bluuebunny/crossref_metadata_2025 huggingface dataset:
How Do Persuasive Health Messages Work? A Health Education Field Study
Authors: Rimer Barbara , Glassman Bernard
Published: February 2007

The authors tested an empirical definition of comprehension and investigated the relationship between comprehension, retention, attitudes, beliefs, and behavioral change in response to a persuasive health message. The study used a randomized post-tests only design with one ex perimental and one control group. A booklet about exercise was given to experimental group participants in their homes. They were interviewed immediately after reading the booklet and one month later. Control group participants were interviewed at both times without exposure to the booklet. The authors found that participants who were able to operationalize key concepts related to the exercise message were the most likely group to have performed the recommended behavior according to self-reports. Measures of recognition and recall were not significantly related to behavior, but measures of psychological-operational meaning (defined as the learner's ability to use the information and relate it to his/her own life) were related significantly to self- reported behavior. The authors also examined the relationship of comprehension to other vari ables, such as attitudes, beliefs, and behavior. The study's results support the hypothesis that comprehension is a necessary but not sufficient precursor of behavior. Implications for both program design and measurement are discussed.
Macro-Intervention to Support Health Behavior: Some Theoretical Perspectives and Practical Reflections
Authors: Green Lawrence W. , McAlister Alfred L.
Published: February 2007

Large-scale, integrated programs—as distinct from multiple and widespread replications of small-scale programs—require for their planning, implementation and evaluation a qualitatively different set of concepts, methods, and procedures. They are not merely the sum of the parts making up numerous applications of the same health education messages and objectives in various organizations or communities. This review of theory, research and the experience of national and community-based studies in mass media and community development for health, family planning and cardiovascular risk reduction identifies some distinctions between micro- and macrointerventions, as well as between the uses of mass media in commercial marketing and those in health promotion.
Health Education Practice and the Literature
Authors: Kling Barry W.
Published: February 2007

A body of meaningful research on the effectiveness of some health education interventions is developing. The emerging health education literature changes the value of innovation for health educators. The growing availability of well-researched methods requires that health educators favor tested programs over innovation in most circumstances. But it is largely up to leaders in the field of health education to assure that, as the literature becomes more meaningful, health educators have access to that meaning. This could be accomplished in part by an ongoing program of small conferences among leading health educators designed to produce clear state ments on the practice implications of new research findings. The availability and promotion of these perspectives on health education practice would help health educators deliver research- based programs despite the demand for trivia they frequently face.
Employee Self-Help Smoking Cessation Programs: A Review of the Literature
Authors: Windsor Richard A. , Bartlett Edward E.
Published: February 2007

The purpose of this article is to present a review of the literature on employee self-help smoking cessation programs. Included in this discussion are: (1) a rationale for self-help smoking cessation interventions; (2) a synopsis of their applicability to occupational settings; (3) a rational and description of the self-help smoking cessation interventions selected for a large group of employees; and (4) several methodological issues faced in conducting evaluations of smoking cessation programs.
Intent to Participate in Worksite Health Promotion Activities: A Model of Risk Factors and Psychosocial Variables
Authors: Davis Keith E. , Jackson Kirby L. , Kronenfeld Jennie J. , Blair Steven N.
Published: February 2007

A model of risk factors and psychosocial variables that should enhance the prediction of participation in worksite health promotion programs was evaluated by a sample survey (10% random sample) of approximately 13,000 State employees in South Carolina. The response rate for the survey was 66.3%, n = 854. A split sample strategy was employed to develop and then validate the psychosocial model. Degree of satisfaction with one's current status and intent to change it were assessed in six health areas: weight, nutrition, exercise, cigarette smoking, alcohol consumption, and the handling of stress and tension. In each area, a known risk factor was used to predict degree of satisfaction and intent to change. Variables from the psychosocial model were added in a step-wise regression procedure. The key variables in the psychosocial model were Personal Efficacy (specific to each of five areas), Job Stress, Trait Anxiety, and Health Knowledge. Risk factors contribute significantly to the prediction of dissatisfaction and intent to change in all areas except cigarette smoking and nutrition. The model of psychosocial factors contributed significantly to the prediction of dissatisfaction and intent to change in all areas. Personal Efficacy was significantly related both to dissatisfaction and intent to change, whereas the Job Stress and Anxiety variables were more effective in predicting dissatisfaction than intent to change. Health Knowledge had little direct or interactive effects on dissatisfaction or intent to participate. The implications of these findings for health promotion programs were examined.
Assessing the Effects of Health Promotion in Worksites: A Review of the Stress Program Evaluations
Authors: McLeroy Kenneth R. , Green Lawrence W. , Mullen Kathleen D. , Foshee Vangie
Published: February 2007

