bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Pedagogy and Its Application to Health Education: A Critical Appraisal of the Casa en Casa Model
Authors: Merideth Emily
Published: February 2007

Casa en Casa is a popular education project of the community health education section of La Clínica de la Raza, a community-based health clinic in Oakland, California. The author examines the Casa en Casa model for its contributions to furthering health education practitioners' understanding of critical pedagogy and community organizing and their relationship to health education. A description of the project's achievements and the obstacles faced in reaching its goals of community empowerment is followed by an analysis of the weaknesses in the project that may undermine its effectiveness. Recommendations are made as to the importance of linking theory to practice and practice to a long-term vision of social change.
Building Community for Health: Lessons from a Seven-Year-Old Neighborhood/University Partnership
Authors: Flick Louise H. , Given Reese Cordie , Rogers Gail , Fletcher Pamela , Sonn Joyce
Published: February 2007

This article presents two case studies highlighting the role of community conflict in the process of community empowerment. A graduate program for community health nurses (CHNs) in a large Midwestern city formed a partnership with a diverse, integrated neighborhood for the dual purposes of enhancing the community's capacity to improve its own health and teaching CHNs community organizing as a means to improve health. Central to the partnership are a broad definition of health, trust developed through long-term involvement, a commitment to reciprocity, social justice, and Freire's model of adult learning.
De Madres a Madres: A Community, Primary Health Care Program Based on Empowerment
Authors: McFarlane Judith , Fehir John
Published: February 2007

Based on the concepts of empowerment of indigenous women through unity, validation of women as key health promoters, and the acceptance of a community's ability to identify and redress its own health needs, the de Madres a Madres Program was started in a Houston inner-city Hispanic community. The program has become a strategy for mobilizing a total community for health. Indigenous volunteer mothers learned how to provide information to increase access to health care. Information was provided through community coalitions the mothers formed with health clinics, social service agencies, local businesses, schools, churches, elected officials, and the media. Outcome data identified the covert functions of the program to be the enhancement of individual women's self-esteem and power, and the collective enhancement of community self-esteem, power, and economy. The concept of a community economy and a theoretical basis of empowerment of women are discussed in terms of community empowerment for community health.
Empowerment in Spanish: Words Can Get in the Way
Authors: Erzinger Sharry
Published: February 2007

In completing the two-issue set on Community Empowerment, Participatory Education and Health, the Guest Editors became aware that the concept of empowerment may have different meanings for different cultures and languages. We were privileged to receive a short piece on how the concept translates into Spanish and Latin American culture. We hope this piece in combination with several articles in these volumes stimulates greater thinking on the cultural and language context of empowerment-oriented practice.
The Importance of Social Interaction: A New Perspective on Social Epidemiology, Social Risk Factors, and Health
Authors: Bloomberg Lynn , Meyers James , Braverman Marc T.
Published: February 2007

Social epidemiology research has provided persuasive evidence of the link between the social environment—especially socioeconomic status—and health outcomes, but has failed to identify underlying mechanisms that might account for the association. The research may have been limited to date by its reliance on traditional epidemiological methods that emphasize a search for specific causal factor-disease relationships. It is time to take the research evidence and recast it to find practical solutions. We argue that the human development perspective supplies a framework for understanding the critical interaction between elements of social environment and health: Analyzing the social epidemiological research from this perspective can help to explain why and how the most potent factor, socioeconomic status, affects health outcomes. Equally important, this alternative perspective also presents health education practice implications.
The Transtheoretical Model of Change and HIV Prevention: A Review
Authors: Prochaska James O. , Redding Colleen A. , Harlow Lisa L. , Rossi Joseph S. , Velicer Wayne F.
Published: February 2007

The transtheoretical model of health behavior change is described and supporting empirical work is presented that reviews the central constructs of the model: the stages of change, processes of change, decisional balance, confidence, and temptation. Model-based applications to a broad range of problem behaviors are summarized. Applications to human immunodeficiency virus (HIV) prevention behavior changes are highlighted for each variable. Finally, several questions about the area of sexual behavior change to reduce risk of HIV exposure are explored and future research ideas are described within the context of this model.
Stages of Change in Adopting Healthy Diets: Fat, Fiber, and Correlates of Nutrient Intake
Authors: Glanz Karen , Patterson Ruth E. , Kristal Alan R. , DiClemente Carlo C. , Heimendinger Jerianne , Linnan Laura , McLerran Dale F.
Published: February 2007

