accessible Exercise: Improving Parks and Recreation in the City of Pontiac. Corey Rowe, Jennifer Lucarelli, Rosemarie D'Angelo, Kristen Wiltfang, and Graeme Harper, Oakland University

Parks and Recreation Master Plans help communities identify and prioritize recreational needs for diverse populations. This project contributed to redevelopment of the city of Pontiac's Parks Plan by recording geographic and pictorial information in twelve parks for use in identifying barriers to accessibility affecting residents with physical disabilities. The parks were selected using existing disability and lifestyle data, council district location, and size. Facilities were assessed with a GPS device and geographic information system (GIS) software. Accessibility features were photographed, assigned location information, and organized into a comprehensive map. Multiple barriers were discovered, including uneven or non-unitary ground surfaces and a complete absence of accessible restrooms, parking, and pathways in 100% of parks assessed. These findings will be integrated into redevelopment of the Pontiac Parks Plan. Proposed short-term solutions included improved grass maintenance, pathway clearing, and redesigning parking areas to improve access for those with disabilities. Long-term proposals included play areas with unitary ground surfaces, new pathways to connect existing park facilities, and restoring restroom facilities. Integrating these solutions into future Master Plans will encourage and enable Pontiac's disabled population to use the park system, leading to a higher number of physically active residents with improved health status.

Deterioration in Recombinant Tissue Plasminogen Activator after Repeated Freezing and Thawing Cycles for Thromboelastography. Kaitlin Rose, Henry Ford Hospital, Detroit; Sean-Matthew Calo, Central Michigan University; Anja-Kathrin Jaehne, Kelly A. Keenan, Jun Xu, and Baruch Tawil, Henry Ford Hospital, Detroit; Richard Thompson, Wayne State University

Thromboelastography (TEG) is often used to measure coagulation dynamics in the setting of acute ischemic stroke and thrombolytic therapy. The stability of thrombolytics has not been investigated in TEG. We conducted an experimental series to test the effects of recombinant tissue plasminogen activator (rtPA) on fibrinolysis in normal blood samples using TEG.

Control-whole blood and rtPA-whole blood TEG was performed for 3 hours on 4 healthy human blood samples. Maximum clot amplitude (mm) and absolute clot strength (dynes/[cm.sup.2]) were measured. Data (mean [+ or -] SD) were analyzed by t-tests and significance inferred at p < 0.05.

Clot amplitude increased with thawing and refreezing (28 [+ or -] 3, p = 0.004; 35 [+ or -] 2, p = 0.01; 50 [+ or -] 3, p = 0.02; and 55 [+ or -] 3, p = 0.30, for testing cycles 1, 2, 3 and 4, respectively) compared to untreated samples (63 [+ or -] 4). Clot strength also increased over the 4 cycles (2 [+ or -] 0.3, p = 0.007; 3 [+ or -] 0.2, p = 0.02; 5 [+ or -] 05, p = 0.01; and 6 [+ or -] 0.7, p = 0.30) compared to untreated (9 [+ or -] 1.4). Lysis initiation time was gradually longer over the 4 tests suggesting delayed fibrinolysis.

One repeatedly thawed and refrozen rtPA stock showed a delay in fibrinolysis in healthy human blood, suggesting a loss of potency. Thus, rtPA should be aliquoted tor 1-time use for experiments using TEG.

Mixed Methods Assessment of Birth and Perinatal Mortality on Malawi's Likoma Island. Arieanna T. Eaton, Alma College; Katherine M. Vaillancourt, Quinnipiac University; Frank H. Bia, Yale University

