bluuebunny/crossref_metadata_2025 huggingface dataset:
Intervention Mapping: A Process for Developing Theory and Evidence-Based Health Education Programs
Authors: Bartholomew L. Kay , Parcel Guy S. , Kok Gerjo
Published: February 2007

The practice of health education involves three major program-planning activities: needs assessment, program development, and evaluation. Over the past 20 years, significant enhancements have been made to the conceptual base and practice of health education. Models that outline explicit procedures and detailed conceptualization of community assessment and evaluation have been developed. Other advancements include the application of theory to health education and promotion program development and implementation. However, there remains a need for more explicit specification of the processes by which one uses theory and empirical findings to develop interventions. This article presents the origins, purpose, and description of Intervention Mapping, a framework for health education intervention development. Intervention Mapping is composed of five steps: (1) creating a matrix of proximal program objectives, (2) selecting theory-based intervention methods and practical strategies, (3) designing and organizing a program, (4) specifying adoption and implementation plans, and (5) generating program evaluation plans.
Social Support and Readiness to Make Dietary Changes
Authors: Sorensen Glorian , Stoddard Anne , Macario Everly
Published: February 2007

This article examines the relationship between reported social support and readiness to increase fruit and vegetable consumption, based on the Transtheoretical Stage of Change Model. Data were collected as part of the baseline assessments for a work site intervention study promoting increased consumption of fruits and vegetables. Among workers who did not live alone, household support was significantly higher for those of Hispanic and African American heritage than other groups, and was also higher among men, nonsmokers, and those living with adults compared to those living only with children. In multivariate analyses, coworker support was significantly associated with being in preparation compared to precontemplation/contemplation. Household support was not significantly related to readiness to change in multivariate analyses. The effectiveness of work site nutrition education interventions is likely to be enhanced by teaching participants to provide social support to coworkers and family members.
Longitudinal Study of Relapse From AIDS-Preventive Behavior Among Homosexual Men
Authors: Graham Robin P. , Kirscht John P. , Kessler Ronald C. , Graham Saxon
Published: February 2007

There is no viable alternative to the control of AIDS besides prevention; factors contributing to relapse from behaviors presumed to reduce risk of that disease were investigated. The authors studied 524 homosexual men who had refrained from or used condoms during receptive or insertive anal sex (RAS and IAS, respectively) for at least 12 months, contacting them at 6-month intervals thereafter to ascertain current practices. They determined, via interviews, personal traits, appraised stress of maintaining safer sex, mental health, life events, and efforts to cope with potential infection. Negative life events, personal control beliefs, problem-solving abilities, and coping via problem-focused (e.g., seeking a monogamous union) rather than emotion-focused (e.g., "when I need a cure, they will have one") behaviors were associated with RAS, but less so with LAS safer sex behaviors. These findings provide a basis for individual and community-level interventions to change behavior and reduce AIDS risk.
Physical Activity and Minority Women: A Qualitative Study
Authors: Eyler Amy A. , Baker Elizabeth , Cromer LaChenna , King Abby C. , Brownson Ross C. , Donatelle Rebecca J.
Published: February 2007

Few physical activity research studies have been conducted with minority women. The purpose of this study was to explore patterns of physical activity among minority women. Focus groups were conducted with volunteers older than age 40. Each group was led by a trained moderator familiar with the ethnic community targeted. The sessions were audiotaped and professionally transcribed. Constructs were researched and codes were developed. Data were analyzed using NUD*IST® qualitative analysis program. While participants did not identify themselves as "exercisers," they indicated they got enough physical activity from caregiving, housekeeping, and workday activities. The most common environmental barriers to becoming more physically active included safety, availability, and cost. Personal barriers included lack of time, health concerns, and lack of motivation. Results indicate the importance of terminology and assessment when conducting physical activity research in these populations. Also, results suggest many barriers are changeable with policies and interventions.
Public Health and Health Education in Faith Communities
Authors: Chatters Linda M. , Levin Jeffrey S. , Ellison Christopher G.
Published: February 2007

This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.
Religion's Role in Promoting Health and Reducing Risk Among American Youth
Authors: Wallace John M. , Forman Tyrone A.
Published: February 2007

Although past research has long documented religion's salutary impact on adult health-related behaviors and outcomes, relatively little research has examined the relationship between religion and adolescent health. This study uses large, nationally representative samples of high school seniors to examine the relationship between religion and behavioral predictors of adolescent morbidity and mortality. Relative to their peers, religious youth are less likely to engage in behaviors that compromise their health (e.g., carrying weapons, getting into fights, drinking and driving) and are more likely to behave in ways that enhance their health (e.g., proper nutrition, exercise, and rest). Multivariate analyses suggest that these relationships persist even after controlling for demographic factors, and trend analyses reveal that they have existed over time. Particularly important is the finding that religious seniors have been relatively unaffected by past and recent increases in marijuana use.
The African American Minister as a Source of Help for Serious Personal Crises: Bridge or Barrier to Mental Health Care?
Authors: Neighbors Harold W. , Musick Marc A. , Williams David R.
Published: February 2007