The stages of change construct, which addresses the readiness to change, has only recently been applied to dietary behavior, such as fat consumption. This article describes the application of the stages of change construct to dietary fat and fiber consumption and examines the association of dietary stages to eating practices and related demographic and psychosocial factors in a large, geographically diverse population of workers. We present results from the baseline survey of 17,121 employees in the Working Well Trial. We assessed stage from an algorithm based on seven items and measured dietary intake with an 88-item food frequency questionnaire. Findings indicated that a greater proportion of the population has actively tried to reduce fat intake than to consume more fiber. Stage of change was associated with fat, fiber, and fruit and vegetable intake in a stepwise manner, as predicted. In multivariate analyses that controlled for demographic characteristics, stage of change predicted between 8 and 13% of the variance in dietary intake, and more than demographic variables. These findings have implications for the design of nutrition interventions and for the evaluation of intermediate outcomes.
Creating Capacity Through Health Education: What We Know and What We Don't
Authors: Clark Noreen M. , McLeroy Kenneth R.
Published: February 2007

Researchers in health education have rarely convened to outline research priorities in the field. This article discusses the results of a meeting to develop a research agenda aimed at creating capacity to promote and maintain health. Salient research findings related to individual and community health are summarized and priority issues for future research are presented.
Strengthening Individual and Community Capacity to Prevent Disease and Promote Health: In Search of Relevant Theories and Principles
Authors: Freudenberg Nicholas , Eng Eugenia , Flay Brian , Parcel Guy , Rogers Todd , Wallerstein Nina
Published: February 2007

The dominant theoretical models used in health education today are based in social psychology. While these theories have increasingly acknowledged the role of larger social and cultural influences in health behavior, they have many limitations. Theories seek to explain the causes of health problems, whereas principles of practice, which are derived from practical experience, assist intervenors to achieve their objectives. By elucidating the relationships between theory and practice principles, it may be possible to develop more coherent and effective interventions. The key research agenda for health education is to link theories at different levels of analysis and to create theory-driven models that can be used to plan more effective interventions in the complex environments in which health educators work.
Creating Capacity: Establishing a Health Education Research Agenda for Special Populations
Authors: McLeroy Kenneth R. , Clark Noreen M. , Simons-Morton Bruce G. , Forster Jean , Connell Cathleen M , Altman David , Zimmerman Marc A.
Published: February 2007

On Day 2 of the joint CDC/SOPHE conference on Creating Capacity: Establishing a Research Agenda for Health Education, the participants were asked to identify research needs or special issues in working with children and adolescents, the elderly, women, men, and underserved groups. This article presents the priority research areas across subgroups identified by the participants. The cross-group priorities are followed by research recommendations for each subgroup.
Contraceptive and Condom Use Adoption and Maintenance: A Stage Paradigm Approach
Authors: Grimley Diane M. , Prochaska James O. , Velicer Wayne F. , Prochaska Gabrielle E.
Published: February 2007

The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of constructs that act as sensitive intervening or outcome variables—the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.
Distinguishing Starters From Nonstarters in an Employee Physical Activity Incentive Program
Authors: Hooper Jacqueline M. , Veneziano Louis
Published: February 2007

Although the vast majority of Americans who are physically active are likely to extol its many physical, psychological, and social values, research indicates that approximately fifty percent of individuals who start a formal physical activity program will drop out in six months or less. The present study employed stepwise discriminant analytical techniques in an attempt to distinguish starters from nonstarters in an innovative employee physical activity incentive program. The results indicated that a combination of health beliefs and lifestyle characteristics, health locus of control expectancies, and physiological characteristics accurately discriminated 81.7% of the starters and nonstarters. It was concluded that physical activity programs need to be designed, implemented, and marketed in such a manner as to attract individuals who are sedentary, smoke, are unable to cope with home-mediated stress, have an external health locus of control expectancy, and/or have a high cardiovascular disease-risk factor profile.
Cancer Risk Reduction in Mexican American Women: The Role of Acculturation, Education, and Health Risk Factors
Authors: Balcazar Hector , Castro Felipe G. , Krull Jennifer L.
Published: February 2007

This article describes a two-factor schema for the development of culturally appropriate cancer risk reduction interventions for Mexican American women. Regarding this approach, risk factors for two major cancer areas are reviewed: cigarette smoking and obesity/diet. We first describe a schema that facilitates the planning of strategies associated with preferred health interventions and preventive approaches for cancer risk reduction with Mexican American and other Latino/Hispanic persons. This schema examines Acculturation and Education as key factors that should be considered in developing health education messages and interventions that are culturally and educationally appropriate to the identified subpopulations of Hispanics in terms of language and informational content of the message and in terms of psychological factors related to health behavior change. Empirical data from a community sample is presented for the purpose of illustrating the validity of this schema.
In-Home Injury Prevention Practices for Infants and Toddlers: The Role of Parental Beliefs, Barriers, and Housing Quality
Authors: Gielen Andrea Carlson , Wilson Modena E. H. , Faden Ruth R. , Wissow Larry , Harvilchuck Judith D.
Published: February 2007