In a recent issue of Health Education Quarterly, Chen( I ) reviewed the evaluations of worksite health promotion programs published in health education journals from 1980 through June 1983. He found few evaluations in the literature that used either quasi-experimental or experimental designs. This paper reviews the evaluations of stress reduction programs in the worksite, most of which were either published outside of health education journals or unpublished. Over one- half of the studies used either experimental or quasi-experimental designs in the evaluations. This suggests that reviews of worksite health promotion program evaluations must encompass journals from a variety of disciplines. Recommendations for improving the evaluations of stress reduction programs in the worksite are included.
A Sense-Making Approach to Understanding Adolescents' Selection of Health Information Sources
Authors: De Pietro Rocco , Clark Noreen M.
Published: February 2007

The authors propose that information sources are best understood as constructed by individuals in an attempt to find answers to questions of immediate relevance. Contact profiles, or patterns of source use for particular information, determine what constitutes a source for an individual. The study explores how adolescents acquire and use health information. Data analyses based on a probability sample of 200 adolescents identified nine contact profiles and supported four study hypotheses. Contact profiles differ according to health topics and are related to message sending and seeking regarding human sexuality and birth control. Adolescents with peer-media, home-oriented or multi-source contact profiles about human sexuality and birth control were more likely than others to be the peer advisors on this topic, and those with peer-media and multi-source profiles the ones more likely to be the information seekers about it. Contact profiles are also related to adolescents' health decision making capacity. Adolescents with peer-media and multi-source profiles for human sexuality and birth control information and those with home- oriented profiles for alcohol and smoking information engaged in more health decision making steps than those with other profiles. Finally, contact profiles are also related to awareness and contact with new information sources. Adolescents with peer-oriented and multi-source profiles were more likely than others to be aware of and have contacted a new peer education program in the school.
Social Ties and Health Status: An Examination of Moderating Factors
Authors: Hibbard Judith H.
Published: February 2007

The goals of the study are to assess the relationship between social ties and health status and to determine if factors that may inhibit or enhance the mobilization of resources available in social ties specify this relationship. Two factors which may influence the effective use of social network resources perceived control and trusting others, are examined as possible moderating factors.

The study population includes 2,603 adults, who were randomly selected from among the enrollees of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services were linked with the survey data on the respondents. The findings indicate that having more social ties, being more trustful of others and perceiving more control are all related to having better health. Perceived control does specify the relationship between social ties and health status. The findings suffest that a larger social network is more important for those less able to utilize the resources available in their networks effectively, while among those more able to mobilize support from their networks, size is less important.

The implications for health education research and practice are discussed.
Evaluation of Family Health Education to Build Social Support for Long-Term Control of High Blood Pressure
Authors: Morisky Donald E. , DeMuth Nancy M. , Field-Fass Marion , Green Lawrence W. , Levine David M.
Published: February 2007

Sustaining patient motivation for long-term adherence to drug therapies remains a substantial problem for physicians, other health care providers, the patients themselves, and their families. Other therapeutic requests such as dietary changes and weight control may be even more difficult to maintain than taking pills. As part of a controlled experimental design implemented in an outpatient teaching hospital, an educational program was implemented to improve family member support for medical compliance among hypertensive patients. Family members were interviewed, counseled, and provided with a booklet for the purpose of educating and involving them in the home management of high blood pressure. The booklet identified ways the family member could assist the patient with medication compliance, appointment keeping, as well as diet and weight control. These items were identified and recorded as behavioral objectives in the booklet. Patients were followed for three years to assess long-term outcomes. Results showed a strong statistically significant difference between the experimental and control groups, with the experimental group demonstrating higher levels of appointment-keeping behavior, weight control, and BP under control (all p values < .001). Analysis of the main effects of the educational program dem onstrated that the family member support intervention accounted for the greatest decrease in diastolic blood pressure variability, R2 = .20, p < .001.
Impact of Breast Self-Examination Planned Educational Messages on Social Network Communications: An Exploratory Study
Authors: Gravell Joanne , Zapka Jane G. , Mamon Joyce A.
Published: February 2007

This two-part study examined the effect of college women's participation in a breast self- examination (BSE) educational program on discussion of BSE with specific members of their social network. In addition, the characteristics of college women who did report discussion with others were investigated as was the relationship between this discussion and the participants' mothers' breast cancer screening behaviors. Results suggest that a BSE education intervention which includes explicit messages to encourage discussion with social network members is effective in increasing communication with mothers, sisters and friends. College women who discussed BSE with their mothers were more likely to have mothers who have a high quality BSE practice and who state an intention to request a clinical breast examination at their next physician visit. The limitations of this study are discussed with recommendations for future research.
Tobacco Industry Response to Public Health Concern: A Content Analysis of Cigarette Ads
Authors: Warner Kenneth E.
Published: February 2007