Using data from the National Survey of Black Americans, this article explores the role of African American ministers in the help seeking of African Americans for serious emotional problems. The authors explore which demographic characteristics and psychosocial factors are related to contacting Black clergy for help, whether certain types of personal problems increase the likelihood of clergy contact, and whether those who go to ministers are also likely to seek help from other professional help sources. Results indicate that women are more likely than men to seek help from ministers. People with economic problems are less likely to contact clergy, while those with death or bereavement problems are more likely to seek help from the clergy. Regardless of the type or severity of the problem, those who contact clergy first are less likely to seek help from other professionals. It is recommended that African American clergy and mental health professionals engage in a mutual exchange of information to increase access to professional care among African Americans with serious personal problems.
Self-Efficacy and Participation in Vigorous Physical Activity by High School Students
Authors: Allison Kenneth R. , Dwyer John J. M. , Makin Susan
Published: February 2007

The relationship between physical activity self-efficacy and participation in vigorous physical activity by high school students is examined in this article. Self-efficacy is hypothesized to be positively related to participation in three settings (physical education class, other school-related activities, and outside of school). The effects of age, gender, perceived barriers, and actual barriers are also examined. The sample consists of 1,041 grade 9 and 11 students from a large Metropolitan Toronto school board. Factors derived from a previous (factor) analysis were used to examine the effects of self-efficacy, perceived barriers, and life strain (an actual barrier). The results of multiple regression analysis indicate that physical activity self-efficacy, despite external barriers (but not internal barriers), is predictive of physical activity participation in the hypothesized direction. Other results show consistent age and gender effects on physical activity participation and some support for the hypothesized relationship between perceived barriers and participation.
Changing Women: The Narrative Construction of Personal Change through Community Health Work among Women in Mexico
Authors: Ramirez-Valles Jesus
Published: February 2007

A major premise of health education is that people can and do change their lives. Personal changes and the events that precipitate them are often told in a form of narrative and are accompanied by a new sense of oneself. This research draws on the study of narratives and women’s community activism to explore processes of personal change in women’s activism as community health workers in Mexico. The research is a case study based on in-depth semistructured interviews. Two major categories of narratives of change emerged: change of the self and little or no change. Within these categories, changes are defined as development of the self, becoming a new and different person, actualization of the self, and little or no change. Although women experience significant changes, their changes are based on normative female identities. Implications for the study of narratives and personal change in health education are discussed.
Self-Regulating Childhood Asthma: A Developmental Model of Family Change
Authors: Zimmerman Barry J. , Bonner Sebastian , Evans David , Mellins Robert B.
Published: February 2007

This article tests a model of self-regulatory development in which families’cognitive beliefs and behavioral skills for managing asthma symptoms emerge in four successive phases: asthma symptom avoidance, asthma acceptance, asthma compliance, and asthma self-regulation. Confirmatory factor analyses revealed that the hypothesized multiphase model provided the best factorial fit for phase items. Subsequent Guttman analyses of the families’phase scores revealed a high degree of sequential ordering. Finally, trend analyses of family phase differences revealed a significant negative linear relation with measures of asthma severity and a significant positive linear relation with physician care and concern measures, asthma regulatory measures, and beliefs in Western biomedical practices. Despite receiving primary care for asthma at a major metropolitan university hospital, 83% of the sample were classified as precompliant. The phase model of asthma self-regulatory development offers a qualitative approach for investigating the psychological determinants of asthma self-regulatory behavior.
Exploring Self-Efficacy as a Predictor of Disease Management
Authors: Clark Noreen M. , Dodge Julia A.
Published: February 2007

Self-efficacy is posited in social cognitive theory as fundamental to behavior change. Few health behavior studies have examined self-efficacy prospectively, viewed it as part of a reciprocal behavioral process, or compared self-efficacy beliefs in the same population across different behaviors. This article first discusses self efficacy in its theoretical context and reviews the available prospective studies. Second, it explores self-efficacy as a predictor of disease management behaviors in 570 older women with heart disease. Although the R2 statistics in each case were modest, the construct is shown to be a statistically significant ( p < .05) predictor at both 4 and 12 months postbaseline of several disease management behaviors: using medicine as prescribed, getting adequate exercise, managing stress, and following a recommended diet. Building self-efficacy is likely a reasonable starting point for interventions aiming to enhance heart disease management behaviors of mature female patients.
Personal Responsibility for Health? A Review of the Arguments and the Evidence at Century’s End
Authors: Minkler Meredith
Published: February 2007

