Pastors' Perceptions of the Black Church's Role in Teen Pregnancy Prevention.

Objective. To identify pastors' perceptions of the Black Church's role in promoting adolescent sexual health and preventing teen pregnancy. The Black Church and pastor are important partners in addressing health disparities in the Black community, especially those addressing sensitive issues as teen pregnancy. Methods. Semistructured interviews (n = 31) were conducted with Black Church pastors in two southwestern U.S. cities from September 2014 to July 2015. The question path was developed based on interviews with local leaders, literature searches, and key informant pastor interviews. Questions included knowledge/beliefs about sexuality education, church's role in preventing teen pregnancy, and implementation obstacles. Interviews were transcribed and thematically analyzed. Results. (1) All pastors believed that the Black Church should address teen pregnancy with parents and congregants. (2) Two major obstacles emerged: (a) all pastors perceived social consequences, including resistant parents and (b) discomfort discussing contraceptives/condoms. (3) All pastors were willing to partner with organizations, but most had reservations based on conflicting missions/values. Conclusions. Black Church pastors support teen pregnancy prevention programs in the church; however, public health partners must be willing to address the church's unique needs and mission.

Parents' beliefs of the Black Church's role in teen pregnancy prevention.

INTRODUCTION: Parents are important decision makers in black churches. The objective of this qualitative study was to identify African American parents' beliefs of the Black Church's role in preventing teen pregnancy and promoting healthy teen relationships. METHODS: Parent members (n = 36) of 27 predominately Black churches in two southwestern US cities participated in semi-structured interviews from February-June 2017. A question path was developed based on literature searches, key informant interviews, and a previous study with local pastors, and questions focused on parents' knowledge/beliefs about 1) sexuality education, 2) the church's role in preventing teen pregnancy, and 3) implementation obstacles. Interviews were transcribed verbatim, coded using NVivo, and open-coded for themes to investigate patterns across codes and participants. Transcripts were then reviewed for quotes to represent each theme. RESULTS: Five themes were identified, with multiple subthemes. Most parents said there should be no boundaries on the type of sexuality information shared by their church, but later changed their minds after reviewing a list of potential topics. Parents listed 'parent-child communication', 'goals and dreams', and 'relationships' as the most important topics for teen pregnancy prevention intervention. Parents said information shared during workshops should be judgement-free and realistic. Parents most often said pastors and/or youth pastors/directors should deliver sexual health information. Parents believed older adults and other parents may oppose sexual education. CONCLUSIONS: By understanding parents' beliefs of teen pregnancy prevention programs, public health practitioners can understand concerns, modify implementation strategies, and utilize parental support to gain buy-in before planning and implementing programs.

Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers.

OBJECTIVES: To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. METHODS: We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes. RESULTS: Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion. CONCLUSIONS: Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.

Needs of a Silent Minority: Mexican Transgender Asylum Seekers.

Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers' (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers.

Exercise-Induced Hypoalgesia Is Not Influenced by Physical Activity Type and Amount.

Physical activity (PA), especially vigorous-intensity PA, has been shown to be related to pain sensitivity. The relationship among PA levels and PA types on endogenous pain inhibition after exercise, termed exercise-induced hypoalgesia (EIH), remains unclear. PURPOSE: This studied examined the EIH response to pressure stimuli among college-age women of differing activity levels. METHODS: Fifty women were tested. Pressure pain threshold (PPT) values were assessed before and immediately after isometric handgrip exercise to exhaustion in the right and left forearms. Participant's PA levels were assessed by wearing an accelerometer for seven consecutive days during waking hours, excluding water activities. Participants were classified into four PA groups: met the American College of Sports Medicine aerobic recommendations (AERO), met aerobic and resistance training recommendations (AERO + RT), insufficiently aerobically active but resistance trained (RT), and insufficiently active (IA) based on their measured and self-reported PA level and type. RESULTS: AERO and AERO + RT had greater vigorous (P < 0.001) and total PA (P < 0.001) compared with RT and IA. EIH was observed for PPT in both right and left arms (P < 0.001), with PPT increasing 7.7% (529 ± 236 vs 569 ± 235 kPa) and 7.0% (529 ± 299 vs 571 ± 250 kPa) in the right and left forearms, respectively. EIH did not differ among activity groups (P = 0.82). PPT values were found to be inversely related to vigorous-intensity PA (r = -0.29). CONCLUSIONS: PA levels and types had no effect on endogenous pain inhibition after exercise in college-age women.

The Effect of an 8-Week Tai Chi Exercise Program on Physical Functional Performance in Middle-Aged Women.

