bluuebunny/crossref_metadata_2025 huggingface dataset:
Using an Interactive Computer Game to Increase Skill and Self-Efficacy Regarding Safer Sex Negotiation: Field Test Results
Authors: Thomas Rosalind , Cahill John , Santilli Loretta
Published: February 2007

This article describes the development, field testing, and evaluation of an interactive computer program, "Life Challenge," developed by the New York State Department of Health as a tool for enhancing adolescents' sense of self-efficacy in HIV/AIDS prevention programs. The computer kiosks were field tested in 13 sites serving high-risk adolescents. The program uses a time travel adventure game format to provide information and nonthreatening skill practice. Users record and play back their responses as they "negotiate" with their chosen partners. A proof of concept evaluation with analysis of 211 audio responses found that users took negotiating tasks seriously; statistically significant learning gains were achieved on knowledge items and in self-efficacy scores (greatest improvement for those with low baseline self-efficacy levels). Challenges and problems encountered in implementing the project are described, and the potential of using computers for skill practice and educational interventions in health education is explored.
Developing Sexual Health Software Incorporating User Feedback: A British Experience
Authors: Turner Ann , Singleton Nicola , Easterbrook Sarah
Published: February 2007

This article describes an interactive prototyping model for development of four computer software modules for British youth on sexual issues. An iterative cycle of development, user review and feedback, and subsequent modification and retesting was used with approximately 150 young adults, with particular attention to presentation style, screen design, usability, relevance of material, enjoyment, and learning. The software was designed to be realistically accommodated in school settings, to be used as a reference tool by students working alone or in a group teaching situation. Feedback from youth and adults attests to the feasibility of development, implementation, and instructional usefulness. Interactive prototyping proved essential in the face of skepticism from teachers concerning young people's information needs and acceptance of a computerized educational approach.
Effects of an Obesity Prevention Program on the Eating Behavior of African American Mothers and Daughters
Authors: Stolley Melinda R. , Fitzgibbon Marian L.
Published: February 2007

Cardiovascular disease (CVD) is the number one cause of death in the United States. Obesity is highly related to CVD risk, especially in African American women. This study explored the efficacy of a culturally specific obesity prevention program. Designed for low-income, inner-city African American girls and their mothers, the program addressed the importance of eating a low-fat, low-cholesterol diet and increasing activity. Mother-daughter dyads were randomly assigned to a 12-week treatment or an attention placebo group. Participants were assessed at pre- and posttreatment on dietary intake, including daily fat intake, daily saturated fat intake, percentage of daily calories from fat, and daily cholesterol intake. Results showed significant differences between the treatment and control mothers for daily saturated fat intake and percentage of calories from fat. Differences among treatment and control groups were also noted for the daughters on percentage of daily calories from fat. Implications of the findings for developing culturally specific health risk reduction programs are discussed.
How D.A.R.E. Works: An Examination of Program Effects on Mediating Variables
Authors: Hansen William B. , McNeal Ralph B.
Published: February 2007

The D.A.R.E. (Drug Abuse Resistance Education) program has relied on a curriculum that addresses a variety of psychosocial processes thought to be related to substance use and potentially modifiable through programmatic intervention. This study examines 12 postulated mediators of substance use prevention programs to determine the degree to which D.A.R.E. has an effect on mediators and the degree to which those effects account for behavioral outcomes of the program. Results indicate that the primary effect of D.A.R.E. is a change in commitment to not use substances. This change significantly mediates behavioral effects. However, the magnitude of D.A.R.E.'s effect on the mediator is relatively small. Other mediators that offer strong potential paths for intervention effectiveness are not affected by the program. These results suggest that in order to achieve prevention effectiveness, the curriculum used in the D.A.R.E. program needs to be replaced with one that targets and meaningfully changes appropriate mediating variables.
The Role of Germs and Viruses in Children's Theories of AIDS (or, AIDS are Not Band-Aids)
Authors: Sigelman Carol K. , Alfeld-Liro Corinne , Lewin Cynthia B. , Derenowski Eileen B. , Woods Teresa
Published: February 2007