Public awareness of the health hazards of smoking intensified when the subject received national publicity. To assess tobacco industry tactics to counter adverse publicity, we performed a content analysis of cigarette ads in selected issues of Time magazine, for selected years from 1929-84. The analysis showed direct responses to health concerns in all of the years of major smoking-and-health "events," with the possible exception of 1964, the year of the first Surgeon General's report. During these years large percentages of ads emphasized health themes instead of the conventional cigarette ad imagery. On average, health-theme ads have a higher verbal content than the more pictorial traditional ads. Correspondingly, they employ many fewer models. Health-theme ads tend to emphasize the "technological fix," such as the scientifically designed filter and the low-tar cigarette. Subtle changes in cigarette advertising include the elimination of visible smoke from ads.

A decade's concentration on standard health themes, prompted by the "tar wars" of the 1970s, appears to have ended in the 1980s. Advertisers seem to have reverted to the "good times" nonhealth imagery of a bygone era, though possibly to deliver a subtle implicit health message.

Understanding industry advertising tactics can assist public health professionals in developing insights into the promotion of smoking and in formulating smoking control strategies. Though highly exploratory and tentative in nature, this study is offered in the spirit of increasing such understanding.
Applications of Behavior Modification to Community Health Education: The Case of Heart Disease Prevention
Authors: Elder John P. , Hovell Melbourne F. , Lasater Thomas M. , Wells Barbara L. , Carleton Richard A.
Published: February 2007

Principles of behavior modification increasingly have been applied to community health education and offer considerable promise for public health in general. Behavior modification procedures can be conceptualized in a 2 x 2 framework with desired goals being either to increase and strengthen or decrease and weaken behavior, and procedures producing essentially positive or negative consequences. Modifying specific behavioral risk factors for the prevention of heart disease may include the use of positive reinforcement, shaping, differential reinforce ment, negative reinforcement, and "punishment." The use of an adequate "behavior analytic" history, highly acceptable interventions, observable effects, inexpensive materials and proce dures, community-owned programs, and other practical guidelines can help optimize the effec tiveness of behavior modification for health education in the community.
Health Education and Medicine: Competition or Cooperation?
Authors: Bartlett Edward E. , Windsor Richard A.
Published: February 2007

Shifts in the expectations of the public. in the practice of medicine, and in the state of the art of health education call for an examination of the nature of the relationship between the health education and medical professions. Their relationship can be characterized in terms of competition or cooperation. This paper examines a number of issues related to these shifts and discusses the potential and pitfalls of this relationship. It is concluded that power is a fundamental issue to be recognized and addressed by health education specialists.
Diaphragm Method Contraceptors: Implications for Service Organization and Delivery
Authors: Zapka Jane G. , Pastides Harris , Rudenberg Elizabeth
Published: February 2007

Despite dissemination of modem contraceptive techniques among college women, unplanned pregnancy and pregnancy termination rates remain a major health issue.1 An investigation of 495 college women who use the diaphragm method of contraception was conducted in order to estimate pregnancy occurrence, to better understand factors related to successful use, and to profile service utilization patterns. Data were collected by medical record audit and client survey. Fifteen percent of the diaphragm clients reported a diaphragm-related pregnancy: clinical ef fectiveness was estimated to be 88% with a rate of 9.75 pregnancies per 100 woman years of diaphragm use. A variety of demographic, personal history, and behavioral variables were found to be related to three dependent variables: pregnancy, consistent diaphragm use, and accurate diaphragm use. Review of clinic service utilization for this group of patients demonstrated considerable resource use, including frequent switching of prescription contraception methods. Considering all pregnancies, diaphragm related or not, 27% of the study subjects reported at least one unplanned pregnancy. Abortion was elected in 98% of these cases.

There is general agreement about the need to focus on education, information, and service measures to reduce the incidence of unintended fertility. Many universities have family planning services available, yet unsuccessful outcome continues to be a concern. Specific and practical protocols for service implementation need clearer definition. Thus, the implications of this research for the content and organization of clinic services are discussed with reference to counseling and education and other systems strategies.
One Voice for Health Education: Can This be Achieved?
Authors: Taub Alyson
Published: February 2007

The need for one voice for health education and health educators has been discussed for some time. Recently, it has become a more prevalent topic at professional meetings. This article discusses the role of professional associations and the process of professionalization, professional associations for health educators, the Coalition of Health Education Organizations, and current issues with possible alternative solutions. The solutions proposed include merging existing associations, fostering greater understanding of the purposes of various professional organiza tions, adopting a new approach for selecting memberships, and strengthening the role and function of the Coalition of National Health Education Organizations. A final point discussed is the importance of health educators belonging to at least one professional association to indicate their support of the profession.
Building Supportive Ties and Sense of Community among the Inner-City Elderly: The Tenderloin Senior Outreach Project
Authors: Minkler Meredith
Published: February 2007