The present research was designed to contribute to the empirical literature on the scope and determinants of parents' injury prevention practices among families living in disadvantaged, urban areas. One hundred fifty mothers were interviewed about their living environment when they brought their children (ages 6-36 months) to a hospital-based, pediatric primary care clinic. Only 37% of respondents reported that they knew their hot water temperature was 125° or less. A majority (59%) of families reported that they did not use stair gates. More than one fourth (27%) of respondents said they did not have smoke detectors. Mothers uniformly reported very favorable attitudes and beliefs and strong support from others for in-home injury prevention practices. Factors significantly associated with the number of injury prevention practices implemented were family income, housing quality, and environmental barriers. Instead of attempting solely to persuade parents about the value of injury prevention practices, skill-based interventions are needed to help parents overcome specific barriers that result from living in substandard housing and having very limited financial resources.
An Evaluation of Mammography Beliefs Using a Decision Model
Authors: Salazar Mary K. , de Moor Carl
Published: February 2007

The purpose of this study was to identify factors that contribute to a group of working women's decision related to mammography. The study was guided by a decision model called the Multiattribute Utility Model. Exploratory interviews were conducted among 36 women to identify positive and negative factors associated with the mammography decision. Eighteen factors emerged and were categorized into three broad areas: Knowledge and Attitudes (Confidence in Efficacy, Personal Risk, Other Means of Knowing, Fear of Cancer/ Treatment, Belief in Fate, Embarrassment), Issues Related to Participation (Accessibility and Convenience, Difficulty Arranging, Time, Cost, Pain, Radiation), and Social Concerns (Role Model, Responsibility to Self, Responsibility to Others, Family/Friends' Influence, Societal Influences, Health Care Providers' Influence). This information served as the basis of a survey among 87 women to determine the importance of these factors. Seven factors emerged as significantly different between compliers and noncompliers. In order of significance, they were Difficulty Arranging, Fear of Cancer/Treatment, Cost, Accessibility and Convenience, Time, Other Means of Knowing, and Influence of Health Care Provider. The predictive validity of this analysis was 85%. Implications of findings are discussed.
The Relative Effects of Perceived Personal Control and Responsibility on Health and Health-Related Behaviors in Young and Middle-Aged Adults
Authors: Ziff Mauri A. , Conrad Peter , Lachman Margie E.
Published: February 2007

We examined whether perceptions of personal control over health and perceptions of personal responsibility for well-being were related, whether they had independent or interactive effects on health and health-related behaviors, and whether the effects of the perceptions varied by income. Young and middle-aged employees of a technology company (N = 186; aged 20-63) completed a questionnaire about perceived control and responsibility, health, health-related behaviors, and demographic information. Correlation analysis indicated that the perceived control and perceived responsibility variables were unrelated. Regression analysis indicated that a main effect of perceived control—but not responsibility—contributed significantly to the explanation of variance in health and several health-related behaviors (medical checkup, breast self-examination, exercise, and health promotion program membership). Perceived control and responsibility did not interact in their influences over health and behavior; however, the hypothesis that the variables would interact with income was partially confirmed. Overall, the results suggest that the sense of control rather than sense of responsibility should be targeted for health promotion efforts.
Community Mobilization to Reduce Point-of-Purchase Advertising of Tobacco Products
Authors: Rogers Todd , Feighery Ellen C. , Tencati Elaine M. , Butler Judith L. , Weiner Linda
Published: February 2007

This project was designed to address the problem of point-of-purchase tobacco advertising through media advocacy and community mobilization. Precampaign assessment revealed a considerable amount and density of tobacco advertising and promotions in more than 100 stores sampled in San Jose, California. After sharing the results with community activists and other residents, a community mobilization campaign was instigated to capitalize on an existing sign control ordinance that limits store window coverage and sidewalk signs. Through presentations and media advocacy efforts, community residents were mobilized to file complaints with the city's code enforcement office when neighborhood stores were shown to be noncompliant with ordinance provisions. Relative to the baseline, significant reductions in campaign-related tobacco advertising variables were seen in the San Jose stores after the sign law campaign. No changes were seen in four smaller reference communities. Differences were noted between stores close to and farther away from schools. These results demonstrate that mobilization of community residents to activate enforcement of laws originally designed for other purposes can have a significant impact on one aspect of tobacco point-of-purchase advertising.
Mobilizing a Low-Income African American Community Around Tobacco Control: A Force Field Analysis
Authors: Ellis Galen A. , Reed Diane F. , Scheider Holly
Published: February 2007

