Randall R. Cottrell

Role of social support, hardiness, and acculturation as predictors of mental health among international students of Asian Indian origin.

This study determined the role of social support, hardiness, and acculturation as predictors of mental health among international Asian Indian students enrolled at two large public universities in Ohio. A sample of 185 students completed a 75-item online instrument assessing their social support levels, acculturation, hardiness, and their mental health. Regression analyses were conducted to test for variance in mental health attributable to each of the three independent variables. The final regression model revealed that the belonging aspect of social support, acculturation and prejudice of acculturation scale, and commitment and control of hardiness were all predictive of mental health (R2 = 0.523). Recommendations have been offered to develop interventions that will help strengthen the social support, hardiness, and acculturation of international students and help improve their mental health. Recommendations for development of future Web-based studies also are offered.

Health Literacy in College Students

Abstract Objective: The purpose of this study was to assess the health literacy levels, and the potential importance of healthy literacy, of college students. Participants: Courses were randomly selected from all upper level undergraduate courses at a large Research I university to obtain a sample size of N = 399. Methods: During the 2007–2008 school year, students were administered the Test of Functional Health Literacy (TOFHLA), which assessed both numeracy and reading comprehension utilizing real-life health care materials. The numeracy scale (n = 17) assessed understanding of prescription labels, appointment slips, and glucose monitoring using actual hospital forms and labels for prescription vials. Ten prompts were given, and participants had to answer quantitatively. The reading comprehension scale (n = 50) assessed understanding of health care texts through 3 reading passages, including instructions for preparation for an upper gastrointestinal (GI) series, Medicaid patient rights and responsibilities, and hospital informed consent agreement. A modified Cloze procedure was employed; every fifth to seventh word in each passage was omitted and the participant selected the best word to fill in the blank from a list of 4 possible choices. Results: The mean health literacy score was 93.83, which was considered adequate functional health literacy. In terms of importance of health literacy to the students, it was found that a majority valued its importance (89.3%). Conclusions: Indeed this group of university students would seem to have good health literacy levels that would allow them to navigate the health care system. However, many students still had problems with individual TOFHLA items, particularly the numeracy questions.

Women’s Knowledge of HPV and Their Perceptions of Physician Educational Efforts Regarding HPV and Cervical Cancer

Human papillomavirus (HPV) was one of the most common sexually transmitted infections in women of child-bearing age in the US. It was estimated that nearly three out of every four American women between the ages of 15 and 49 would be infected with genital HPV over the course of their lifetime. Human papillomavirus was present in almost 100% of cervical cancers. Despite this growing epidemic, there was little knowledge and awareness of HPV among the general public. HPV was most often detected in abnormal Pap test results. However, women undergoing Pap tests lacked basic knowledge about HPV testing, abnormal results, and follow-up procedures. The purpose of this study was to determine women’s knowledge of HPV and their perceptions of the education they received from their physician regarding the reason for a Pap test, explanation of Pap test results, and how effectively the physician explained associations between HPV and cell abnormalities, cervical cancer, risk factors, and preventive measures. A survey containing 33 questions was completed by 109 primarily professional women. Based on the data collected in this study it seems that physicians were not routinely providing HPV information to their female patients. Women reported their physicians were not educating them on testing for HPV and cervical cancer, risk factors associated with contracting HPV, and preventive measures associated with HPV. Younger physicians were more likely to discuss these topics with women than older physicians. Single women also reported more discussion with their physician on these topics than married women.

Current Developments in Accreditation and Certification for Health Promotion and Health Education: A Perspective on Systems of Quality Assurance in the United States

The health education profession in the United States employs parallel, and overlapping, systems of voluntary credentialing to ensure quality in professional preparation. The U.S. approach to quality assurance comprises credentialing at the individual level, including certification, and at the institutional level, including regional and program-specific accreditation or approval of professional preparation degree programs. These multiple systems and levels of quality assurance have evolved during a half century but have not been uniformly available or universally embraced by the field, employers, or those in the institutional settings in which health educators now receive their professional preparation. This article reviews the current scope of credentialing systems in the United States and explains whom they serve and how they function. Recent developments that are now reshaping the landscape of quality assurance in health education and health promotion are also discussed.

Melanoma Knowledge and Sun Protection Attitudes and Behaviors among College Students by Gender and Skin Type

Abstract The purpose of this study was to evaluate the melanoma and sun protection knowledge, attitudes and behaviors of college students attending a large Midwestern university. Further, gender and skin type (fair, medium, or dark) were examined as potential intervening variables. Results indicate that the college students studied had low knowledge levels related to melanoma and sun prevention behaviors. Their attitudes toward sun protection were in the medium range, being neither strongly positive nor negative. Their general sun protection behaviors and specific sunscreen use behaviors were fairly poor. Both gender and skin type were found to have a significant impact on melanoma knowledge and sun protection attitudes and behaviors. Females and those with fair skin were more knowledgeable and had better attitudes and behaviors. Implications of these findings for health educators are thoroughly discussed.