For the low-income elderly residents of America's single room occupancy (SRO) hotels, poor health, social isolation, and powerlessness often are intimately connected. This article presents a case study of an attempt to address these interrelated problems by fostering social support and social action organizing among elderly residents of San Francisco's Tenderloin hotels. Following a brief look at the parameters of the problem, an overview of the Tenderloin Senior Outreach Project (TSOP) is presented. The Project's theoretical base is described, followed by a brief account of TSOPs genesis and growth from an informal University-sponsored project to a privately incorporated community-based organization. Examples of individual and community empowerment through TSOP are presented, as is a look at some of the dilemmas and compro mises that are encountered as a community group trades its grassroots status for a more formal and bureaucratized structure. Problems in the areas of indigenous leadership development and community versus funding agency agendas are examined, as is the utility of combining social action and social planning approaches to community organizing. Finally, the potentials and limitations of Freire's "education for critical consciousness" as an organizing tool in this en vironmental context are discussed, with implications drawn for other projects attempting to build self-reliance and community cohesion among inner-city populations.
Utilizing the Health Belief Model to Predict Dieting and Exercising Behavior of Obese and Nonobese Adolescents
Authors: O'Connell Janelle K. , Price James H. , Roberts Stephen M. , Jurs Stephen G. , McKinley Robert
Published: February 2007

This study was undertaken to explain dieting and exercising behavior of obese and nonobese adolescents as measured by the elements of the Health Belief Model (HBM). An elicitation questionnaire was used to determine salient beliefs about dieting, exercising, and obesity for each of the major components of the HBM. The Health Belief Model questionnaire, developed from the elicited salicnt beliefs, contained items employed to measure attitudes towards obesity and exercise, knowledge of obesity and exercise, weight locus of control, and beliefs and evaluations about obesity and exercise. Discriminant analysis and stepwise discriminant analysis were employed in the data analysis of the 69 obese and 100 nonobese HBM respondents to determine the relative importance of the investigated factors in predicting obesity.

It was found that benefits of dieting was the most powerful predictor of dieting behavior for the obese adolescents, whereas susceptibility to the causes of obesity best explained present dieting behavior of nonobese adolescents. Exercising behavior of obese teenagers was best explained by cues to exercising. No HBM variables were significant in predicting exercising behavior of nonobese adolescents.
Seat Belt Use Laws: The Influence of Data on Public Opinion
Authors: Schenck Anna P. , Runyan Carol W. , Earp Jo Anne L.
Published: February 2007

Motor vehicle crashes are a major public health problem. Mandatory seat belt use laws capable of lessening the highway death and injury toll have recently received a great deal of public attention.

Public opinions toward such laws were assessed in a representative sample of 410 North Carolina drivers. In our experimental design, subjects were randomly assigned to receive one of six types of data expressing the effectiveness of the proposed mandatory and the current voluntary policies. A comparison group received no data. Exposure to data about the effec tiveness of the proposed seat belt law was strongly predictive of policy preferences, though the specific type of data did not appear to have an influence. Additional characteristics predictive of policy preferences included attitudes toward other government regulations, beliefs about the effectiveness of seat belts, and personal seat belt use. The findings suggest that health educators need to continue to provide the public with data about potential safety regulations. Furthermore, health educators, to be more effective, should target information toward certain critical beliefs such as those about the relative effectiveness of a particular policy.
The Role of Health Belief Attitudes, Sex Education, and Demographics in Predicting Adolescents' Sexuality Knowledge
Authors: Eisen Marvin , Zellman Gail L.
Published: February 2007

As part of a pretest-posttest design to evaluate a 15-hour Health Belief Model (HBM)-based sex education program, we interviewed 203 teenagers (aged 13-17) of both genders regarding their preintervention sexual and contraceptive knowledge, attitudes toward pregnancy and con traception, and prior sex education and sexual activity experiences. A multiitem sexual and contraceptive knowledge measure yielded several specific topic area scales and a total knowledge score, and a multiitem attitudes measure also yielded five reliable HBM-based scales. A series of regression analyses that used teenagers' previous sexuality-related experiences, demographic information, and attitudes predicted knowledge scores well ( R2 = 0.22-0.54). Across specific knowledge areas, HBM-based attitudes (e.g., perceived serious consequences of teen pregnancy) were consistently significant predictors. Interestingly, neither previous sex education nor personal sexual experiences were significantly associated with specific knowledge areas (e.g., venereal disease), although they were related to total knowledge scores. Similarly, age and gender were poor predictors of specific areas of knowledge, but minority ethnic status was consistently associated with less sexual and contraceptive knowledge. Our model was highly successful in accounting for a substantial portion of the variance in total knowledge scores ( R2 = 0.54). Results are discussed in terms of their implications for designing sex education programs that focus on motivation for pregnancy avoidance and contraception as well as factual information for teenagers.
Skills Methods to Prevent Smoking
Authors: Schinke Steven Paul , Gilchrist Lewayne D. , Schilling Robert F. , Snow William H. , Bobo Janet Kay
Published: February 2007