A statewide tobacco control campaign in California has been highly successful in reducing public exposure to the health hazards of secondhand smoke. Over 250 cities and counties in California have enacted local ordinances to regulate smoking in public places and workplaces. Although low-income people of color are disproportionately affected by the use of tobacco, the issue of regulating secondhand smoke tends to be a lower priority in communities that are confronted by other, more immediately pressing social justice issues, such as high rates of violence and lack of economic opportunity. This article describes the process undertaken by a county health department to mobilize a low-income African American community in a San Francisco Bay Area city to support a local ordinance mandating 100% smoke-free workplaces and restaurants. These efforts are more likely to succeed if health advocates (1) reframe issues in a context that acknowledges the political, economic, and social justice realities and strengths of the community; (2) organize within existing local networks and foster the integration of tobacco issues into the group's existing work; and (3) can defer their own agendas during times of community grieving and healing.
Environmental and Policy Interventions to Control Tobacco Use and Prevent Cardiovascular Disease
Authors: Brownson Ross C. , Matson Koffman Dyann , Novotny Thomas E. , Hughes Robert G. , Eriksen Michael P.
Published: February 2007

Despite its declining prevalence during the past few decades, tobacco use remains one of the most significant public health issues of the 1990s. Environmental and policy interventions are among the most cost-effective approaches to control tobacco use and prevent cardiovascular diseases. In this article, the authors review and offer to state and local health departments and other public health partners a summary of recommended policy and environmental interventions that have either reduced or show potential to reduce tobacco use. Priority recommendations include clean indoor air policies, restrictions on tobacco advertising and promotion, policies limiting youth access to tobacco, comprehensive school health programs, and excise taxes and other economic incentives. Many of these recommendations should be integrated with other health promotion interventions to also improve nutrition and physical activity. The authors also highlight several successful interventions and strategies used to establish policies at the state and local levels.
Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Physical Activity: Issues and Opportunities
Authors: King Abby C. , Jeffery Robert W. , Fridinger Fred , Dusenbury Linda , Provence Susan , Hedlund Sonja A. , Spangler Kathy
Published: February 2007

The majority of Americans remain inactive despite evidence of significant health benefits from even moderately intense activity. Previous intervention efforts have generally focused on changing individual behavior. This article discusses the use of policy, legislative and regulatory, and environmental interventions in promoting physical activity to prevent cardiovascular disease (CVD) and other chronic diseases. The authors present evidence on the need, formulation, description, and effectiveness of policy and environmental intervention approaches. Types of approaches addressed to promote physical activity include federal, state, and local legislation and regulation, policy development and implementation, and environmental support. They also describe opportunities for state and local health departments to initiate and participate in environmental and policy approaches.
Environmental and Policy Approaches to Cardiovascular Disease Prevention Through Nutrition: Opportunities for State and Local Action
Authors: Glanz Karen , Lankenau Becky , Foerster Susan , Temple Sally , Mullis Rebecca , Schmid Thomas
Published: February 2007

This article reviews environmental and policy intervention approaches to cardiovascular disease prevention through nutrition and recommends opportunities for state and local health departments to initiate and participate in environmental and nutrition policy initiatives. By addressing these complementary aims, the authors hope to stimulate further efforts to achieve progress in nutrition promotion among state and local health-related organizations. Key categories of opportunity to develop new or expanded nutrition policies and environmental strategies include economic incentives, food assistance and feeding programs, regulations for institutional food service operations, and nutrition services in health care. Environmental strategies to reduce barriers to following dietary guidelines, such as point-of-choice programs and school nutrition programs, should be tailored for local communities and widely disseminated. In addition, current federal policy efforts, notably nutrition labeling rules, will provide a valuable focal point for state and local advocacy, education, and monitoring.
The Prediction of Accurate Contraceptive Use From Attitudes and Knowledge
Authors: Jaccard James , Helbig Donald W. , Wan Choi K. , Gutman Marjorie A. , Kritz-Silverstein Donna C.
Published: February 2007

A framework of the relationship between knowledge, attitudes, and behavior was described in the context of couple's use of birth control. It was hypothesized that when knowledge of behavioral enactment is present, attitudes and beliefs about susceptibility to pregnancy will be predictive of accurate use of the diaphragm. Respondents were 111 women who participated in a three-wave panel design focusing on diaphragm use. Analyses indicated that the level of knowledge about what a woman should do to use the diaphragm correctly was high. Correct knowledge, however, did not translate into accurate behavior. Motivational factors focusing on attitudes, perceived susceptibility to pregnancy, and normative factors were also relevant.
A Meta-Analysis of Smoking Prevention Programs After Adjustment for Errors in the Unit of Analysis
Authors: Rooney Brenda L. , Murray David M.
Published: February 2007