The development of knowledge of germs and viruses in relation to AIDS and flu was examined in a predominantly Mexican American sample of children aged 8-9, 10-11, and 12-13. Children progressed with age from identifying the disease agent for these diseases as a nondescript germ or something other than a germ to implicating a disease-specific germ or virus. Parallel age trends in mastery of the two diseases were observed; gender and ethnic differences were minimal. Solid command of germ and virus concepts in relation to AIDS was associated with more causally sophisticated understanding of the disease but not with more accurate knowledge of modes of HIV transmission. Grasp of flu germ/virus concepts did not contribute to greater understanding or knowledge of AIDS. Overall, children seem predisposed to construct a germ theory of an unfamiliar disease such as AIDS but need help in differentiating between one germ and another.
A National Assessment of Secondary School Principals' Perceptions of Violence in Schools
Authors: Price James H. , Everett Sherry A.
Published: February 2007

The purpose of this investigation was to examine the perceptions of secondary school principals regarding violence and weapons in public and private schools in the United States. Student weapon carrying was most often reported in larger schools, schools with higher levels of violence in the school's neighborhood, and in schools with a higher percentage of low-socioeconomic (SES) students. Perceived as major etiological factors of violence were lack of parental supervision at home, lack of family involvement with school, and exposure to violence in the mass media. Perceived as the major reasons students in the principals' own school committed acts of violence were the student was provoked by others or was jealous of a girlfriend/boyfriend. Just over one-third of schools had already implemented some type of violence prevention program, and another reported they were planning to implement some type of violence prevention program. The most common barriers reported by the remaining principals were believing there was no need for a program in their school, being unsure which programs were needed, and being unsure of which programs were best.
Changes in Reported Awareness of Product Warning Labels and Messages in Cohorts of California Hispanics and Non-Hispanic Whites
Authors: Marin Gerardo , Gamba Raymond J.
Published: February 2007

A cohort of 777 Hispanics and 234 non-Hispanic Whites were interviewed in San Francisco, California, over the telephone in 1991 and again 1 year later. Overall, both Hispanics and non-Hispanic Whites showed an increase in awareness of a general product warning label for beer and wine containers but a decrease in awareness of a product warning label for cigarettes. High- and low-acculturated Hispanics' awareness of a general product warning label increased for alcoholic beverage containers, although highly acculturated Hispanics were more aware. Both Hispanics and non-Hispanic Whites showed an increase in awareness of specific warning messages. The highly acculturated Hispanics showed more increased awareness of specific messages than the less acculturated Hispanics.
A Scale for Assessing Health Care Providers' Teaching and Communication Behavior Regarding Asthma
Authors: Clark Noreen M. , Gong Molly , Schork M. Anthony , Maiman Lois A. , Evans David , Hurwitz Martin E. , Roloff Dietrich , Mellins Robert B.
Published: February 2007

Partnership between health care providers and patients is important for controlling illness. A limited number of studies show how to assess health professionals' communication and partnering behavior. The relationship between these aspects of professional behavior and enhanced management of disease by patients has received little empirical study. The research reported here developed a Health Care Providers' Teaching and Communication Behavior (TCB) scale for assessing the teaching and communication behavior of clinicians treating patients with asthma. Such a tool is needed for research related to provider-patient relationships and for evaluation of professionals' performance.
Using Sponsorship to Promote Health Messages to Children
Authors: Corti Billie , Donovan Robert J. , J. Holman C. D'Arcy , Coten Ned , Jones Stephen J.
Published: February 2007

A survey of children aged 8 to 14 years attending a three-day football clinic was undertaken to examine the relative impact of different sponsorship strategies used to promote health messages. It was found that promotional clothing worn by role models was an effective method for promoting a specific health message (i.e., "Smoking? No Way!"). Personal endorsement of the health message by an external role model and, to a lesser extent, personal endorsement by clinic leaders and promotional clothing worn by clinic leaders and external role models were also effective in promoting a general health message (i.e., "Don't smoke"). The implications for health sponsorship and the promotion of commercial products to children are discussed.
Adolescents' Perceptions of Health Concerns: An Exploratory Study among Rural Midwestern Youth
Authors: Weiler Robert M.
Published: February 2007