School health educators have devoted much attention to cigarette smoking. Recent years have seen the testing of interventions to prevent smoking. To date, controlled studies have not evaluated the added value of skills methods for preventing smoking. This article describes such an evaluation with sixth-grade students from two schools. Subjects were pretested and randomly assigned to receive conventional health education methods or to receive skills intervention. Both conditions included films, peer testimonials, discussions, and homework. Health education condition subjects additionally participated in oral quizzes, games, and debates. Skills condition subjects additionally learned problem-solving, self-instruction, and interpersonal communication methods. At postintervention, skills condition subjects, more than health education condition subjects, had better scores on measures of smoking-related knowledge, attitudes, and intentions. In addition, reported cigarette use, validated by biochemical data collection, was lower in the skills condition than in the health education condition at all postintervention measurements, including a 24-month follow-up. The article discusses the strengths, limits, and implications of the study for other smoking prevention efforts in schools.
Highlighting Specific Patient Education Needs in an Aging Cardiac Population
Authors: King Abby C. , Martin John E. , Morrell Eric M. , Arena John G. , Boland Michael J.
Published: February 2007

Given the utility of a multifactoral approach to cardiac rehabilitation and the importance of tailoring such an approach to the needs of the specific cardiac population being treated, early assessment of targeted risk factors and health-related practices is becoming increasingly indi cated. The present article describes how, by using a paper-and-pencil multiple-risk-factor as sessment instrument referred to as the Heart Health Assessment Questionnaire, the specific educational needs of an aging veteran population were more clearly identified. Among the health areas found in need of particular attention were patient smoking behavior, medication education, and reported tension and worry over health problems. In addition, given the large unemployment rate within this population, the need for the adoption of activities such as physical exercise and hobbies that could have a positive impact on self-esteem and quality of life was strongly indicated. These and other findings are discussed in relation to the pivotal role of the health education professional for older cardiac populations.
Correlates of Accurate Knowledge of Cancer
Authors: Stone Anna J. , Siegel Judith M.
Published: February 2007

Knowledge acquisition, although a prerequisite of preventive behavior, has been a neglected area of research. Mass communication research shows that audience characteristics explain most of the variation in knowledge acquistion. Since cancer information is mainly disseminated via the media, we hypothesized that the same audience characteristics would be related to accuracy of cancer knowledge. Bivariate and multivariate associations between the hypothesized variables and a cancer knowledge score were tested using a three-stage random sample of Los Angeles County ( N = 931). Smoking status, education, degree of cancer worry, health improvement behavior, ethnicity, age, household size, and frequency of health worry were related to knowl edge accuracy. An examination of the underlying dimensions of cancer knowledge revealed three beliefs about cancer: smoking causes cancer; cancer can be cured; and the environment does not cause cancer. Smoking status, ethnicity, health improvement behavior, and worry about cancer and health were associated with the belief that smoking causes cancer. The in dependent variables in this study were not significantly related to the other two beliefs. These results conform with the general predictions of mass communication research. We conclude that targeting of cancer information and particular uses of media could raise the general level of cancer knowledge.
Patient Medication Instruction and Provider Interactions: Effects on Knowledge and Attitudes
Authors: De Tullio Pamela L. , Eraker Stephen A. , Jepson Christopher , Becker Marshall H. , Fujimoto Elaine , Diaz Cindy L. , Loveland Robert B. , Strecher Victor J.
Published: February 2007

This prospective study examines whether a patient medication instruction sheet (PMI) given to clinic patients by their health care provider affects knowledge and/or attitudes with thiazide diuretic use as part of an antihypertensive regimen.

Adult male patients ( N = 285) in a general medicine clinic were assigned to groups receiving the American Medical Association PMI describing their diuretic. Patients getting the PMI obtained it either directly from their provider or at the pharmacy dispensing window. All patients were surveyed by phone 1 week following the clinic visit with regard to the PMI, knowledge of medication use, and attitudes toward drug use.