In 2013, Malawi achieved Millennium Development Goal 4 (MDG4), to reduce childhood mortality by 2015. However, recent research has shown that large population centers have outpaced rural areas in MDG4 achievement. Likoma Island, with one healthcare center, St. Peter's Hospital, is one of Malawi's most remote locations and its MDG4 achievement has yet to be assessed. This research utilized mixed methods to put Likoma Island's progress of achieving MDG4 in the context of Malawi. Ethnographic interviews, which work to develop an understanding of cultural norms, were conducted to determine birthing practices of island residents, guests from Mozambique, and healthcare providers. Maternity discharge records from St. Peter's Hospital were used to estimate perinatal mortality, a subset of childhood mortality. Preliminary analysis of interviews indicated that healthcare providers taught patients to avoid traditional medicines and to seek community support for hospital care, while community members indicated gratitude for the available healthcare services and a preference for formalized care over traditional methods. The data showed an estimated perinatal mortality rate for 2013-2017 of 45 deaths per 1000, greater than Malawi's most recent national report of 35 perinatal deaths per 1000. Future analysis using a multiple imputation technique will focus on determining if perinatal mortality can be correlated to any maternal characteristics.

The Effect of the 2017 Tax Cut and Jobs Act on Michigan Hospital Operations. Zigmond A. Kozicki, University of Detroit Mercy; Stephanie J.S. Baiyasi-Kozicki, Central Michigan University

The 2017 Tax Cut and Jobs Act is expected to close hospitals in the United States because of an expected reduction of Medicare funding. The proposed cuts to Medicare in 2018 as a result of The Tax Cuts and Jobs Act could be $25 Billion. A systematic review and quantitative analysis of 90 Michigan Hospitals listed in the 2017 American Hospital Directory was conducted using return on investment (ROI) of 2% or less as a criteria for risk of closing. In Michigan 54 hospitals (36 urban and 18 rural hospitals) are currently at risk. If these hospitals close this would cause the shifting of patient days (1,832,268 days) from the 54 at-risk hospitals to the remaining 36 hospitals. This will become a statewide population health problem. There are specific actions that can be initiated to help prevent hospital closures in Michigan. These preventive actions will be shared in the PowerPoint presentation by the researchers. Population health issues will be explored.

Regional Incidence of Methicillin Resistant Staphylococcus aureus in the United States. Patrick O'Dowd and Carly J. Nowicki, Madonna University

Methicillin resistant Staphylococcus aureus (MRSA) is a bacterial infection that is a national concern, affecting factions of people at disproportionate rates. Therefore, there should be geographical differences in the prevalence of MRSA in various regions of the United States. States were placed in standard regions of the United States based on census provisions. Data were then generated from the Center for Disease Control's (CDC) Hospital Acquired Infection (HA1) Progress Report database. The 2014 standardized infection ratio (SIR) for each region was compared to the 2011 national SIR baseline, along with other categories. Since 2011, all regions of the United States reported a lowered incidence of MRSA infection; however, there were clear geographic discrepancies in MRSA infections. The region with the highest rate of MRSA infection, the South (2014 regional SIR = 0.96), was analyzed by divisions within this region. The South Atlantic was the division with the highest rate of MRSA infection (divisional S1R= 1.00). The region with the lowest MRSA infection rate was the Northeast (2014 regional SIR = 0.66), with New England division having the lowest rate of MRSA infection (SIR = 0.53). Variables including income, climate, and preventative care were examined to explain the potential cause of these geographical rate variations.

What Are the Attributes of U.S. Hospitals' Financial Performance? Laurie Latvis, Lihua Dishman, Kryn McClain, Sarah Smith, and Jason Studley, A.T. Still University

National healthcare spending is at 17.8% of GDP and may reach 19.9% by 2025. Currently, 5,564 U.S. facilities meet American Hospital Association's criteria as hospitals, with over 35 million annual total admissions. To gain a better understanding of U.S. hospitals, this time'Series, and cross-sectional observational study explored performance attributes by analyzing Tenet Healthcare Corporation's 2014-2016 financial ratios and comparing its 2016 financial ratios to those of Community Health Systems and Hospital Corporation of America. The three together operate 425 hospitals in U.S. Liquidity, debt management, asset management, and profitability ratios were evaluated. Data were collected from the companies' publicly available, audited annual financial statements. Descriptive evidence indicates that financial performance of U.S. hospital companies may be attributable to external and internal factors. Key external factors include legislation and regulations, economic conditions, market competitions, and target markets' population composition. Key internal factors include establishing sound actionable organizational strategies, maintaining short-term liquidity, managing capital-structure and cost of capital, cultivating positive relationships with employees, focusing on patient-centered care by engaging patients and families, and analyzing market, care quality, and patient data for making data-driven decisions. Study findings may provide insights to hospital companies regarding how to provide better patient care at lower costs.