This article examines the continuing controversies regarding personal versus social responsibility for health as they are being played out at the turn of the century. Following a brief examination of the contested meaning of “personal responsibility for health” in recent historical context, attention is focused on the arguments for and against holding the individual to be primarily accountable for his or her health behavior. The paper then makes the case for more balanced, ecological approaches that stress individual responsibility for health within the context of broader social responsibility. The article concludes by briefly summarizing the Canadian approach to health promotion as a useful example of what such a balanced, ecological approach might look like.
Sex in the New World: An Empowerment Model for HIV Prevention in Latina Immigrant Women
Authors: Gómez Cynthia A. , Hernández Mónica , Faigeles Bonnie
Published: February 2007

In 1996, nearly 60% of U.S. AIDS cases among Latinas were attributed to unprotected sex with men. Economic disadvantage, language barriers, and strong cultural gender norms regarding sex exacerbate the risk for HIV infection among Latina immigrant women. Through a collaboration among scientists and providers, this study was designed to evaluate the impact of a multifaceted empowerment program for Latina immigrant women on HIV risk behaviors. Women ( N = 74) were followed for the first 6 months of their participation and attended up to nine distinct types of activities (e.g., information meetings, friendship circles, and workshops). Although the program was not developed to specifically target HIV risk behaviors, women showed significant increases in sexual communication comfort, were less likely to maintain traditional sexual gender norms, and reported changes in decision-making power. Targeting broader sociocultural issues may increase the necessary skills for Latina women to prevent HIV infection from their sexual partners. Successful collaborations between scientists and providers are critical in developing effective, community-relevant interventions.
A Collaborative Evaluation of a Needle Exchange Program for Youth
Authors: Weiker Rebecca L. , Edgington Renee , Kipke Michele D.
Published: February 2007

Limited research has been conducted to examine the effectiveness of existing HIV prevention and harm reduction interventions targeted to injection drug-using youth. Moreover, although there are a growing number of needle exchange programs being developed for youth throughout the United States, the effects of these services have yet to be systematically evaluated. This article describes a collaborative evaluation conducted by the Division of Adolescent Medicine, Childrens Hospital Los Angeles, and Clean Needles Now, a needle exchange serving young injection drug users. The evaluation employed a multimethod research design that included both qualitative and quantitative methods. Findings are presented about how a community-based agency’s service delivery philosophy can affect the design and implementation of an evaluation. Lessons learned from this collaborative evaluation are presented, including the potential benefits of incorporating harm reduction principles into research activities.
Collaborative Research to Prevent HIV among Male Prison Inmates and Their Female Partners
Authors: Grinstead Olga A. , Zack Barry , Faigeles Bonnie
Published: February 2007

Despite the need for targeted HIV prevention interventions for prison inmates, institutional and access barriers have impeded development and evaluation of such programs. Over the past 6 years, the authors have developed a unique collaborative relationship to develop and evaluate HIV prevention interventions for prison inmates. The collaboration includes an academic research institution (the Center for AIDS Prevention Studies at the University of California, San Francisco), a community-based organization (Centerforce), and the staff and inmate peer educators inside a state prison. In this ongoing collaboration, the authors have developed and evaluated a series of HIV prevention interventions for prison inmates and for women who visit prison inmates. Results of these studies support the feasibility and effectiveness of HIV prevention programs for inmates and their partners both in prison and in the community. Access and institutional barriers to HIV intervention research in prisons can be overcome through the development of collaborative research partnerships.
The Collaboration Process in HIV Prevention and Evaluation in an Urban American Indian Clinic for Women
Authors: Klein Dorie , Williams Diane , Witbrodt Jane
Published: February 2007

Collaboration between providers and researchers can be key to doing women’s HIV prevention that is holistic, gender sensitive, and responsive to communities. This report centers on providers’ and evaluators’ experiences in developing and implementing a project promoting “healthy relationships” with low-income women from different ethnicities at an urban American Indian clinic. During planning, decisions on the health problems to be targeted, division of labor, program goals, resource allocation, evaluation design, and outcome measures were jointly made. Other factors were the input of participants and the influence of American Indian values at the clinic. The implementation process was fully collaborative. There are implications for creating conditions for successful collaborations in health education.
Organizing Community Research Partnerships in the Struggle against AIDS
Authors: Schensul Jean J.
Published: February 2007