Results indicate that a provider-dispensed PMI results in higher levels of drug knowledge and greater patient satisfaction with their knowledge than a pharmacy-dispensed PMI. In addition, the PMIs educational value may be lessened by an incomplete verbal consult. This study demonstrates that the AMA PMI is an effective educational tool when distributed by a provider and can promote better understanding and use of prescribed medications.
Never Smokers, Triers and Current Smokers: Three Distinct Target Groups for School-Based Antismoking Programs
Authors: Gordon Nancy P.
Published: February 2007

Previous research on adolescent smoking has shown that past smoking experience is the best predictor of smoking onset during the school year. The present study utilized a social learning framework to test the hypothesis that adolescents who have tried smoking in the past (Triers) differ from those who have never smoked on several factors that theoretically place them at higher risk for smoking rc-onset. In October 1980, 2339 seventh- and eighth-grade students in Eastern Massachusetts and Northern California were surveyed in conjunction with a school- based smoking prevention program. Never Smokers comprised 69% of the sample, Triers 7.9%, and Smokers 23.1%. As hypothesized, relative to Never Smokers, Triers were significantly more likely to have a predominantly smoking peer referent group, a best friend who smoked, siblings and/or parents who smoked, were more likely to experience peer pressure to smoke, more likely to believe that smoking would make them more relaxed, and were more rebellious. Girl Triers were also more likely to report that cigarette ads made them want to smoke. Triers did not differ significantly from Never Smokers in the perception of the harmfulness of smoking. Triers were less likely than Current Smokers to report that the majority of their friends, the best friend, and siblings (girls) smoked, less likely to believe that smoking would help them relax, and more likely to believe that smoking was harmful and would make their parents angry. Triers and Current Smokers did not differ significantly in their normative expectations about smoking. Implications of these findings for the design of school-based smoking prevention programs are discussed.
The ABCs of Adolescent Smoking Prevention: An Environment and Skills Model
Authors: Elder John P. , Stern Robert A.
Published: February 2007

Smoking prevention programs vary dramatically in terms of the primary focus of the inter ventions. Most current programs are based on a Social Pressures Model of smoking acquisition which focuses on antecedents and specific behavioral aspects of smoking. Based on social skills and operant behavioral perspectives, an Environment and Skills Model of smoking acquisition and prevention is proposed. This model involves an integrated examination of the antecedents, behaviors, and consequences of smoking. The importance of the "consequence end" of this three-term contingency is discussed as is the differential effectiveness of prevention strategies and suggestions for future research.
Family Life Education for Young Teens: An Assessment of Three Interventions
Authors: Herz Elicia J. , Reis Janet S. , Barbera-Stein Linda
Published: February 2007

The impact of three variations of a family life education (FLE) program for 172 inner-city, junior-high-level students was investigated. Variations in exposure time, instructional methods, and teacher quality led to the classification of each intervention on a general intensity dimension. Separate pretest-posttest nonequivalent comparison group designs were utilized to assess pro gram impact along seven knowledge and attitudinal dimensions. Survey results revealed that, in comparison to no-treatment groups, the more intensive the program ( a) the greater the gains in knowledge about reproductive physiology, contraception, and the consequences of teen pregnancy and parenthood (especially among experimental group females); and (b) the more birth control methods participants became familiar with over time. Changes in personal accep tance of premarital intercourse and perceived responsibility for contraception were observed only in the study examining the most intensive treatment. The results of the evaluations point to the combined importance of instructional methods, teacher quality, and in-class exposure time for producing change in young adolescents' knowledge of and attitudes toward sexuality. Further potential for the impact of school-based sex education programs on knowledge and attitudes is discussed within the broader context of the young adolescent's social environment.
Health Policy and Cost Containment Laws: Lessons for Public Health Education in Social and Behavioral Change
Authors: Garcia Jose Joel
Published: February 2007

As an extension of a contribution by Health Policy and Law to Public Health Education in areas of mutual concern, a descriptive model of cost containment policy in health care delivery is developed. The model starts from the basis of a typology of key Congressional enactments promoting economically motivated policymaking in the Medicare and Medicaid programs. These policies and laws are, in turn, related to the resulting multilevel adaptive behavior in health care services delivery and acquisition. From this descriptive model the thesis is developed that although government has improved its effectiveness in attaining economic and budgetary goals, this type of policy is also creating displacements and generally leading to the retrenchment of national commitment to equity-promoting social welfare policy and the possibility of abandoning longstanding historical commitments on strictly economic and budgetary grounds. The article concludes by placing emphasis on the need for public health disciplines to collaborate in order to strengthen national policy, to create a new health policy synthesis, and to strengthen the ability of individuals to qualitatively improve their situation and more effectively assert their health and social welfare rights.
Single-Subject Evaluation in Health Education
Authors: Dattilo John , Nelson Gary D.
Published: February 2007