The Effect of a Summer Health Camp Program on the Nutrition Knowledge and Attitudes of Girls. Arlene J. Hoogewerf, Barbara Bosscher Timmermans, Elise Veurink, and Josephine Granner, Calvin College; Donald Bryant, Bryant's Healthcare Solutions; Adejoke B. Ayoola, Calvin College

Two one-week day camps focused on promoting a culture of health, educating girls about their bodies, leadership, and the health professions. Week 1 included 48 girls (9-12 years), and week 2 included 41 girls (12-15 years). The camp featured daily healthy snacks and a college cafeteria lunch, and nutrition and food preparation among other health-related sessions. The study purpose, to determine whether a one-week broadly-focused health camp can improve nutrition knowledge and attitudes towards fruits and vegetables, was assessed using pre-and post-test questionnaires with questions about knowledge and attitudes towards 25 fruits or vegetables. Each camp had two 55-minute nutrition/food preparation sessions. Week 1 focused on healthy beverages and colorful fruits and vegetables; 12 foods from the questionnaire were featured in recipes. Post-test attitudes were improved for 15 foods, of which 8 were featured foods. The post-test correct answers increased for all five knowledge questions (p < 0.05 for three questions). Week 2 focused on whole grains and better fast food choices; 8 foods from the questionnaire were featured in recipes. Post-test attitudes were improved for 18 (including all 8 featured) foods. The post-test correct answers increased for all five knowledge questions. Our data suggest that nutrition knowledge and attitudes can be improved by broadly-focused health camps.

Mental Health and Risk for Cancer among Berrien County Youth in Michigan: A Systems Analysis. Colleen Staniszewski, Michael Krause, Melody Page, Evin Liu, Justis M. Mcneal, and Morgan Winkfield, Andrews University

In Berrien Springs, Michigan, the priority health need cited by students was mental health. Youth expressed concerns about being overwhelmed with schoolwork, social acceptance, and the emotional effects of being bullied. Berrien County ranks 66th in terms of health behaviors among Michigan's 83 counties. Smoking, drinking and substance abuse increase risk for cancer. The purpose of this study is to apply systems analysis technology to solve mental health issues with the goal of reducing the risk for lifestyle-related cancers among Berrien youth. Mental health data for Berrien County youth were obtained from Community Needs Assessment data that were generated and analyzed by the input of 1,300 community residents who participated in focus groups, key informant interviews, surveys, and photovoice projects. Secondary data analysis identified key influences for mental health as health behaviors related to exercise, diet, smoking, drinking and substance abuse. Bottlenecks were lack of access to health care, provider availability, lack of health education, and lack of affordable places to workout. Opportunities identified were having access to mental health counselors, health care providers, and health education. A systems analysis approach is suggested for prevention and mitigation of mental health issues among youth in Berrien County, Michigan.

Comparison of Maximum Reaction Force, Maximum Muscle Contraction, and Biomechanics between Running and the Bionic Runner Predator Elliptical Bike. Mitch Zigler, Ben Havenaar, and Christian Dawe, Spring Arbor University