This article presents the results of a meta-analysis designed to test the prevailing view that we largely understand why adolescents start to smoke and how to delay it. This view has developed even though none of the major reviews of the last 12 years has adjusted for the important methodological problems that all of those reviews identified as common in the published literature. School-based smoking prevention programs based on peer or social-type programs, published between 1974 and 1991, were included in this meta-analysis. Treatment characteristics were used to predict an effect size after adjustment for study design and population characteristics, and in particular, after a post hoc correction for errors in the original unit of analysis. The results suggest that the average effect for peer or social-type programs is likely to be quite limited in magnitude, and that the reduction in smoking may be only 0.10 standard deviation units, or perhaps 5%. Even under optimal conditions, the reduction in smoking may be only 0.50 to 0.75 standard deviation units, or perhaps 20%-30%.
Interest in a Stepped Approach Model (SAM): Identification of Recruitment Strategies for University Alcohol Programs
Authors: Black David R. , Coster Daniel C.
Published: February 2007

This study evaluates interest in a stepped approach model (SAM) of service delivery and identifies variables to enhance recruitment to alcohol programs. Subjects were 2,443 college student drinkers (1,420 men and 1,023 women) at a large midwestern university (selected by stratified systematic sampling) who completed a questionnaire on drinking behavior and interest in five intervention steps. Results indicated that there was more interest in interventions that required less time, which supports predictions of SAM. Overall lack of interest peaked at 67% for men and 65% for women and did not change significantly across the last three steps of SAM, which included traditional interventions of group and individual counseling. The data suggest that the stepped approach is more viable than conventional approaches, recruitment is unquestionably an exigent research priority because of the overwhelming lack of interest in alcohol programs, and specific variables that were identified may be important for recruiting particular subgroups.
The Ecology of Work and Health: Research and Policy Directions for the Promotion of Employee Health
Authors: Stokols Daniel , Pelletier Kenneth R. , Fielding Jonathan E.
Published: February 2007

This article identifies new research and policy directions for the field of worksite health in the context of the changing American workplace. These directions are viewed from an ecological perspective on worksite health and are organized around three major themes: (1) the joint influence of physical and social environmental factors on occupational health, (2) the effects of nonoccupational settings (e.g., households, the health care system) on employee well-being and the implications of recent changes in these settings for worksite health programs, and (3) methodological issues in the design and evaluation of worksite health programs. Developments in these areas suggest that the field of worksite health may be undergoing a fundamental paradigm shift away from individually oriented wellness programs (provided at the worksite and aimed primarily at changing employees' health behavior) and toward broader formulations emphasizing the joint impact of the physical and social environment at work, job-person fit, and work policies on employee well-being.
A Work-Systems Analysis of Compliance With Universal Precautions Among Health Care Workers
Authors: DeJoy David M. , Gershon Robyn R. M. , Murphy Lawrence R. , Wilson Mark G.
Published: February 2007

Universal precautions are work practices designed to protect health care workers from occupational exposure to HIV and other bloodborne pathogens. However, despite aggressive dissemination efforts by CDC and regulatory action by OSHA, compliance remains less than satisfactory. This article argues that the minimization of risk from bloodborne pathogens requires a multilevel or work-systems perspective that considers individual, job/task, and environmental/organizational factors. The available literature on universal precautions suggests the potential of such an approach and provides insight into the limited success of current worker-focused mitigation efforts. In particular, specific opportunities exist to develop and apply engineering controls, to improve the design and organization of jobs and tasks, and to create organizations that facilitate and reinforce safe behavior.
The Integrated Model: Implications for Worksite Health Promotion and Occupational Health and Safety Practice
Authors: Baker Elizabeth , Israel Barbara A. , Schurman Susan
Published: February 2007

Within a single firm it is common to find both occupational safety and health and worksite health promotion interventions operating in isolation from one another, with different intervention targets, methods, and personnel. Overcoming the segmentation of the two fields will require, among other things, the promulgation of an overarching model of work and health. The purpose of this article is to describe an integrated model and to show how it can be applied to improve worksite health interventions for both occupational safety and health and worksite health promotion. Practice examples from both fields are used to illustrate interventions that focus on different areas of the model (individual behavior, psychosocial, organization, and contextual factors). It is argued that occupational safety and health and worksite health promotion practitioners need to develop more comprehensive interventions and rigorously evaluate these programs to determine if they are more effective than programs with a more narrow focus.
Worker Participation in an Integrated Health Promotion/Health Protection Program: Results From the WellWorks Project
Authors: Sorensen Glorian , Stoddard Anne , Ockene Judith K. , Hunt Mary Kay , Youngstrom Richard
Published: February 2007