This exploratory investigation examined health concerns of adolescents and their perceptions of their peers' health concerns. Data were collected from a convenient sample of 419 high school students in rural southern Illinois in May 1990, using the Adolescent Health Concerns Inventory (AHCI). The AHCI contains 150 health-related items, grouped into 12 topical subscales. Analysis of the 150 items found statistically significant differences for all but 2 items: use of alcohol and acne. Analysis of the 12 subscales found that students believed other teenagers were concerned more about issues related to substance use and abuse, human sexuality, and personal health than about the issues they reported as concerns for themselves or their best friends. These findings indicate what health issues students are personally concerned about. They also suggest that students believe their personal health concerns differ from the health concerns of their best friends and other teenagers.
Evaluation of an Educational Program to Prevent Adolescent Pregnancy
Authors: Mitchell-DiCenso Alba , Thomas B. Helen , Devlin M. Corinne , Goldsmith Charlie H. , Willan Andy , Singer Joel , Marks Susan , Watters Derek , Hewson Sheila
Published: February 2007

The authors evaluated the effectiveness of a school-based sex education program in decreasing rates of sexual intercourse, improving birth control use, and decreasing the incidence of pregnancies among teenagers 16 years of age and younger. Twenty-one schools received either the McMaster Teen Program or the conventional didactic sex education program. Preprogram, the mean age of the students was 12.6 years. There were no statistically significant differences between groups in time to first sexual activity for males, χ2(1) = 2.93, p = 0.09; time to first sexual activity for females, χ2(1) = 0.50, p = 0.48; and time to first pregnancy, χ2(1) = 1.90, p = 0.17. Significantly more experimental group males reported always using birth control at year 1 (difference 8.9%; 95% confidence interval [CI] = 0.4,17.4). Limitations of the program that may have influenced the results were the exclusion of contraception information and its short duration.
The Impact of the Wellness Guide/Guía on Hispanic Women's Well-Being-Related Knowledge, Efficacy Beliefs, and Behaviors: The Mediating Role of Acculturation
Authors: Bell Robert A. , Alcalay Rina
Published: February 2007

This study examined how acculturation mediated the impact of the California Wellness Guide/La Guía del Bienestar on Hispanic women's knowledge, efficacy beliefs, and behaviors. Knowledge gaps were found between acculturated and less acculturated women. Acculturated mothers had more confidence in their abilities to acquire wellness-related information both before and after Guide/Guía distribution and also had more assistance-seeking efficacy. Guide/Guía recipients were more knowledgeable, had greater confidence in their knowledge and their abilities to acquire information, and possessed better information acquisition strategies than nonrecipients. The publication also enhanced low-acculturated recipients' assistance-seeking self-efficacy. High-acculturated and low-acculturated recipients of the Guide/Guía were equally likely to have retained and used their copies, to anticipate using the publication in the future, and to have made a change in behavior as a result of the guide. Finally, the Guide/Guía did not increase the knowledge gap between high- and low-acculturated guide recipients.
Reducing Inequities through Participatory Research and Community Empowerment
Authors: Travers Kim D.
Published: February 2007

Information dissemination for behavior change has been the mainstay of traditional health education practice, despite lack of demonstrated effectiveness in improving the public's health. Following a critique of traditional health education practice, an alternative orientation is proposed. Health education for social change, based on Paulo Freire's empowerment education and principles of participatory research, is examined theoretically within the context of the need to address inequities in health. The theoretical justification forms the basis for a description of a case study in reducing nutritional inequities. The case study analyzes how a process of participatory research and community organization was an empowering educational experience for a group of low-income urban women. The process of learning and social action is highlighted by chronicling changes associated with the experience. The realities and limitations of the project are also reflected upon. Implications for health education practice and future social change are highlighted.
Self-Efficacy as a Predictor of Dietary Change in a Low-Socioeconomic-Status Southern Adult Population
Authors: Shannon Jackilen , Kirkley Betty , Ammerman Alice , Keyserling Thomas , Kelsey Kristine , DeVellis Robert , Simpson Ross J.
Published: February 2007

There is an increasing emphasis on designing health promotion interventions for low-socioeconomic-status (SES) individuals. However, many previously developed behavior change tools have not been tested in this population. Self-efficacy was measured at pre- and postintervention as part of a randomized clinical trial to reduce cholesterol levels in rural low-SES Southern adults. A 22-item scale was designed and validated to measure subjects' confidence in their abilities to make dietary changes. High mean self-efficacy was noted in both control and intervention subjects at pre- and postintervention. Mean self-efficacy score was a significant predictor of dietary change at both preintervention and postintervention. This study demonstrates that self-efficacy is a predictor of ability to make dietary changes in a low-SES rural population. This finding is of significance to researchers and practitioners wishing to design theory-based health promotion interventions in this population.
Recruitment and Training Issues from Selected Lay Health Advisor Programs among African Americans: A 20-Year Perspective
Authors: Jackson Ethel J. , Parks Carolyn P.
Published: February 2007