Despite pharmaceutical advances, AIDS remains a health problem difficult to treat, leaving preventive interventions as the primary means of promoting risk avoidance. Increasing the capacity of university-based researchers to develop culturally, developmentally, and contextually appropriate AIDS prevention strategies requires the collaboration of community service and advocacy partners. To date, neither university researchers nor community providers have a great deal of partnership experience. Thus, a common language and set of experiences are yet to be developed. This article reviews the history of university-community and researchercommunity collaboration for AIDS research and intervention, placing the innovative work of the University of California, San Francisco (UCSF) Center for AIDS Prevention Studies and its community and foundation partnerships among those efforts at the forefront of the community-university dialogue. It concludes with suggestions derived from the collaborative work of UCSF researchers and community service partners to strengthen efforts to develop theory, research methods, and results that are immediately useful and productive of long-term prevention research efforts.
Skin Cancer Prevention: The Problem, Responses, and Lessons Learned
Authors: Graffunder Corinne M. , Wyatt Stephen W. , Bewerse Barbara , Hall Irene , Reilley Barbara , Lee-Pethel Rebeca
Published: February 2007

Skin cancer is one of the most common forms of cancer and has rapidly increased during the past three decades in the United States. More than 1 million new cases of skin cancer are estimated to be diagnosed in the United States each year. The National Skin Cancer Prevention Education Program (NSCPEP) was launched by the Centers for Disease Control and Prevention (CDC) in 1994 as a national effort to address the Healthy People 2000 objectives for skin cancer prevention. The NSCPEP is a comprehensive, multidimensional public health approach that includes (1) primary prevention interventions; (2) coalition and partnership development; (3) health communications and education; and (4) surveillance, research, and evaluation. In 1994, through support from the CDC, state health departments in Arizona, California, Georgia, Hawaii, and Massachusetts initiated primary prevention intervention projects to conduct and evaluate skin cancer prevention education. This article discusses the comprehensive, multidimensional public health approach highlighting examples from the state demonstration projects.
Skin Cancer Prevention for Children: A Critical Review
Authors: Buller David B. , Borland Ron
Published: February 2007

Increasing sun protection for children may reduce their risk for skin cancer, so many health authorities recommend comprehensive sun safety for children. Sun protection of children in North America and Europe is generally lower than desired and lower than in Australia. This article provides a critical reviewof evaluations on the effects of 24 sun protection programs for children under age 14. Programs are classified based on the target population, setting, and features. Most programs improved sun safety knowledge, but changes in sun protection attitude and behaviors were smaller. Multiunit presentations were more effective than short-duration presentations. Peer education was effective but needs further evaluation. Some programs for parents have been shown to increase sun protection for children. Strategies to improve sun safety policies need further study. A few community-wide programs have effectively improved sun protection. Future research should address innovative strategies and issues of design and measurement. There is no gold standard for measuring sun protection behavior, but self-report, prospective diaries, and observational techniques show small positive correlations.
Factors Associated with Skin Cancer Prevention Practices in a Multiethnic Population
Authors: Glanz Karen , Lew Robert A. , Song Valerie , Cook Valerie Ah
Published: February 2007

A better understanding of factors influencing sun protection practices can improve the design and evaluation of skin cancer prevention programs. These data are from a cross-sectional survey of 756 parents with children in Grades 1 through 3, and 176 recreation program staff members in a multiethnic population in Hawaii. Questionnaires asked about skin cancer prevention practices (sunscreen use, covering up, shade seeking), knowledge, benefits and barriers, policies, and staff norms for prevention. The most important correlates of children’s prevention practices were their parents’ sun protection habits. Multiple regression models—which included knowledge, beliefs, program policies, and covariates related to sun protection—explained a total of between 38% and 41% of the variance in children’s sun safety habits, 22% to 25% of parents’habits, and 24% of recreation staff members’sun safety habits. The models were less successful at predicting the use of hats, shirts, and shade seeking and a composite sun protection habits index. Parents and caregivers’knowledge, beliefs, and behaviors, as well as recreation program policies, are strong predictors of sun protection practices among children in Grades 1 to 3 in a multiethnic sample.
Sun Avoidance Practices among Non-Hispanic White Californians
Authors: Hoegh Holly J. , Davis Bonnie D. , Manthe Andrew F.
Published: February 2007

This study measures self-reported sun avoidance practices, use of protective clothing, and use of sunscreen among 4,749 non-Hispanic white adults living in households in California. Data are from the California Behavioral Risk Factor Survey, a population-based telephone survey of health behaviors and attitudes. The average respondent spent at least 15 minutes in the sun on 21.4 days out of the last 30 days. Regular use of protective clothing was reported by 30.7%, regular use of sunscreen by 22.2%, and regular sun avoidance by 17.1% of the respondents. Results varied by month, gender, skin tone, age, education, and presence of children in the household. Health strategies should target younger adults (especially men), households with children and adults with less than a high school education. Because of relatively low rates of sun avoidance behaviors overall, a general population campaign also is warranted.
Communicating about Youth’s Sun Exposure Risk to Soccer Coaches and Parents: A Pilot Study in Georgia
Authors: Parrott Roxanne , Duggan Ashley , Cremo Jeff , Eckles Alan , Jones Karyn , Steiner Carol
Published: February 2007