Bionic Runner is an elliptical bike that is an alternative for runners to continue to exercise without negative effects from ground reaction forces. The research compares ground reaction forces between the Bionic Runner and running while maintaining similar muscular contractions in the vastus medialis, semitendinosus, and semimembranosus muscles while offering similar lower extremity biomechanics. A BioPac surface EMG unit measured muscular contractions in the vastus medialis, semitendinosus, and semimembranosus muscles. Twenty participants ran on a treadmill at 60% of maximal exertion for two minutes followed by 60% of maximal exertion for two minutes on the Bionic Runner. Posterior and lateral camera views were used for gait analysis. Force impact was also recorded for both the Bionic Runner and running. An average of the maximal forces for both the Bionic Runner and running were recorded for analysis. Comparisons were made between the Bionic Runner and running that validate the hypothesis indicating that the Bionic Runner Bike offers a low impact exercise option. The muscular contraction comparison of the vastus medialis, semitendinosus, and semimembranosus revealed less overall contraction with the Bionic Runner. The biomechanic movement pattern comparisons demonstrated a shorter stride length with the Bionic Runner.

Thoracic Spine Mobility and Its Effects on Throwing Mobility. Bethany Ulrich, Mitch Zigler, and Leslie Tanis, Spring Arbor University

For athletes involved in a repetitive overhead throwing/hitting motion, the risk for injury to the upper extremity can be high. When there is a decrease in thoracic rotation with the same movement, the risk for injury increases. In a pretest, post-test experimental design, this study examined the effects of manual spinal manipulation and/or stretching techniques on collegiate overhead athletes. Thirty-six athletes volunteered from the Spring Arbor University baseball, Softball, volleyball, and track and field teams. The participants were randomly divided into three groups of twelve, a control group with no intervention, a group who performed daily stretches for the thoracic spine, and a group who received manual spinal manipulation from a physical therapist as well as the same stretching program as the second group. The intervention period lasted six weeks. A pre-test and a post-test were conducted involving two tests, a seated thoracic trunk rotation and the overhead movement of the participant's sport. The tests were video recorded and were later analyzed using Dartfish video analysis software. Statistical analysis of the data was conducted using paired sample t-test.

The Breast Kind of Tattoos: A Study of Tattoos on Mastectomy Scars. Kaitlin Reed and Brandon Youker, Grand Valley State University

Mastectomy surgeries often leave surgical scarring in the place of the affected breast tissue. The purpose of this study was to investigate cisgender women who have undergone a single or double mastectomy in the United States and how they came to the decision to cover their mastectomy scars with tattoos. Additionally, the research sought to uncover how the mastectomy tattoo has impacted the mental and emotional well-being of the participant. The researcher used phenomenological approach guides to explore the experiences and perceptions of the participants about their own perspectives. Twelve participants were contacted through breast cancer groups on social media and participated in semi-structured interviews via webcam from varied locations in the United States. The data were analyzed in two ways: results linked to changes in affect in self-esteem and body image before, during, and after the mastectomy surgery, as well as how the covering of the scarring by the mastectomy tattoos altered the participant's self-esteem and body image after. Results showed that body image and self-esteem increased positively after the tattooing process. The current body of knowledge on this subject is nearly nonexistent, so further additional research may be able to help inform breast cancer survivors with new options and avenues after mastectomy surgery to help improve quality of life.

The Feasibility and Use of Simulation to Assess Parent Learning: Implementation and Evaluation of Parent Discharge Teaching when Caring for Technology Dependent Children. Michelle Whalen, University of Detroit Mercy

Children dependent upon long term mechanical ventilation post discharge from an acute care center are at high risk for readmissions, morbidity, and mortality directly related to the care they receive in the home environment. Parents are inadequately prepared to provide the level of care needed in the home setting prior to their child's discharge home.

The primary goal of the PAWS (Parental Airway Assessment with Simulation) program was to assess parent learning and confidence to manage these children in the home setting post discharge. The Simulation Model for Improved Learner and Health Outcomes (SMILHO) framed this assessment program's development, implementation, and evaluation which focused on airway management using an on-site simulation-based assessment focused on observation and evaluation of parental clinical skills. This program implemented a multi-step simulation-based assessment intervention using a mixed methods design over a 6-8-week period including a home visit post discharge. In all, 15 patients were enrolled with 8 completing the program.