According to prior reports, blue-collar workers are less likely to participate in worksite health promotion programs than are white-collar workers. This study examined worker participation in the WellWorks worksite cancer prevention intervention, which integrated health promotion and health protection. Analyses were conducted to assess relationships among participation in health promotion and health protection programs, and workers' perceptions of management changes to reduce potential occupational exposures. Results indicate that blue-collar workers were less likely to report participating in health promotion activities than white-collar workers. A significant association was observed between participation in nutrition- and exposure-related activities, suggesting that participation in programs to reduce exposures to occupational hazards might contribute to blue-collar workers' participation in health promotion activities. Furthermore, when workers were aware of changes their employer had made to reduce exposures to occupational hazards, they were more likely to participate in both smoking control and nutrition activities, even when controlling for job category. These findings have clear implications for future worksite cancer prevention efforts.
Effect of Organization-Level Variables on Differential Employee Participation in 10 Federal Worksite Health Promotion Programs
Authors: Crump Carolyn E. , Earp Jo Anne L. , Kozma Chris M. , Hertz-Picciotto Irva
Published: February 2007

Guided by a conceptual model, the authors used both qualitative data (e.g., individual interviews, focus groups) and quantitative data from an employee survey (N = 3,388) m 10 federal agencies to investigate whether organization context and implementation process affected participation in worksite health promotion and disease prevention (HPDP) activities among demographic subgroups. Overall, employees on average participated in fewer than two agency-supported health-related activities per year (17% in fitness, 40% inhealth risk assessment activities). Employees participated more where coworkers endorsed such programs. Minority employees and employees in lower level positions were more likely to participate in fitness activities when organizations had a more comprehensive program structure, engaged in more marketing strategies, gave time off to employees to participate, or had on-site facilities. Management support for the program was related to participation by employees who were male, white, and had upper level positions. The data supported the proposed model; also confirmed was two predicted relationships between model constructs, which provided a better understanding of differential participation by employee groups.
Empowerment Education: A Case Study of the Resource Sisters/Compañeras Program
Authors: Lugo Nancy Rudner
Published: February 2007

Empowerment education is a social action process that promotes participation of communities in gaining control over their lives and their community. The Resource Sisters/Compañeras Program represents a case study in implementing an empowerment education effort. The program developed skills of women from the community to facilitate peer support groups that brought other women together. The program attempted to foster community development while also providing individual case management services. The program, its challenges, and its successes are described. The difficulties of possibly conflicting goals and objectives are discussed.
MADD Massachusetts Versus Senator Burke: A Media Advocacy Case Study
Authors: DeJong William
Published: February 2007

In 1991, the Massachusetts legislature considered a bill that would have allowed a drunk driving defendant's refusal to take a breathalyzer test to be admitted as evidence in a criminal trial. After the measure passed in both houses, a state senator used a parliamentary maneuver to prevent it from being prepared for the governor's signature. Mothers Against Drunk Driving (MADD) employed media advocacy techniques to alert the public, but the senator was unyielding and the legislative calendar ran out with the bill unsigned. Because of MADD's efforts, however, the senate president put the bill on a "fast track" the following year. The news media's focused attention on MADD's protests exposed deep schisms among its volunteer leadership regarding the nature and purpose of the organization and the appropriateness of using confrontational media strategies to advance its agenda. Paralyzed by the lack of consensus, MADD Massachusetts was rendered a far less effective advocate for policy change.
Alcohol Advertising and Violence Against Women: A Media Advocacy Case Study
Authors: Woodruff Katie
Published: February 2007

This article describes one effort to help prevent violence against women by addressing some of the larger societal factors involved. The Dangerous Promises campaign is based on the premise that sexist advertising images contribute to an environment conducive to violence against women. The goal of the campaign is to convince alcohol companies to eliminate sexist alcohol advertising and promotions. Using the tools of community organizing and media advocacy, the campaign pressures the alcohol industry to change the ways in which they portray women in much of their advertising. Media advocacy has been instrumental in the successes of the campaign. This article examines the strategies and outcomes of the Dangerous Promises efforts to date and makes a case for application of media advocacy as a tool for increasing community voice in policymaking processes.
Effects of the Stanford Five-City Project Media Advocacy Program
Authors: Schooler Caroline , Shyam Sundar S. , Flora June
Published: February 2007