Efforts to increase the sun-protective behaviors of children were extended to outdoor recreational sports and youth soccer settings in this study. The pretest results of a pilot survey of coaches ( n= 12), parents ( n= 50), and youths ( n= 61) on eight soccer teams in south Georgia were used to guide the development of a health education program for coaches. In the pilot program, half the coaches were trained to be involved in soccer-playing youths’ sun protection by acting as positive role models and promoting sun protection to youths and their parents. The pilot demonstrated coaches’ willingness to participate in sun protection promotion to youth: Youths indicated that coaches and parents were more likely to tell youths to wear sunscreen after the training than before, and coaches perceived getting youths to wear sunscreen to be less difficult than before.
Illness Representations: Mapping the Experience of Lupus
Authors: Wiginton Kristin L.
Published: February 2007

Lupus, a chronic illness that mainly affects women, presents numerous challenges to health professionals due to the unpredictable nature of the disease course. To provide appropriate educational interventions for those living with lupus, health educators must develop methods best suited to individuals’current mental representations of their illness. A cognitive mapping strategy was used in this study to ascertain the patients’own perceptions of living with lupus. The participants ( N = 20) identified 192 unduplicated concepts in their maps, which were ultimately collapsed into 12 major categories. The results of this study indicate that, although diagnosed with the same illness, the women presented with different mental representations of their illness. Consequently, cognitive mapping could serve as a useful tool to initiate tailored educational interventions for those living with lupus.
Impact of the Working Well Trial on the Worksite Smoking and Nutrition Environment
Authors: Biener Lois , Glanz Karen , McLerran Dale , Sorensen Glorian , Thompson Beti , Basen-Engquist Karen , Linnan Laura , Varnes Jill
Published: February 2007

This article reports the effect of a worksite cancer control intervention on aspects of the physical and social environment related to dietary and smoking behaviors of employees. Data are from 111 intervention and control worksites that participated in the Working Well Trial. Employee surveys and interviews with key organizational informants assessed environmental and normative changes relevant to nutrition and tobacco use. Results indicated significant effects of the intervention on all nutrition outcomes: access to healthy food, nutritional information at work, and social norms regarding dietary choice. Significant benefits were not found for smoking norms or smoking policies. However, changes occurred in both the control and intervention sites on these variables. This first large analysis of environmental and normative effects of a worksite intervention is consistent with the employee behavior change findings for the trial and serves as a model for future analyses of multilevel worksite health promotion programs.
Lay Health Advisor Activity Levels: Definitions from the Field
Authors: Altpeter Mary , Earp Jo Anne L. , Bishop Caroline , Eng Eugenia
Published: February 2007

One type of lay health advisor model assumes that an effective mechanism for reaching the underserved is through informal advice-givers called natural helpers. Despite the growing use of this approach, few programs have defined what an active lay health advisor does within the natural helping process. To explore perceptions and definitions of lay health advisors’ activity, we conducted semistructured, in-person interviews with four field staff who coordinate the advisors’ activities in a breast cancer screening program. These staff viewed lay health advisor activity as fluctuating over the course of a year, occurring along a continuum of participation (inactive, moderately active, active, and superactive), and reflecting varying degrees of proactivity and participation in multiple activities. These results suggest an empirical process for refining the definition of an active lay health advisor, improving advisors’productivity in achieving outreach objectives, and managing and monitoring their ongoing activities.
Stages of Change for Increasing Fruit and Vegetable Consumption among Adults and Young Adults Participating in the National 5-a-Day for Better Health Community Studies
Authors: Campbell Marci Kramish , Reynolds Kim D. , Havas Stephen , Curry Susan , Bishop Donald , Nicklas Theresa , Palombo Ruth , Buller David , Feldman Robert , Topor Marie , Johnson Carolyn , Beresford Shirley A. A. , Motsinger Brenda McAdams , Morrill Calvin , Heimendinger Jerianne
Published: February 2007