Post program completion, parents had a demonstrated 22% increase in self reported confidence in caring for their child following discharge using an administered pre-post Family Assessment Survey. At the conclusion of the program parents demonstrated statisically improved clinical skills with a significant increase across all four tracheostomy skill assessments.

Motivating by Finding What Truely Matters: Provider Attributes that Influence Type 2 Diabetes Adherence. Yolonda Freeman-Hildreth, University of Detroit Mercy

Diabetes affects over 29 million people in the United States requiring the integration of complex medical tasks in an individual's life. Patients who receive compassionate care are shown to have greater participation in their care.

This research aims to examine provider attributes that influence Type 2 Diabetes (T2D) diabetes adherence. Our research question is as follows: Which provider attributes influence patients with T2D to adhere to their treatment plan and have successful outcomes?

We designed a quantitative study applicable to individuals with T2D to investigate provider attributes that influence T2D adherence. We sampled 474 T2DM using a 62-item online survey administered to three different groups.

Our results revealed full mediation effects with Coping Ability on Self-Management via Compassion and with Coping Ability on Self-Management via Optimism. In addition, our results revealed a full mediation effect with Coping Ability on Treatment Satisfaction via Compassion as well as Coping Ability on Treatment Satisfaction via Optimism.

Our research has implications for improving patient-provider communication. Providers who communicate with optimism and compassion positively affect coping ability. Practically, providers can influence coping ability by communicating optimistically while delivering realistic expectations. Lastly, there are implications for the development of provider communication tools aimed at improving patient coping strategies and compassionate care.

Effect of Having an Antiretroviral Therapy Adherence Monitor on CD4 Cell Count among Pregnant Women Living with HIV in Ghana. Jennifer R. McCullough, Arfah Anjum, and Vanessa R. Salmo, Oakland University; Prince O. Gyebi, Center for Learning and Childhood Development-Ghana; Kwame S. Sakyi, Oakland University, Center for Learning and Childhood

A key part of HIV care in Ghana is for newly diagnosed patients to attend at least two antiretroviral therapy (ART) adherence counseling sessions with an ART adherence monitor. Research is yet to evaluate the choice of a monitor and the number of counseling sessions attended with a monitor on CD4 cell count. A retrospective cohort study of 135 pregnant women diagnosed with HIV in 2011-2013 was conducted using data from patients' medical records at Korle Bu Teaching Hospital, Ghana. The outcome was participants' first post baseline CD4 cell count, categorized as high ([greater than or equal to] 350 cells/[mm.sup.3]) versus low (< 350 cells/[mm.sup.3]). 62% attended [greater than or equal to] 2 counseling sessions with a monitor. In a multivariate logistic model, the odds of having a high CD4 cell count was over three times higher among those who attended [greater than or equal to] 2 counseling sessions with a monitor [Adjusted OR= 3.44; 95% CI: 1.10, 10.70; p-value = 0.03] compared to those who did not. The choice of an adherence monitor (partner vs. non-partner) was not associated with high CD4 cell count. Given the benefits of having an ART adherence monitor, efforts should focus on in increase the proportion of women attending [greater than or equal to] 2 counseling sessions with a monitor.

Analysis of Student Perceptions of the Campus Nutrition Environment at a Four-Year Public University. Katherine Brennecke, Rachel Golaszewski, Kyle Mcintosh, and Melissa M. Reznar, Oakland University

College is a vital time to focus on promoting and utilizing a healthy lifestyle. With obesity rates in the US continuously rising, positive changes are necessary to encourage today's young people to establish a better future. A closed-question survey was designed to investigate potential changes that can be made to Oakland University's nutrition environment, guided by literature review and cognitive evaluations. Under the guidance of Dr. Melissa Reznar, an assistant professor of health sciences at Oakland University, three undergraduate researchers compiled survey questions in four categories: (1) demographics, (2) current eating habits, (3) barriers to healthy eating, and (4) perceptions of the nutrition environment on campus. This survey was taken by 53 students between the ages of 18 and 24. Price, taste preference, availability, food sustainability, location, stress, and time constraints were chosen as "somewhat big" or "very big" barriers to healthy eating by the majority of students. Candy/snack chips and sugar-sweetened beverages were said to be "very easy" to find on campus by 80.77% and 90.38% of students surveyed, respectively. However, the majority of students rated the ease of buying fruits (80.39%) and vegetables (82.00%) from "neutral" to "very difficult." We plan to distribute this survey to more students with the overall goal of improving Oakland University's campus nutrition.