The authors investigated the effects of a media advocacy program to build support for cardiovascular disease (CVD)-related policy changes and to encourage adoption of heart-healthy behaviors in the Stanford Five-City Project, a long-term trial of community-wide CVD risk reduction. The authors content analyzed 4,824 health articles in two treatment city newspapers and two reference city newspapers between 1977 and 1990. One treatment city newspaper responded well to the program; the other did not. In the Salinas Californian, the number of CVD-related articles increased during the campaign; these articles became more prominent and conspicuous, the focus on prevention increased, and more of these articles were written by local staff. Maintenance of these effects after the campaign was mixed. Results suggest that frequent, regular, systematic contact with media professionals and provision of materials influence newspaper coverage of health-related topics, which has important implications for shaping public opinion and policy change.
Use of Ethnographic Methods for Applied Research on Diabetes Among the Ojibway-Cree in Northern Ontario
Authors: Gittelsohn Joel , Harris Stewart B. , Burris Krista L. , Kakegamic Louisa , Landman Laura T. , Sharma Anjali , Wolever Thomas M. S. , Logan Alexander , Barnie Annette , Zinman Bernard
Published: February 2007

This article presents the results of applied ethnographic research aimed at developing a community-based diabetes prevention program in an isolated Ojibway-Cree community in northern Ontario. Using qualitative techniques, the authors describe diabetes in its sociocultural context and underlying belief systems that affect related activity and dietary behaviors. Local concepts of food and illness are dichotomized into "Indian" and "white man's" groupings, with Indian foods perceived as healthy and white man's foods felt to be unhealthy. Diabetes is believed to result from consumption of white man's "junk foods" (sugar, soda); some believe the disease can be avoided by eating traditional Indian foods such as game animals (moose, beaver, duck). While dietary linkages to diabetes are recognized, physical activity as a means of controlling obesity and decreasing the risk for diabetes is not part of the local ethnomedical model. This information is being used to develop culturally appropriate health education interventions.
Challenges and Rewards of Involving Community in Research: An Overview of the "Focus on Kids" HIV Risk Reduction Program
Authors: Galbraith Jennifer , Ricardo Izabel , Stanton Bonita , Black Maureen , Feigelman Susan , Kaljee Linda
Published: February 2007

Acquired immunodeficiency syndrome (AIDS) continues to be a significant concern for adolescents, especially in minority populations. There is a scarcity of knowledge of the cultural context of sexual behavior in this age group and the influences that lead to early initiation of sex and unsafe sex. Few efforts targeting young adolescents have been community based, although there has been an increased awareness of the need for such research and intervention programs. Four key processes have been defined in gaining community participation in health education programs: (a) defining the community and reaching the community; (b) recognizing tensions among service, research, and community participation; (c) involving community residents; and (d) considering cultural differences in a community. These processes are used to describe the "Focus on Kids" project, a human immunodeficiency virus (HIV) risk reduction intervention that resulted in significant increases in condom use demonstrated by a randomized controlled trial.
Delivering the Goods, Showing Our Stuff: The Case for a Constructivist Paradigm for Health Promotion Research and Practice
Authors: Labonte Ron , Robertson Ann
Published: February 2007

This article argues that there has been a tendency to empower the "conventional" positivist paradigm in health promotion research, often at the expense of confounding or ignoring much of health promotion practice. This article argues further that a "constructivist" research paradigm not only has the potential to resolve some of the tensions between research and practice in health promotion but also is inclusive of knowledge generated by the conventional paradigm. The usefulness of a constructivist paradigm is demonstrated through the use of four practice-based case examples drawn from actual community-based health promotion efforts. The congruence of a constructivist paradigm with the health promotion principles of empowerment and community participation are discussed. Finally, this article argues for the acceptance of the legitimacy of knowledge generated from the constructivist paradigm and concludes that this paradigm is more suited to the goals of current health promotion.
Planned Development and Evaluation of AIDS/STD Education for Secondary School Students in the Netherlands: Short-Term Effects
Authors: Schaalma Herman P. , Kok Gerjo , Bosker Roel J. , Parcel Guy S. , Peters Louk , Poelman Jos , Reinders Jo
Published: February 2007