Stress status and related characteristics among urban residents: a six-province capital cities study in China.

Objectives To estimate current prevalence levels of stress, and to identify related characteristics among urban residents in China. Design A cross-sectional, multilevel study. Selected through multi-stage quota-sampling, survey participants were 4,735 urban residents aged 15 years and older who resided in one of six selected Chinese capital cities. Data were collected on stress levels and sociodemographic characteristics. Stress was assessed using the Perceived Stress Scale, Chinese version (CPSS). A multilevel variance component model was employed to analyze associations between sociodemographic variables and stress. Results The mean stress score for urban residents was 22.34 (SD: 3.22), and 36.8% of those surveyed (95% CI: 33.5–40.2%) were severely stressed (>25). Multilevel regression analysis indicated that residents aged 55 years and older were less stressed than residents under age 25. The most educated and higher income earners had lower stress levels than the least educated and poorest. High levels of stress were apparent among all other occupational groups, relative to managers and clerks, except retirees and operational workers. Residents in the north of China exhibited higher stress levels than counterparts in the south. Conclusions This study suggests that higher stress levels are positively associated with social class in China. Our findings could inform health policy, guide prevention strategies, and justify the design and implementation of targeted interventions.

Progress and Directions in Professional Credentialing for Health Education in the United States

This article provides an update on initiatives in individual certification and accreditation of academic programs in public/community health education and school health education in the United States. Although we provide some historical context, the focus primarily addresses credentialing efforts that have evolved since the Galway Consensus Conference was convened in 2008 and publication of the Galway Consensus and related manuscripts in 2009. Significant progress has been achieved in updating the health education competencies for entry and advanced levels of practice, as well as in establishing a Master Certified Health Education Specialist designation. Also discussed are contemporary initiatives to expand and improve the accreditation process of academic programs and the evolving higher education contexts in which such systems operate. We conclude by presenting lessons learned from the U.S. experience with credentialing efforts and by offering recommendations that may be applicable to future quality assurance efforts, both in the United States and abroad.

Differences between family physicians and patients in their knowledge and attitudes regarding traditional chinese medicine.

Background: With patients turning more to alternative medicine, most physicians are still conservative in their views toward these practices. It is important to know whether there is a difference between physicians and patients regarding knowledge and attitudes about alternative medicine. This study focused on information regarding a specific type of alternative medicine, traditional Chinese medicine (TCM). Methods: Two questionnaires-one for physicians, one for patients-were designed. Two clinics were chosen as sites where patients could fill out the questionnaires while they were waiting for treatment. A total of 85 patient questionnaires were collected. Forty-four completed questionnaires were returned from family physicians in Cincinnati area. Data analyiss included t-test, analysis of variance, and logistic regression. Results: Generally, physicians and patients had the same knowledge level on TCM. Physicians, however, had more knowledge on basic concepts, whereas patients knew more about practice, such as the specific conditions that could be treated by TCM. A difference between physicians and patients on attitudes toward TCM was found, with patients having a more positive attitude. More than 60% of the patients in this study had visited alternative practitioners during the year prior to this study. The inform rate was higher for the patients visiting physicians who practiced alternative treatment. Conclusions: There are differences between physicians and patients regarding their knowledge and attitudes about TCM.

Comparative Stress Levels among Residents in Three Chinese Provincial Capitals, 2001 and 2008

Objectives To compare stress levels among residents in large Chinese cities between 2001 and 2008. Methods Survey data were collected in three mainland Chinese capital cities in two waves, in 2001 and 2008, respectively. Participants were recruited through a multi-stage stratified sampling process. Stress was assessed using the Perceived Stress Scale, Chinese version (CPSS). Descriptive methods were used to estimate mean stress levels and associated 95% confidence intervals. Estimates were adjusted by post-stratification weights. Results Indicating stable stress levels, respective adjusted mean stress scores for the combined samples of study participants were 23.90 (95%CI: 23.68–24.12) in 2001 and 23.69 (95%CI: 23.38–24.01) in 2008. A lower stress level in 2008 than in 2001 manifested among residents who were under 25 years of age; female; with a college or higher level education; divorced, widowed, or separated; members of the managerial and clerical group; students or army personnel; or with an annual income of at least 30,000 RMB. Conclusion The overall stress level did not change among the combined sample of residents in the three Chinese study cities between 2001 and 2008. However, levels remained high and varied across social strata, and may have reflected a national trend among urban residents. Findings indicate a need for a new health policy, and call for the design and implementation of evidence-based interventions that target the highest-risk groups.

Networking for Career-Long Success: A Powerful Strategy for Health Education Professionals

Networking is a proven strategy to enhance professional recognition and skills while promoting career development. Through a variety of techniques and for a multitude of reasons, health educators can enrich their professional endeavors by interacting and engaging in formal and informal networking with others. Through networking, health education professionals can offer each other assistance and support while establishing long-lasting mutually beneficial relationships. This article provides an overview of the basics of networking, reasons that networking is important, persons who can benefit from networking, and strategies on how to network and how to develop, maintain, and nurture a network.