The utilization of single-subject methodology represents a means to improve evaluation efforts in health education. This article provides a rationale for the application of the methodology in health education evaluation. Two variations of the single-subject evaluation methodology (ABAB and multiple baseline) are described. Appropriate methods of data analysis are recommended. Applications of single-subject designs in health education settings are presented. Dilemmas in health education evaluation are identified and reviewed in light of the potential contributions of single-subject methodology.
AIDS Risk Reduction: A Community Health Education Intervention for Minority High Risk Group Members
Authors: Williams Linda Stewart
Published: February 2007

During the past year, members of the Detroit Health Department health education staff have developed an Acquired Immunodeficiency Syndrome (AIDS) community education intervention. The intervention was designed in response to the growing public health problem of AIDS and the need to provide the community with accurate information regarding the transmission and prevention of the disease. The gap in AIDS education and information was particularly evident in the black community. In attempting to develop a comprehensive health education program, the staff encoun tered a number of barriers. Traditional antagonisms between the high-risk groups, homosexual and bisexual males and intravenous drug abusers, and the health depart ment hampered the ability of the intervention team to design a clinic centered pro gram. Concurrently, lack of access to the high-risk population and reactionary public sentiment toward the disease posed serious problems for developing community sup port for the implementation of an effective community-based program. The inter vention team also found that traditional methodologies of health education program planning were inadequate. The staff lacked sufficient data on the beliefs and attitudes of the high-risk populations necessary to design relevant risk reduction activities. Recognizing our limited awareness and accessibility to the high risk groups, a strategy was developed to encourage members of the high-risk population to assume a leader ship role in the development and implementation of the community-based program. The success of the Community Health Awareness Group (C-HAG) is, in part, a result of the willingness of high risk individuals to assume some responsibility in educating themselves and others. It also speaks to the efficacy of collaborative relationships between health workers and target populations when designing public health inter ventions.
Ethical Issues in Government Sponsored Public Health Campaigns
Authors: Faden Ruth R.
Published: February 2007

Health communications campaigns are a major strategy used by governments to promote health. This article discusses key issues in the ethics of health communica tions campaigns, including the compatibility of health campaigns with the principle of respect for autonomy and how conflicts with this principle can be justified. Five potential justifications for state-sponsored health communications campaigns are re viewed : (1) the public's health as an independent value; (2) collective efficiency and majoritarian preferences; (3) third party or state's interests; (4) harm to the health of others; and (5) countering the short-term contingencies of a market.
Ethical and Philosophical Issues in Developing A Health Promotion Consortium
Authors: DeFrank Richard S. , Levenson Phyllis M.
Published: February 2007

This case study describes the establishment and operation of a community-based health promotion consortium. The ethical implications of membership criteria, use of mailing lists, public education and policy, and communications are examined. The organization's responses to questions raised in these areas are discussed. Increased com munication and sharing of ideas and experiences among health promotion consortia are recommended. Issues in the activities of health promotion consortia which require further philosophical and sociological examination are identified.
Report from the AAHE/SOPHE Joint Committee on Ethics
Authors: Taub Alyson , Kreuter Marshall , Parcel Guy , Vitello Elaine
Published: February 2007

In 1984, the Society for Public Health Education (SOPHE) and the Association for the Advancement of Health Education (AAHE) convened a joint committee to de velop a profession wide code of ethics for health education. The following article is a compilation of the Committee's work over two years. The Committee's report appears first. It presents the Committee's position on how a code of ethics is developed and constitutes guidelines for future refinements in the code. Appendix A is the SOPHE code of ethics produced in 1976. It is included to show the evolution of the code into its current form as presented in Appendix B. Appendix B is the Code of Ethics devel oped by a SOPHE Committee in 1983. SOPHE and AAHE through a joint committee are continuing efforts to develop a code of ethics for the profession of health educa tion. We invite reader's reactions to the Code. Comments and questions can be di rected to the AAHE/SOPHE Ethics Committee, c/o the Editors of Health Education Quarterly.
The Business of Health Promotion: Ethical Issues and Professional Responsibilities
Authors: McLeroy Kenneth R. , Gottlieb Nell H. , Burdine James N.
Published: February 2007

In the nine years since an entire issue of Health Education Quarterly (then Health Education Monographs) was devoted to considering ethical issues in health education, several important social changes have occurred which have substantially influenced the practice of that discipline. New practice contexts and ethical issues have resulted, which require a fresh look at both these new issues as well as those addressed in the earlier monograph. The importance of understanding the principles underlying the eth ical dilemmas raised by the authors is emphasized as a concern for both the individual practitioner as well as the profession of health education itself. Recommendations for personal and professional action are made by the authors.
Evaluating Health Promotion: A Longitudinal Quasi-Experimental Design
Authors: Kronenfeld Jennie J. , Jackson Kirby , Blair Steven N. , Davis Keith , Dell Gimarc Jerry , Salisbury Zora , Maysey Dorothy , McGee Joan G.
Published: February 2007