The use of lay health advisors (LHAs) to address the health disparity among African Americans is well documented and considered a culturally appropriate model of community health promotion. The recruitment and training of LHAs are important components of the model but have not been fully explored in the LHA literature. Recruitment and training of LHAs should reflect both the existing roles they have in their respective communities and those proposed by the programs to which they are recruited. This article reviews and describes the components of recruitment and training as implemented in selected LHA programs among African Americans. The article will address the role and purpose of LHAs in health promotion among African Americans, a historical perspective of recruitment and training, recruitment and training methods in selected LHAs programs for African Americans, and recommendations for the recruitment and training of LHAs for health promotion among African Americans.
Changes in Empowerment: Effects of Participation in a Lay Health Promotion Program
Authors: Booker Victoria K. , Robinson June Grube , Kay Bonnie J. , Najera Lourdes Gutierrez , Stewart Genevieve
Published: February 2007

The Camp Health Aide Program is a lay health promotion program for migrant and seasonal farmworkers. The program increases access to health care while facilitating leadership development and empowerment of individual farmworkers through training and experience as lay health promoters (camp health aides [CHAs]). This article describes a study which documents impacts on the CHAs of working as lay health promoters in terms of changes in personal empowerment. The authors developed a working definition of personal empowerment and interviewed 27 CHAs at three program sites (Arizona, New Jersey, and Florida) at hree different times. CHAs are grouped in five descriptive categories reflecting varying degrees of change in empowerment over this period. Of the total group of 27 CHAs, 24 exhibited some increase in personal empowerment during the study period. These changes are described in detail, and implications are discussed.
"It's a 24-Hour Thing... a Living-for-Each-other Concept": Identity, Networks, and Community in an Urban Village Health Worker Project
Authors: Schulz Amy J. , Israel Barbara A. , Becker Adam B. , Hollis Rose M.
Published: February 2007

Social networks are webs of relationships between individuals, and they play an important role in the complex social processes through which individuals seek information, obtain social support, and mobilize for collective action to modify social, economic, and environmental conditions associated with health and illness. Studies have described and evaluated lay health advisor (LHA) programs that use social networks to improve individual and community health. The experience and perceptions of community members involved with LHA programs have been explored less often and offer essential information to health educators about the design, implementation, evaluation, and support of such programs. This article examines the perspective of LHAs in Detroit, Michigan. Their understanding and experience of their work, the relationships between their activities and a sense of self and community, and personal and programmatic rewards and challenges are examined. The authors discuss implications for health educators related to LHAs' roles, relationship to supporting organizations, recruitment, training, and ongoing support.
The Latino Health Advocacy Program: A Collaborative Lay Health Advisor Approach
Authors: Baker Elizabeth A. , Bouldin Niva , Durham Maria , Lowell Monica Escobar , Gonzalez Maria , Jodaitis Nancy , Cruz Leo Negron , Torres Idali , Torres Miriam , Adams Sara Trillio
Published: February 2007

There have been numerous calls in the literature for health educators to develop programs to improve access to and utilization of health and human services by traditionally underserved communities, including Latinos. While the literature suggests several principles that can guide the development of these programs, it is important to address the needs, and build on the strengths, of the specific community of interest. It is, therefore, important to use collaborative approaches in which community members take an active role in the initiation, design, implementation, and evaluation of program activities. Lay health advisor programs are particularly well suited to this approach as they are designed to build on the strength of already existing community relationships to improve community health. This article describes a collaborative, culturally appropriate, holistic, and ecological lay health advisor program—the Latino Health Advocacy Program. Lessons learned and implications for future program development are discussed.
Community Health Workers: Who they are and What they do
Authors: Love Mary Beth , Gardner Kristen , Legion Vicki
Published: February 2007

