Utilizing instructor practice experience to promote critical thinking for program proposals in an undergraduate public health course.

Objective: To encourage the inclusion of research practice in instruction. Methods: The choice to bring existing research into a classroom to enhance student engagement and learning does not have to rest with one's own practice; however, those whose primary responsibility is to teach may be required to connect their research to teaching. Results: This article describes one instructor's use of research to introduce evaluation concepts to undergraduate program planning students and suggests the value of sharing field experiences. Outcomes: The example field work is a handwashing program for preschool children for which the instructor was hired to complete an evaluation. Instructors who do not engage in research may find inspiration for classroom activities in the works of others, especially in the public health field.

School-based, blacklight handwashing program can improve handwashing quality and knowledge among pre-school aged children.

In the United States, lack of proper handwashing is associated with respiratory and gastrointestinal illnesses. Interventions to improve handwashing practices have led to an increase in handwashing knowledge and behavior, and decreases in gastrointestinal illnesses. Most studies have evaluated their interventions in the context of reported handwashing rates by observation, reduction of illnesses, as well as reduced absences, however none of these studies examined handwashing quality or knowledge as outcome measures. The objective of this paper is to present the results from a handwashing program with a special focus on the evaluation methods. A pre-post design was used to evaluate a handwashing program that took place in two pre-schools the northeast of the United States. The program utilized a black light technology to demonstrate to children the importance of good quality. The evaluation consisted of assessing knowledge and quality of handwashing using a linear puzzle and individual handwashing observation, respectively. Students from both schools improved on both knowledge and quality over time (p-values 0.071 and <0.001, respectively). The present study demonstrates that the use of black light technology as an educational tool may help to improve handwashing quality among pre-school aged children, even after only one instructional session.

Authority of Pharmacists to Administer Human Papillomavirus Vaccine: Alignment of State Laws With Age-Level Recommendations.

OBJECTIVES: One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15. METHODS: Using information from the Centers for Disease Control and Prevention's (CDC's) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states' laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups. RESULTS: Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non-patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states. CONCLUSIONS: Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue.

State Laws on Emergency Holds for Mental Health Stabilization.

OBJECTIVE: Psychiatric emergency hold laws permit involuntary admission to a health care facility of a person with an acute mental illness under certain circumstances. This study documented critical variation in state laws, identified important questions for evaluation research, and created a data set of laws to facilitate the public health law research of emergency hold laws' impact on mental health outcomes. METHODS: The research team built a 50-state, open-source data set of laws currently governing emergency holds. A protocol and codebook were developed so that the study may be replicated and extended longitudinally, allowing future research to accurately capture changes to current laws. RESULTS: Although every state and the District of Columbia have emergency hold laws, state law varies on the duration of emergency holds, who can initiate an emergency hold, the extent of judicial oversight, and the rights of patients during the hold. The core criterion justifying an involuntary hold is mental illness that results in danger to self or others, but many states have added further specifications. Only 22 states require some form of judicial review of the emergency hold process, and only nine require a judge to certify the commitment before a person is hospitalized. Five states do not guarantee assessment by a qualified mental health professional during the emergency hold. CONCLUSIONS: The article highlights variability in state law for emergency holds of persons with acute mental illness. How this variability affects the individual, the treatment system, and law enforcement behavior is unknown. Research is needed to guide policy making and implementation on these issues.

Prevalence and predictors of bicycle helmet use in a southeastern, US city.

Fatalities and head injuries from bicycle-related crashes remain a concern in the United States. Despite legislation in many states, helmet use remains low. This observational study examined the helmet use and related factors in a North Carolina city. The sample consisted of 2088 observations of bicyclists. The objectives were to (1) determine helmet use; (2) describe other safe bicycling practices; and (3) examine the relationship of demographic variables and safe riding practices with helmet use. Helmet use was observed for 25% of the sample. Demographic factors related to helmet use were being female (OR = 1.32), 26 years old or older (OR = 4.94), and White (OR = 2.17). Bicyclists riding on the road with traffic were more likely to wear a helmet than bicyclists riding on the sidewalk (OR = 2.04). Findings indicate that helmet use remains low in the city. Research to monitor, better understand, and promote helmet use is needed.

Does providing nutrition information at vending machines reduce calories per item sold?

In 2010, the United States (US) enacted a restaurant menu labeling law. The law also applied to vending machine companies selling food. Research suggested that providing nutrition information on menus in restaurants might reduce the number of calories purchased. We tested the effect of providing nutrition information and 'healthy' designations to consumers where vending machines were located in college residence halls. We conducted our study at one university in Southeast US (October-November 2012). We randomly assigned 18 vending machines locations (residence halls) to an intervention or control group. For the intervention we posted nutrition information, interpretive signage, and sent a promotional email to residents of the hall. For the control group we did nothing. We tracked sales over 4 weeks before and 4 weeks after we introduced the intervention. Our intervention did not change what the residents bought. We recommend additional research about providing nutrition information where vending machines are located, including testing formats used to present information.

Factors related to the number of fast food meals obtained by college meal plan students.

OBJECTIVES: This study tested whether days on campus, financial access through a meal plan, and health consciousness were associated with number of meals that college students obtained from fast food restaurants. PARTICIPANTS AND METHODS: In April 2013, all students currently enrolled in a meal plan were invited to participate in an online survey (N = 1,246). Students were asked to report the total number of meals eaten in the past week and where they obtained them. RESULTS: Negative binomial regression was used, and it was found that the number of meals obtained from fast food restaurants was positively associated with financial access and negatively associated with health consciousness. An association between days on campus and the number of meals obtained from fast food restaurants was not found. CONCLUSIONS: Increasing levels of health consciousness and reducing access to fast food restaurants through flex plans may reduce college students' consumption of fast food.

Brothers Leading Healthy Lives: Outcomes from the pilot testing of a culturally and contextually congruent HIV prevention intervention for black male college students.

We used a treatment group-only design to pilot test a newly developed intervention to increase condom use among higher risk heterosexually active African American/black male college students. A community-based participatory research partnership developed the intervention called Brothers Leading Healthy Lives. Following an initial screening of 245 men, 81 eligible men were contacted for participation. Of the 64 men who agreed to participate, 57 completed the intervention and 54 of those completed the 3-month follow-up assessment, for a 93% completion rate. Results show significant changes between the baseline and 3-month follow-up assessments in behavioral outcomes, including reductions in unprotected sex, increase in protection during last intercourse, and fewer condom use errors. Most potential mediators (knowledge, attitudes, intentions, and condom use self-efficacy) also changed significantly in the expected direction. These demonstrated changes provide good evidence that men exposed to this intervention will see changes that reduce their risk for HIV.