School Social Workers' Professional Development, Personal Contact and HIV Attitudes in Adolescent Prevention Strategies. Leona Mickles-Burns, Marygrove College

Adolescents are at risk of contracting HIV/AIDS. Stigma is a barrier to HIV prevention, and prevention is essential to decrease the transmission of HIV/AIDS. Youth who are HIV positive experience discrimination, ostracism, and negative attitudes by professionals who service them. They are in need of academic, emotional, social and behavioral support. To examine the relationship between professional development, personal contact with youth who are HIV+, and the attitudes of school social workers toward students who are HIV+, this study analyzed data from 169 New York Department of Education school social workers, who took part in the School Professional's Attitude towards AIDS survey. The study found no relationship between personal contact with persons who are HIV+ and attitudes. The study shows a significant relationship between professional workshops on HIV/AIDS and school social workers' improved attitudes. This study has implications for improved service delivery, intervention, and treatment of HIV positive school-age youth. Professional development on HIV/AIDS positively influences attitudes of school social workers towards students who are HIV+.

Improving Public Health through Positive Youth Development at the Lawn Academy in Detroit. Laurel Stevenson, Catherine McGhie, Alicia Tollefson, and Sruthi Sreedhar, Oakland University

Strategies to address positive youth development (PYD) are an important avenue to improve public health and social problems. The Lawn Academy of Detroit was established to promote PYD for male adolescents that may not have a positive male role model in their lives. PYD encompasses "Six Cs": competence, confidence, connection, character, compassion, and then contribution to self, family and community emerges. Developing these "Six Cs" among adolescents is necessary to create strong community foundations. Adolescents participate in leadership and academic training throughout the summer. Community service activities constitute lawn and other outdoor home care. Lawn Academy adolescents maintain numerous properties of the elderly, disabled, and veterans in Detroit and gain skills in leadership, PC and MAC use, resume development, and other career building, while establishing connections with positive male role models. The Lawn Academy of Detroit provides a mechanism for male adolescents to engage in activities to foster PYD, while providing community service to Detroit-specific populations. Similar programs attentive to developing specifically the "Six Cs" should be created for other youth populations to establish strong community foundations with the long-term goals of improving public health and social problems.

"It's Pretty Much the Same Thing Every Day": Food Environment at a Four-Year Public University. Candis Jarbo, Katherine Brennecke, Danielle Bohn, and Melissa M. Reznar, Oakland University

College students, with their hectic schedules and potential newfound independence, are known for having unhealthy diets characterized by high fast food intake and low fruit and vegetable intake. This study examined various aspects contributing to students' unhealthy lifestyles and strategies that could be used to improve them. Six focus groups, each containing six to ten undergraduate Oakland University students, were conducted. A total of forty-one students participated. Audio recordings of the focus groups were transcribed verbatim. Data were then qualitatively analyzed using NVivo version 10 Software. Three researchers coded the data and evaluated themes. Five major themes emerged: food characteristics, barriers to healthy eating, availability of food, convenience/inconvenience impacting food decisions, and future suggestions. Quality and taste of foods on campus were very influential on participants' decisions to eat unhealthily. They noted many barriers to healthy eating, such as the high cost of healthy foods and lack of healthy options available on campus. Students reported that this made it less convenient for them to eat healthily. Participants also suggested desired potential improvements, like embedding a nutrition course into OU's curriculum. Results of the study will be used to increase nutrition awareness on Oakland University's campus and improve the overall food environment.
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Publication:Michigan Academician
Article Type:Clinical report
Geographic Code:1U3MI
Date:Sep 22, 2018
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