Community health workers (CHWs) are community members who serve as frontline health care professionals. They generally work with the underserved and are indigenous to the community in which they work—ethnically, linguistically, socioeconomically, and experientially. This article presents the results of a survey of 197 systematically selected health care providers in eight Bay Area counties. The authors found that 25% of the health care providers in these eight counties hire CHWs. The hiring projections indicate that opportunities are expanding for these frontline professionals; the majority of growth is in public health departments and community-based organizations. The majority of CHWs are women (66%) of color (77%) with a high school degree or less (58%). A total of 44% earn an annual salary of $20,00 to $25,000; 30% make more than $25,001. AIDS and maternal and child health are the two major content foci of CHW work.
La Esperanza del Valle: Alcohol Prevention Novelas for Hispanic Youth and their Families
Authors: Lalonde Bernadette , Rabinowitz Peter , Shefsky Mary Lou , Washienko Kathleen
Published: February 2007

With extensive Hispanic community involvement, a television, radio, and storybook novela were developed to improve Hispanic parent-youth communications and youth attitudes regarding alcohol. Focus groups with the target audiences determined the novelas' concentration on alcohol, their medium and language of choice for Hispanic youth versus parents, and the health messages and cultural values to be portrayed. Reactions to the novelas were obtained via self-report surveys, random street interviews, radio listener call-ins, and community group meetings. Favorable reactions were obtained regarding the novelas' cultural sensitivity and appropriateness, and their potential to affect future behavior change. The affect of the television novela on Hispanic youth was evaluated by a pre-post self-report survey administered to middle and high school students. Survey results indicated the television novela may have had some positive impact on Hispanic youth attitudes and behavioral intentions regarding alcohol. The evaluation time line was limiting, however, and further evaluation is required.
AIDS Risk Behaviors, Knowledge, and Attitudes among Pregnant Adolescents and Young Mothers
Authors: Koniak-Griffin Deborah , Brecht Mary-Lynn
Published: February 2007

This study assessed AIDS risk behaviors, knowledge, and related attitudes of pregnant adolescents and young mothers (n = 151). Results revealed that a substantial portion of the sample engaged in sexual behaviors (e.g., unprotected sex and multiple sex partners) that increased their risk for acquiring HIV and possibly transmitting the disease to their children. Knowledge about major modes of HIV transmission was high; however, commonly held misconceptions were expressed concerning the spread of disease and methods of prevention. Results suggest that neither the experience of having an unplanned pregnancy nor knowing about HIV transmission was a sufficient motivator to reduce risk behaviors in this sample.
Using Cultural Knowledge in Health Promotion: Breastfeeding among the Navajo
Authors: Wright Anne L. , Naylor Audrey , Wester Ruth , Bauer Mark , Sutcliffe Emily
Published: February 2007

Although many attempts have been made to promote breastfeeding in a variety of contexts, few programs have explicitly incorporated cultural beliefs in these efforts. This article describes a breastfeeding promotion program conducted on the Navajo reservation. This program was designed to be culturally appropriate. Background information regarding beliefs and factors affecting infant feeding practices in this setting is provided, followed by a description of the intervention. The intervention, which incorporated both social marketing and community participation techniques, consisted of three components: an intervention in the health care system, a community intervention, and an individual intervention. Based on medical records review of feeding practices of all the infants born the year before ( n = 988) and the year after ( n = 870) the intervention, the program was extremely successful. This combination of techniques, including qualitative and quantitative research into local definitions of the problem, collaboration with local institutions and individuals, reinforcement of traditional understandings about infant feeding, and institutional change in the health care system, is an effective way of facilitating behavioral change.
Creating Tobacco Control Policy at the Local Level: Implementation of a Direct Action Organizing Approach
Authors: Blaine Therese M. , Forster Jean L. , Hennrikus Deborah , O'Neil Stephen , Wolfson Mark , Pham Huy
Published: February 2007

This article describes the community activation and policy change process in seven Minnesota communities involved in the Tobacco Policy Options for Prevention (TPOP) study. The study's intervention employed a direct action organizing model, which relies on mobilizing large numbers of people to alter decision making and leverage the power of elites. As part of the organizing process, TPOP organizers and teams made 1,319 personal contacts with community members, generated 309 media stories, and initiated 445 public events related to tobacco use. These actions resulted in the establishment of comprehensive tobacco ordinances in all seven communities. The authors discuss the goals, training, activities and political factors relevant to four phases of the TPOP intervention: information gathering and team recruitment, community awareness building and ordinance development, preparing for city council, and ordinance establishment and enforcement. Included are suggestions for practitioners interested in using policy change and community-based advocacy to resolve public health problems.
Detroit's East Side Village Health Worker Partnership: Community-Based Lay Health Advisor Intervention in an Urban Area
Authors: Parker Edith A. , Schulz Amy J. , Israel Barbara A. , Hollis Rose
Published: February 2007