Higher fruit and vegetable consumption is associated with a reduced risk of certain cancers and chronic diseases. The 5-a-Day for Better Health community studies are evaluating population-based strategies to achieving dietary behavior change using the stages-of-change model and associated theories. The authors present baseline comparisons of stages of change for fruit and vegetable consumption among adults and young adults in eight study sites representing diverse regions of the United States and diverse populations and settings. Three dominant stages, precontemplation, preparation, and maintenance, were found across sites. Women and those with college degrees were more likely to be in action/maintenance. Fruit and vegetable consumption, self-efficacy, and knowledge of the 5-a-Day recommendation were positively associated with more advanced stages of change in all study sites. The authors discuss the findings in relation to possible limitations of this and other dietary stages-of-change measures and suggest directions for future research.
Early Detection of Cervical Cancer among Native American Women: A Qualitative Supplement to a Quantitative Study
Authors: Messer Lynne , Steckler Allan , Dignan Mark
Published: February 2007

The North Carolina Native American Cervical Cancer Prevention Project was a 5-year (1989-1995) National Cancer Institute–funded, community-based, early detection of cervical cancer intervention implemented among two Native American tribes in North Carolina: the eastern band of the Cherokee Indians and the Lumbee. The initial quantitative analysis of the intervention showed modest effects and found that the intervention had different effects in the two communities. Due to the equivocal findings, a retrospective qualitative study was conducted. The qualitative study found that two types of factors influenced the intervention’s results. The first were project and intervention characteristics, and the second were community and cultural factors over which the project had no control. The community and cultural factors took two forms: enhancers, which contributed to greater intervention effect, and attenuators, which created barriers to success. Examples of each factor are presented, and implications for cervical cancer detection among Native American women are discussed.
Enhancing Community Participation in Intervention Research: Farmworkers and Agricultural Chemicals in North Carolina
Authors: Arcury Thomas A. , Austin Colin K. , Quandt Sara A. , Saavedra Rose
Published: February 2007

The participation of affected communities in the development of public health intervention research improves project sustainability and effectiveness by making projects more relevant and acceptable to the communities. This article presents a multimode, multidomain model approach for community participation in different project components, which ensures the benefits of participation without requiring the same level of participation in every activity or by every community sector. A case study is used to illustrate the model, describing procedures for establishing and maintaining farmworker participation in developing an intervention to reduce exposure to chemicals. Farmworkers are a poor and underserved population for which the empowering and culturally appropriate benefits of community participation are especially needed. However, this population presents challenges for participatory health projects: geographic dispersion, ethnic diversity, lack of organization, sense of powerlessness, and communication and transportation difficulties. The lessons learned in this case extend the method and theory of community participation.
Psychosocial Factors Associated with the Use of Breast Cancer Screening by Women Age 60 Years or Over
Authors: Michielutte Robert , Dignan Mark B. , Smith Bonnie Lanier
Published: February 2007

This study examined psychosocial factors related to breast cancer screening among older women. Data for the study were obtained from interviews with 719 women age 60 years or over attending rural and urban primary care clinics in North Carolina. The results indicated that 50% of the women had mammograms in the past year, 65% reported clinical breast examinations in the past year, and 31% said they practiced breast self-examinations once a month. Several psychosocial factors were significant predictors of a lower likelihood of being screened. Multivariate analysis confirmed the importance of psychosocial factors as predictors of breast cancer screening. Educational intervention to increase screening for breast cancer in this population is needed, and the results provide specific suggestions regarding the content of effective educational materials and approaches for older women.
The Use of Significant Reduction Rates to Evaluate Health Education Methods for Pregnant Smokers: A New Harm Reduction Behavioral Indicator?
Authors: Windsor Richard A. , Li Chang Qing , Boyd Neal Richard , Hartmann Katherine E.
Published: February 2007

This article evaluates the evidence to support the use of biochemical measurement of significant reduction (SR) rates among pregnant smokers as a new behavioral indicator of “harm reduction” (HR). The results of four studies—three randomized patient education clinical trials of pregnant smokers (Trials I, II, and III) and an epidemiological study (Study IV)—are presented. Among Trial I, II, and III cohorts of pregnant smokers, control group SR rates of 7% (I), 9% (II), and 20% (III) were increased among experimental groups to 17% (I), 18% (II), and 32% (III) by the same patient education methods. Analyses of infant birthweight data in Study IV found that a patient SR rate representing a 50% or more decrease between a baseline and follow-up test was associated with an increase in adjusted birthweight of 92 grams.
Do Black and White Adults Use the Same Sources of Information about Aids Prevention?
Authors: Cunningham William E. , Davidson Pamela L. , Nakazono Terry T. , Andersen Ronald M.
Published: February 2007

