Background: Perceived risk is a predictor for adopting risk-reducing behaviors. Despite the rising incidence of type 2 diabetes in Korean immigrants and their increased risk of coronary heart disease (CHD) associated with diabetes, little is known about the level of CHD risk perception and risk factor control in this group. Purpose: 1) Describe the level of coronary heart disease (CHD) risk perception and risk factors; 2) examine factors associated with CHD risk perception; 3) describe glucose control status; and 4) examine determinants of glucose control in Korean immigrants with type 2 diabetes. Methods: A cross-sectional descriptive study design was used. Data were collected from a community sample of 143 Korean adults with type 2 diabetes, aged 30 to 80 years old. Participants completed questionnaires and submitted to a finger stick blood test for glycosylated hemoglobin (HbA1c), cholesterol panel, and anthropometric measures. Multiple regression analyses were conducted to evaluate factors influencing CHD risk perception and glucose control in Korean immigrants with type 2 diabetes. Findings: Perception of CHD risk among participants was low. Most (76.9%) perceived their risk to be the same or lower than their peers in the general population. According to American Diabetes Association (ADA) guidelines, CHD risk- factor control was suboptimal. More than half had uncontrolled blood pressure and higher low density lipoprotein cholesterol (55% and 53.6% respectively) than the target goal. CHD knowledge had a significant positive effect and self-reported general health had a significant negative effect on the perception of CHD risk. The mean HbA1c level was 7.6 % (SD = 1.5; range = 5.6 to 12.5). Less than half of the participants (41.3%) met the ADA's goal of less than 7%. Roughly 22% of variance in HbA1c levels was explained by a linear combination of family diet support, acculturation, body mass index (BMI), waist-to-hip ratio (WHR), the duration of diabetes, the number of diabetic medications, age, gender, and education (R² = 0.223, F[9,133] = 4.24; p < .0001). In the final model, family diet support, age, WHR, the duration of diabetes, and the number of diabetic medications determined glucose control.

Coronary heart disease (CHD) has been second to cancer as the most common cause of death for more than three decades in Hong Kong (HK). The purpose of this study was to examine the knowledge, perceived risks and preventive behavior regarding CHD among Chinese women living in HK. A cross-sectional study of 168 community dwelling women from HK was conducted in three settings. The respondents completed surveys or participated in interviews which included basic sociodemographic information, personal health data, the CHD risk factor knowledge test, CHD risk perception scale, Family APGAR test, Center for Epidemiological Studies-Depression CES-D and the Health-Promoting Lifestyle Profile II questionnaires. Results showed that family function was considered to be "moderately dysfunctional" and the likelihood of depression was 29%. The respondents also showed a low level of CHD risk factor knowledge and a moderate concern for perceived CHD risk. This sample had a low commitment to physical activity in daily life. Pearson correlation coefficient tests were performed to examine relationships between independent and dependent variables. A multiple regression model showed that eight socio-demographic variables, with family functioning and depression, explained 13.6% of the variance in CHD risk factor knowledge (R2=.136, F=2.481, p=.009); and 17.2% of the variance in CHD perceived risk (R2=.172, F=3.266, p=.001). Another regression model with CHD risk factor knowledge, CHD perceived risk, and eight sociodemographic variables (age, educational attainment, number of people living in the household, monthly household income, marital status, self-reported body mass index, economic activity status and religion) as independent variables explained 28.6% of the variance in Chinese Hong Kong women's CHD preventive behavior (R2=.286, F=5.164, p=.000). Results showed that family functioning (Family APGAR) (6.9%) and depression scores (CES-D) (2.9%) significantly contributed to the variance in CHD preventive behavior. This study revealed that family functioning and depression symptoms independently predict CHD preventive behaviors in Chinese women living in HK. Improving family functioning and decreasing depression should be considered as a strategy for heart health promotion.

Background. Community -based participatory research (CBPR) is an egalitarian approach to research that is gaining popularity due to its success in achieving long-term sustainable improvements in community health, yet little CBPR is currently underway in Malawi, Central Africa. Malawians suffer from poverty, food insecurity, HIV and AIDS and have a reported life expectancy of 48 years of age. Although non-governmental organizations (NGOs) have pivotal roles in their work with donors and local communities in addressing these issues, little CBPR literature reflects NGO perspectives.

Theoretical framework. Ecosocial theory underpins the study with its dual emphasis on social justice and scientific methods. Health disparities are examined in light of social, environmental and economic constructs as well as from a biological basis.

Purpose. The purpose of this research was to explore perspectives of NGO staff in order to understand barriers and facilitators in their work with communities. The study addressed three primary questions: 1) How do NGOs build trust and relationships with community members and agencies?; 2) What are the perspectives of NGO staff regarding their interactions or experiences with donors?; 3) How do Malawi women effect change in their communities?

Methods. Using a qualitative, public ethnographic method, 26 semi-structured interviews were conducted in the US and Malawi of staff, volunteers, board members and partners of NGOs and community-based organizations (CBOs). Interviews were audio-taped, transcribed and the data input into Atlas.ti, and analyzed.

Findings. Three themes emerged: 1) how NGOs gain community trust; 2) donor power; and 3) how socially disempowered Malawi women effect change in their communities. Study participants consistently advised a bottom-up approach when working with communities and stated that donors and NGOs need to respect cultural norms, listen to community members' priorities, engage communities in activities or research and recognize that communities possess important knowledge. Participants cautioned that while it is easy to slip back into top-down roles, the time and patience required to work from a bottom-up approach does produce long-term sustainable results. Although most participants were unfamiliar with CBPR, their recommendations concur with CBPR principles.

Conclusion Community -based participatory research is an appropriate approach to working with Malawian communities.

The HIV/AIDS epidemic is one of the most significant public health challenges of our times. Interventions have slowed the number of deaths from AIDS and allowed those infected to live longer than was previously possible. While most HIV infections continue to be transmitted via heterosexual sex, vertical transmission from mother to child remains the primary cause of pediatric HIV infections. Prevention of mother-to-child transmission (PMTCT) of HIV is a major focus, with rapid scale up of programs designed to initiate antiretroviral therapy (ART) in all pregnant women.

One group of vulnerable pregnant females is adolescents; few studies have included pregnant HIV-infected adolescents. The purpose of this study was to determine HIV prevalence in a population of pregnant adolescents and elicit the barriers and facilitators of the uptake of PMTCT services in those who were HIV-infected.

A mixed methods study was conducted in Blantyre, Malawi. A survey questionnaire sought demographic and reproductive health information; in-depth interviews were conducted with those who revealed their HIV infection. The interview questions sought to elicit the barriers and facilitators of adhering to PMTCT protocols faced by these participants.

The survey questionnaire determined that the study population had an HIV prevalence of 7.8%, higher than in the general Malawian adolescent population. Those who were orphaned and had a history of forced sexual encounter(s) were more likely to be HIV-infected.

The interviews with HIV-infected pregnant adolescents found that all had revealed their HIV status to at least one family member; two who were married had not told their husbands. All identified the support they received as important to their adherence to ART. Few barriers to adherence were identified: several mentioned the stigmatization of HIV, but such fears did not preclude their adhering to the PMTCT protocols.

As children who were perinatally infected with HIV live into adolescence, pregnancy will become more common in this population. Identifying the characteristics of adolescent pregnancy complicated by HIV allows health care providers to capitalize on the strengths of this population to prevent HIV infection in their children.