The purpose of this study was to determine the effectiveness of an 8-week Tai Chi Chih exercise program on physical functional performance (PFP) among women aged 45 to 65 years. A quasi-experimental design with a nonequivalent comparison group was used. Forty-one healthy inactive women were assigned to either an intervention group (n = 19) or a comparison group (n = 19). A 60-min Tai Chi Chih exercise class was conducted twice a week for 8 weeks. PFP was measured at baseline and postintervention using the Continuous Scale Physical Functional Performance-10 (CS-PFP 10). Between-group differences were analyzed using one-way analysis of covariance (ANCOVA). After participating in the 8-week program, intervention group participants showed greater improvement in the CS-PFP measures (p < .05, η(2) > .06). However, the comparison group had little changes. The findings from this study suggest that participation in an 8-week Tai Chi Chih exercise program can improve PFP in healthy, community-dwelling middle-aged women.

Pedometer-based walking interventions for free-living adults with type 2 diabetes: a systematic review.

Physical activity (PA) is prescribed as an important method of treatment for type 2 diabetes (T2DM), but is neglected in a majority of patients. Walking is an appropriate and safe form of PA which improves glucose utilization in inactive people diagnosed with T2DM. Pedometers have been successfully used to motivate and track progress in many types of walking programs, but there is no current review of their effectiveness compared to other methods to increase PA in people with T2DM. A systematic literature review was performed using MEDLINE, CINAHL, SPORTDiscus, ERIC, and Academic Search Premier to determine the effectiveness of pedometer-based walking interventions at increasing PA in free-living adults with T2DM. Ten studies from 2004 to 2011 were included. All studies were randomized controlled trials except for one quasi-experimental design. Interventions lasted from 6 weeks to 6 months and only 2 studies showed significant improvements in blood glucose control following the intervention. Nine of the ten interventions were able to produce an increase in PA using a pedometer and/or other methods. Pedometers are effective means of increasing PA among T2DM patients in the short-term while several other intervention methods beyond normal treatment are also successful. Future research should include longer intervention durations, low cost methods, larger sample sizes, and dietary intervention components to further understand successful intervention techniques for patients with T2DM.

Assessment of factors that predict physical activity among Oklahoma clergy: a theory of planned behavior approach.

The purpose of this study was to examine predictors of physical activity among clergy members in Oklahoma, using the theory of planned behavior. A 51-item valid and reliable instrument, measuring theory of planned behavior constructs and physical activity, was developed and administered to 141 clergy members. Results indicated that the majority of those surveyed were white (93%), college educated (97%), and overweight or obese (84%). Stepwise multiple regression analysis found that intentions accounted for 13.8% of the variance of physical activity whereas attitudes, subjective norms, and perceived behavioral control accounted for 54.8% of the variance of intention. Implications for intervention development are discussed.

Dietetic preceptor educational needs from the preceptor, student, and faculty perspectives.

Quality dietetic education relies on strong preceptors to encourage, motivate, and teach dietetic students so that they can excel as practitioners. The purpose of this study was to examine the needs of dietetic preceptors, determine how those needs should be met, and suggest who can best address those needs. Grounded theory methodology was used to design this study of preceptor needs. Focus groups and one-on-one interviews were conducted with 22 preceptors, 5 former students, and 4 faculty members of a clinical dietetic training program. Data were analyzed using open, axial, and selective coding. The central category/ factor that influenced preceptor participation and effectiveness was determined to be lack of time. Preceptors felt they did not have sufficient time to devote to precepting students. Other categories found to be important for successful precepting included student-preceptor orientation, the teaching-learning environment, views of dietetic professionalism, and the responsibilities and rewards of precepting. Based on the themes that emerged with this grounded theory methodology, this study suggests that preceptors should be trained in the following five areas: 1) basic teaching skills, 2) time management strategies, 3) methods for coaching students, 4) adult learning styles, and 5) methods for providing constructive feedback. This training should increase the likelihood that the experience will be both time-efficient and successful for the preceptor, student, and faculty involved. This should improve the effectiveness of preceptors as educators, which should consequently facilitate recruitment and retention of dietetic preceptors.

Minimal-contact physical activity interventions in women: a pilot study.

OBJECTIVE: To examine the impact of 3 minimal-contact lifestyle interventions on physical activity in women. METHODS: Fifty female volunteers were randomly assigned to one of 3 lifestyle physical activity interventions for 8 weeks. Subjects wore an accelerometer for a week at baseline and postintervention to objectively monitor their physical activity. RESULTS: Participants significantly increased their physical activity from baseline to postintervention; however, there was no significant difference in physical activity among the 3 intervention groups. CONCLUSIONS: Results of this pilot study support the use of minimal-contact lifestyle interventions to promote physical activity in women.