Although AIDS prevention campaigns need to target population segments that are at highest risk to be effective, little is known about how various sources of AIDS information vary by race, education, and age. To determine the most common communication channels for AIDS information reported by Blacks and Whites, the authors interviewed 1,769 adults in Baltimore, Maryland, to obtain data on nine common sources of information about AIDS and analyzed their reports by race, age, and education. Television and newspapers were the most common sources but varied little across groups. National and local public health agencies, as well as medical doctors and dentists, were more commonly reported by Blacks than by Whites. Religious organizations were much more commonly reported by Blacks than by Whites. Public health organizations working collaboratively with religious organizations and health care providers might be more effective in developing AIDS prevention strategies than has been considered previously.
Health Care Providers’ Perspectives on Patient Delay for Seeking Care for Symptoms of Acute Myocardial Infarction
Authors: Zapka Jane , Estabrook Barbara , Gilliland Janice , Leviton Laura , Meischke Hendrika , Melville Sharon , Taylor Judy , Daya Mohamud , Laing Brian , Meshack Angela , Reyna Roy , Robbins Mark , Hand Mary , Finnegan John
Published: February 2007

To inform intervention development in a multisite randomized community trial, the Rapid Early Action for Coronary Treatment (REACT) project formative research was undertaken for the purpose of investigating the knowledge, beliefs, perceptions, and usual practice of health care professionals. A total of 24 key informant interviews of cardiologists and emergency physicians and 15 focus groups (91 participants) were conducted in five major geographic regions: Northeast, Northwest, Southeast, Southwest, and Midwest. Transcript analyses revealed that clinicians are somewhat unaware of the empirical evidence related to the problem of patient delay, are concerned about the practice constraints they face, and would benefit from concrete suggestions about how to improve patient education and encourage fast action. Findings provide guidance for selection of educational strategies and messages for health providers as well as patients and the public.
Coming Up in the Boogie Down: The Role of Violence in the Lives of Adolescents in the South Bronx
Authors: Freudenberg Nicholas , Roberts Lynn , Richie Beth E. , Taylor Robert T. , McGillicuddy Kim , Greene Michael B.
Published: February 2007

This article presents data gathered from young people in a poor urban community in New York City, the South Bronx. It seeks to help public health professionals better understand young people’s perceptions of violence in the context of their daily lives. Sources of data include a street survey, five focus groups, interviews with incarcerated young males, and observations of several youth programs. These data suggest that violence is pervasive in the lives of both young men andwomen, although gender plays an important role in shaping the experience of violence. Other factors that influence the experience of violence include patterns of substance use, availability and use of weapons, and a perception that the police do not respect young people. Despite numerous challenges, many young people do take actions to reduce violence. The article suggests actions public health professionals can take to strengthen the ability of families, schools, youth organizations, and young people themselves to reduce violence in low-income urban communities.
Neighborhood Solutions for Neighborhood Problems: An Empirically Based Violence Prevention Collaboration
Authors: Randall Jeff , Swenson Cynthia Cupit , Henggeler Scott W.
Published: February 2007

Youth antisocial behavior is influenced, in part, by neighborhood context. Yet, rather than attempting to ameliorate factors contributing to youth antisocial behavior, service dollars are primarily devoted to expensive and often ineffective out-of-home placements. This article describes the development and implementation of a collaborative partnership designed to empower an economically disadvantaged neighborhood to address violent criminal behavior, substance abuse, and other serious antisocial problems of its youth while maintaining youth in the neighborhood. Through a collaboration between a university research center and neighborhood stakeholders, services are being provided to address the key priorities identified by neighborhood residents, and extensive efforts are being made to develop family and neighborhood contexts that are conducive to prosocial youth behavior.
Establishing LA VIDA: A Community-Based Partnership to Prevent Intimate Violence against Latina Women
Authors: Maciak Barbara J. , Guzman Ricardo , Santiago Anna , Villalobos Graciela , Israel Barbara A.
Published: February 2007

LA VIDA—the Southwest Detroit Partnership to Prevent Intimate Violence Against Latina Women— evolved in response to community concern about the problem of intimate partner violence (IPV) and the lack of culturally competent preventive and support services for Latino women and men in southwest Detroit. Since 1997, diverse organizations have mobilized as a community-academic partnership to ensure the availability, accessibility, and utilization of IPV services. This article describes and analyzes the evolution of LA VIDA within a community-based participatory research framework using a case study approach that draws on multiple data sources including group and individual interviews and field notes. The challenges and lessons learned in addressing a complex multifaceted problem such as IPV in an ethnic minority community are highlighted in an examination of the process of mobilizing diverse organizations, conducting community diagnosis and needs assessment activities, establishing goals and objectives within a social ecological framework, and integrating evaluation during the development phase.
Subtle upper limb impairment in asymptomatic multiple sclerosis subjects
Authors: Solaro C. , Brichetto G. , Casadio M. , Roccatagliata L. , Ruggiu P. , Mancardi G.L. , Morasso P.G. , Tanganelli P. , Sanguineti V.
Published: February 2007