In recent years, there have been few reports in the literature of interventions using a lay health advisor approach in an urban area. Consequently, little is known about how implementation of this type of community health worker model, which has been used extensively in rural areas, may differ in an urban area. This article describes the implementation of the East Side Village Health Worker Partnership, a lay health advisor intervention, in Detroit, Michigan, and notes how participatory action research methods and principles for community-based partnership research are being used to guide the intervention. Findings are presented on how the urban context is affecting the design and implementation of this intervention. Implications of the findings for health educators are also presented and include the utility of a participatory action research approach, the importance of considering the context and history of a community in designing a health education intervention, and the importance of recognizing and considering the differences between rural and urban settings when designing a health education intervention.
Learn, Share, and Live: Breast Cancer Education for Older, Urban Minority Women
Authors: Skinner Celette Sugg , Sykes Roslyn K. , Monsees Barbara S. , Andriole Dorothy A. , Arfken Cynthia L. , Fisher Edwin B.
Published: February 2007

Among older urban minority women, for whom breast cancer risk is high and the propensity to be screened is low, both social support and breast cancer knowledge have been linked to mammography use. The authors describe a theory-based breast cancer education program implemented via an existing informal network for low-income urban elderly coordinated by a social service agency. The program is both structured and flexible. Core education sessions include delineated content and methods and are led by health professionals. Participants choose from a variety of follow-up activities to promote screening within their community. Pre and posttests administered among 80 program attendees in two sites indicate significant improvement in knowledge (p < .001). Program attendees in each site also planned and participated in follow-up activities to promote screening among their peers. Learn, Share, and Live seems to be an effective program for promoting breast cancer screening among older, urban, primarily minority women.
The Fresno Asthma Project: A Model Intervention to Control Asthma in Multiethnic, Low-Income, Inner-City Communities
Authors: Wilson Sandra R. , Scamagas Peter , Grado Joy , Norgaard Linda , Starr Norma J. , Eaton Sandra , Pomaville Katherine
Published: February 2007

The Fresno Asthma Project targeted the entire low-income, inner-city, multiethnic population of Fresno, California. For 36 months following a 6-month planning phase, continuing education was provided to a high proportion of physicians, pharmacists, nurses/respiratory therapists, emergency medical technicians, school personnel, and allied health professionals involved in asthma care in Fresno, including virtually all those providing care/services to the target population. Small group patienteducation was made available and provided in age and culturally appropriate formats to patients/families in clinics, hospitals, and schools. General and ethnic media and a Speakers Bureau were used to raise public awareness of asthma as a serious but controllable health problem. This community intervention model is particularly appropriate to multiethnic communities. It is relatively low cost (total direct costs were $140,000 per year), uses existing educational resources, and appears to have minimized counterproductive competition. Although morbidity and mortality trend data are not yet available to monitor program impact, penetration into the target community has been substantial: community physicians refer patients to asthma classes, asthma educator training is ongoing through the local American Lung Association chapter, hospitals and managed care systems serving low-income/MediCal patients offer asthma classes, and public schools and HeadStart are institutionalizing asthma awareness and self-management classes.
Reaching Seriously At-Risk Populations: Health Interventions in Criminal Justice Settings
Authors: Hammett Theodore M. , Gaiter Juarlyn L. , Crawford Cheryl
Published: February 2007

More than 6 million people are under some form of criminal justice supervision in the United States on any given day. The vast majority are arrested in and return to urban, low-income communities. These are men, women, and adolescents with high rates of infectious diseases such as HIV/AIDS, other sexually transmitted diseases (STDs), and tuberculosis (TB), as well as substance abuse and other health problems. A review of recent literature indicates that an increasing problem for these populations is that they have had little prior access to primary health care or health interventions, and many are returning to their communities without critical preventive health information and skills, appropriate medical services, and other necessary support. Periods of incarceration and other criminal justice supervision offer important opportunities to provide a range of health interventions to this underserved population, and general evaluations show the potential for this strategy. Public health and criminal justice agencies have the expertise and should collaborate to provide interventions needed by incarcerated populations. Moreover, many recently released inmates require primary care for HIV/AIDS, other STDs, and TB. Consequently, timely discharge planning is essential, as are linkages with community-based organizations and agencies that can provide medical care, health education, and necessary supportive services.
The Healthy Neighborhoods Project: A Local Health Department's Role in Catalyzing Community Development
Authors: El-Askari Galen , Freestone Julie , Irizarry Chicky , Kraut Karen L. , Mashiyama Susan T. , Morgan Mary Anne , Walton Sheryl
Published: February 2007