This study evaluated the effects of an AIDS/STD curriculum for 9th- and 10th-grade students in the Netherlands. Curriculum development was based on (1) theory-based need assessments among students and teachers, (2) pilot testing of data-based and theory-based methods and materials, and (3) cooperation between researchers and students, teachers, and gatekeepers within the school system. Using a quasi-experimental design, program effects on students' attitudes, beliefs, and sexual behavior were compared with those of current AIDS/STD education practice. The results indicated that the experimental curriculum had a stronger favorable impact on students' attitudes and beliefs regarding using condoms consistently. Regarding sexual risk behavior, a differential curriculum effect could be demonstrated. These findings support the contention that current AIDS/STD education can be improved by (1) using empirical data, (2) applying multiple theories from the social sciences, and (3) involving representatives within the school system in the development process.
Prevention Campaigns for Hard-to-Reach Populations at Risk for HIV Infection: Theory and Implementation
Authors: Pulley LeaVonne , McAlister Alfred L. , Kay Linda S. , O'Reilly Kevin
Published: February 2007

Using applied behavioral science techniques that have been successful in other areas of health promotion, community-level campaigns were implemented in 5 cities to prevent HIV infection among hard-to-reach, at-risk populations: men who have sex with men but do not self-identify as gay; women who engage in sex for money or drugs; injecting drug users (IDUs); female sex partners of IDUs; and youth in high-risk situations. Communication materials presented positive role models for risk-reducing behaviors, and peer networks prompted and reinforced the behavior change process. This article describes the first year of intervention experience and documents the practical application of theoretical concepts of persuasion and learning. The use of theory and data to develop 188 educational messages is illustrated and training methods and experiences are reported for 150 peer leaders, 104 other community networkers, and 22 outreach workers. These activities are feasible and appear to offer an effective, general approach for diverse, special populations.
Correlates of Alcohol Use and Misuse in Fourth-Grade Children: Psychosocial, Peer, Parental, and Family Factors
Authors: Loveland-Cherry Carol J. , Leech Sharon , Laetz Virginia B. , Dielman Ted E.
Published: February 2007

To determine level of alcohol use/misuse and to examine correlates of these behaviors, 1,314 fourth-grade students were surveyed. The questionnaire included 55 items concerning tolerance of deviance, deviant self-image, self-efficacy, susceptibility to peer pressure, personal and peer approval of alcohol use, peer adjustment, parent nurturance and monitoring, family adjustment, parental permissiveness, peer use of alcohol, and exposure to alcohol. The items were factor analyzed and indices constructed. The indices generally had acceptable alpha coefficients (α = .61-.91); two exceptions were peer adjustment (α = .51) and parental permissiveness (α = .42). Tolerance of deviance, deviant self-image, susceptibility to peer pressure, personal and peer approval, peer use and exposure by peers, and parental permissiveness were positively correlated with alcohol use/misuse. Self-efficacy, child-parent interactions, family adjustment, and peer adjustment were negatively correlated with alcohol use/misuse. Implications for the design of family-based alcohol use/misuse prevention programs are discussed.
Usefulness of Multiple Equations for Predicting Preventive Oral Health Behaviors
Authors: Ronis David L. , Antonakos Cathy L. , Lang W. Paul
Published: February 2007

Canonical correlation analyses of a previous dental survey suggested that dental checkups, flossing, and tooth brushing could all be predicted from a single equation. Most theories and research about the influence of beliefs on behavior, however, suggest different behaviors will be best predicted by different behavior-specific measures. The current survey investigated influences on brushing, flossing, and dental checkups in a probability sample of adults in the Detroit tri-county area. Both behavior-specific variables, such as perceived benefits and costs of flossing, and general variables, such as gender, were included as predictors. Canonical correlation analysis indicated three equations were needed to predict the three oral health behaviors. Flossing frequency, for example, was best predicted by confidence in flossing ability and beliefs about the benefits of and barriers to flossing. The results suggest that even these closely related behaviors are best predicted using separate equations that include mostly behavior-specific predictors.
Using Behavioral Theory in Computer-Based Health Promotion and Appraisal
Authors: Rhodes Fen , Fishbein Martin , Reis Janet
Published: February 2007

This article explores how behavioral theory can facilitate the development, implementation, and evaluation of health promotion software packages intended to influence personal health practices and/or assess health risks. Current behavioral theories and models are reviewed, and their relevance to developing health promotion software is discussed. A series of six steps is suggested for developing and evaluating health promotion and appraisal software within a behavioral theory framework. These steps should help to facilitate direct application of the theory-based process to health promotion software development.
Interactive Multimedia Software Design: Concepts, Process, and Evaluation
Authors: Hardin Paul C. , Reis Janet
Published: February 2007

This article provides the health educator with a review of the design and construction of computer-based health education materials. Specifically, this review considers questions of instructional objectives as defined in the field of instructional design, a body of expertise not often deployed in the area of health education. It discusses in some detail the computer materials development process, associated documentation, and the range of personnel required. This article also briefly updates discussion of the costing process, and current costs for multimedia hardware and authoring software. The review touches on, but does not synthesize, emerging possibilities with the Internet.