A quasi-experimental research design is used to evaluate Carolina Healthstyle, a health promotion project for South Carolina state employees. A 10% stratified ran dom sample of employees was surveyed in the Spring of 1983 and again in 1984. Eighteen agencies were intervention agencies and the rest comparison that year. This article reports changes with simple before-after comparisons in the intervention agencies and matched pair analysis and randomized block designs to compare inter vention and comparison agencies. Results are reported for smoking, exercise, safety, nutrition, stress, and alcohol. Significant increases in exercise were found in both intervention and comparison agencies. The number of smokers decreased in interven tion from 30% - 26% with no change in comparison agencies. Safety practices changed at similar rates in both intervention and comparison groups. Consumption of chicken increased significantly only in the intervention agencies. Few other diet or stress changes were found. There were changes in alcohol consumption in intervention agen cies only. The presence of the comparison group helps to separate the program effects from secular trends.
The Short-Term Effects of Competition and Rewards in an Adolescent Smoking Prevention Program
Authors: Burke Julie A. , Naughton Michelle J. , Becker Samuel L. , Arbogast Rebecca , Lauer Ronald M. , Krohn Marvin D.
Published: February 2007

This study evaluated whether interventions involving competition and rewards would enhance a school-based educational curriculum on tobacco use. Written pre- and post-tests were used to assess the relevant knowledge of 1068 seventh grade students in three comparable communities. The students' smoking beliefs, intentions, and behavior were assessed by questionnaires before and after the educational unit. Students in two communities participated in interventions designed to enhance knowl edge acquisition, social activism, and non-use of tobacco; students in one community served as controls.

Students in competitive and control communities did not differ prior to interven tion. The interventions influenced respondents' concern about their health and the health of their family and friends and increased the likelihood that they would asso ciate smoking with maturity and short-term bad effects, regardless of their pre-inter vention smoking behavior. Experimenters' and regular smokers' knowledge about smoking and its consequences, and concern about the amount of substance use in their town were increased by the competitions. The competitions were also more like ly to reduce their intentions to smoke. The interventions did not affect smoking be havior. Fortunately, competition losers and winners were not differentially affected by the interventions.
The Gatekeeping Funnel: Tracking a Major PSA Campaign from Distribution through Gatekeepers to Target Audience
Authors: Hammond Sharon Lee , Freimuth Vicki S. , Morrison William
Published: February 2007

This article presents the gatekeeping funnel as a model of the process that a public service announcement (PSA) goes through from distribution until it reaches its target audience. Process measures such as bounceback postcards, the Broadcast Advertisers Report (BAR), and analysis of audience response are suggested as ways of monitoring this funneling process.

The model is then applied to the National Cancer Institute's PSA campaign de signed to promote cancer prevention awareness. Three waves of PSAs were distributed between March 1984 and May 1985. Two of these waves of PSAs were targeted to the general public and the third wave was targeted to black audiences.

Bounceback postcards, BAR data, and the Cancer Information Service (CIS) call data exemplify the gatekeeping funnel model described in the article. When the mes sages were distributed, they had the potential of reaching 170 million adults with tele visions. BAR data show that the gatekeeping function narrowed the number of people potentially exposed to the messages to 24 million, or 14% of the total. Yet only 144,000 people, or less than one-tenth of 1% responded to the messages by calling the CIS number and asking about cancer prevention. This analysis may help PSA campaign planners to develop more realistic expectations for message effects.
Workplace Health Promotion: A Commentary on the Evolution of a Paradigm
Authors: Sloan Richard P.
Published: February 2007

Reports of workplace health promotion programs are reviewed in light of Kuhn's views on paradigmatic advances in science. Such reports fall into two categories: (1) those which describe single health-habit interventions (e.g., smoking cessation, weight control, or stress management) and (2) those which describe comprehensive efforts to incorporate many single health-habit interventions into integrated programs. Com mon to virtually all of these programs in their focus on the modification of the health behavior of individuals. Consideration of such organizational-level factors as work design or climate which are beyond the control of the individual, yet may contribute heavily to illness and absenteeism of employees, is typically omitted. It is concluded that workplace health promotion in the United States has achieved the status of a paradigm and that this paradigm is associated with several limitations and ethical prob lems in light of the programs' objectives: to reduce organizations' medical-care costs and improve productivity.