We evaluated upper limb function in multiple sclerosis (MS) subjects (11 clinically definite MS patients and seven clinically isolated syndrome (CIS) subjects), with a normal upper limb standard neurological examination. Subjects performed center-out reaching movements under visual control, with and without vision of the hand. Their movements were recorded through a digitizing tablet. Motor performance was also related to lesion load, estimated from magnetic resonance imaging (MRI). We found that in MS and CIS subjects, under the hand vision condition, movements were significantly less smooth, and had a less symmetric speed profile. However, the observed impairment did not correlate with MRI findings. This result may be interpreted as evidence of a compensatory strategy, elicited by subtle alterations in sensorimotor control. Multiple Sclerosis 2007; 13: 428-432. http://msj.sagepub.com
The clinical response to minocycline in multiple sclerosis is accompanied by beneficial immune changes: a pilot study
Authors: Zabad R.K. , Metz L.M. , Todoruk T.R. , Zhang Y. , Mitchell J.R. , Yeung M. , Patry D.G. , Bell R.B. , Yong V.W.
Published: February 2007

Minocycline has immunomodulatory and neuroprotective activities in vitro and in an animal model of multiple sclerosis (MS). We have previously reported that minocycline decreased gadolinium-enhancing activity over six months in a small trial of patients with active relapsing-remitting MS (RRMS). Here we report the impact of oral minocycline on clinical and magnetic resonance imaging (MRI) outcomes and serum immune molecules in this cohort over 24 months of open-label minocycline treatment. Despite a moderately high pretreatment annualized relapse rate (1.3/year pre-enrolment; 1.2/year during a three-month baseline period) prior to treatment, no relapses occurred between months 6 and 24. Also, despite very active MRI activity pretreatment (19/40 scans had gadolinium-enhancing activity during a three-month run-in), the only patient with gadolinium-enhancing lesions on MRI at 12 and 24 months was on half-dose minocycline. Levels of the p40 subunit of interleukin (IL)-12, which at high levels might antagonize the proinflammatory IL-12 receptor, were elevated over 18 months of treatment, as were levels of soluble vascular cell adhesion molecule-1. The activity of matrix metalloproteinase-9 was decreased by treatment. Thus, clinical and MRI outcomes are supported by systemic immunological changes and call for further investigation of minocycline in MS. Multiple Sclerosis 2007; 13: 517-526. http://msj.sagepub.com
Voxel-based analysis of grey matter magnetization transfer ratio maps in early relapsing remitting multiple sclerosis
Authors: Audoin B. , Davies G. , Rashid W. , Fisniku L. , Thompson A.J. , Miller D.H.
Published: February 2007

Previous studies using magnetization transfer ratio (MTR) histogram analysis have demonstrated the existence of global grey matter (GM) abnormalities in patients with early relapsing-remitting multiple sclerosis (RRMS). However, MTR histogram analysis does not provide any information on the localization of the morphological changes within the GM. The aim of this study was to investigate the localization of GM injury in early RRMS, performing voxel-based analysis of GM MTR maps. Statistical mapping analysis of GM MTR maps was performed in a group of 38 patients with early RRMS and 45 healthy controls. Between-group comparisons (P<0.05, corrected for multiple comparisons) demonstrated significant GM MTR decrease in patients located in the bilateral lenticular nuclei, the bilateral insula, the left posterior cingulate cortex, and the right orbitofrontal cortex. To limit the potential confounding effect of regional GM atrophy, the percentages of GM were assessed in the regions showing significant MTR decrease, and no GM atrophy was evidenced in these regions. This study demonstrates that several GM regions are commonly affected in patients with early RRMS. Predominant involvement of these structures may be partly related to their vulnerability to anterograde or retrograde degeneration from transected axons in the white matter and/or to the predominant localization of GM demyelinating lesions in such regions. Multiple Sclerosis 2007; 13: 483-489. http://msj.sagepub.com
UCP2 and mitochondrial haplogroups as a multiple sclerosis risk factor
Authors: Otaegui D. , Saenz A. , Ruίz-Martίnez J. , Olaskoaga J. , López de Munain A.
Published: February 2007

In the actual scenario of the search for further genetic susceptibility factors, a recent paper noted an SNP in the UCP2 gene as a multiple sclerosis (MS) risk factor. UCP2 is a member of the mitochondrial proton transport family, which uncouples proton entry in the mitochondrial matrix from ATP synthesis. mtDNA haplogroups are also associated with ATP production, and are linked with mitochondrial proton transport. In this work, we studied the UCP2 SNP and the mitochondrial haplogroups distribution in a Spanish MS population, with a population sub-group of Basque-origin patients. Our results confirm the link between UCP2 SNP and MS, and show a slight relation between this SNP and mitochondrial haplogroups. Multiple Sclerosis 2007; 13: 454-458. http://msj.sagepub.com