Studies show that community development approaches to health education may lead not only to improved social, economic, and health status but also to increased individual participation in health education and preventive health care activities. However, because of categorical funding restraints and philosophical issues, local health departments have rarely given control of defining project outcomes to the community. One such project was in a low-income urban neighborhood in the San Francisco Bay Area. In this Healthy Neighborhoods Project, the health department catalyzed community development and organization in a multiethnic public housing complex. As a result, an empowered community successfully advocated to improve public safety by installing street speed humps and increased street lighting. After project completion, residents initiated several additional health actions, including the removal of a neighborhood tobacco billboard. This article describes the project, which may serve as a model for other urban public health programs to explore their role in community empowerment.
Breaking the Cycle of Violence Among Youth Living in Metropolitan Atlanta: A Case History of Kids Alive and Loved
Authors: Thomas Stephen B. , Leite Bernadette , Duncan Ted
Published: February 2007

More teenagers in the United States die from gunshot wounds than from all natural causes of disease combined. Firearm-related mortality accounts for almost half of all deaths among African American teens. Residents of central cities have the highest probability of experiencing violent crimes. This article describes an innovative community-based intervention designed to break the cycle of violence among youth in metropolitan Atlanta. The intervention, Kids Alive and Loved (KAL), emerged from the African American community as one mother's response to the violent death of her 17-year-old son. The authors describe how her response to tragedy gave birth to a culturally appropriate intervention for youth exposed to violence. This article delineates the evolution of KAL, the role of community partners in the design of the intervention, and how diffusion of innovation theory has implications for understanding the KAL approach to breaking the cycle of violence.
Youth Violence in the City: The Role of Educational Interventions
Authors: Greene Michael B.
Published: February 2007

Interpersonal violence is a major cause of ill health in urban communities and a significant social and political problem. The epidemiology of interpersonal violence is summarized, highlighting the fact the youth are overrepresented as victims and perpetrators of violence. General areas of agreement and disagreement about programmatic approaches to reducing youth violence are summarized, emphasizing that the most effective programs are comprehensive and integrated and incorporate multiple strategies at multiple levels in multiple settings. Four types of educational strategies to reduce youth violence are summarized: conflict management skills training, youth-operated programs, psychoeducational strategies, and family-based educational strategies. Exemplars of each are presented, and their strengths and weaknesses are discussed. Strategies to implement effective programs are summarized, and the policy and program planning implications of what is known are discussed.
Preventing Halloween Arson in an Urban Setting: A Model for Multisectoral Planning and Community Participation
Authors: Maciak Barbara J. , Moore Madison T. , Leviton Laura C. , Guinan Mary E.
Published: February 2007

Arson is a violent crime and a public health problem that causes injuries and deaths, destroys homes, and destabilizes neighborhoods. During the late 1970s, pre-Halloween pranks in Detroit, Michigan, turned destructive when hundreds of fires were set deliberately throughout the city; in 1984, a record of 810 fires were set during the Halloween period. In 1985, a citywide anti-arson campaign that involved the mobilization and training of thousands of community volunteers was begun in Detroit. This report describes the multiple components of the anti-arson intervention from 1985 through 1996 and changes in the incidence of Halloween fires. Both the decrease in annual Halloween arson fires after the intervention began and the inverse relationship between the number of volunteers and the number of fires suggest a causal effect. This study illustrates the capacity of an urban community to mobilize its residents and stakeholders, the importance of community participation and multisectoral partnerships in program planning and implementation, and the challenges faced in retrospectively evaluating an apparently successful, complex, community-based intervention.
CINCH: An Urban Coalition for Empowerment and Action
Authors: Butterfoss Frances D. , Morrow Ardythe L. , Rosenthal Jorge , Dini Eugene , Crews R. Clinton , Webster J. DeWitt , Louis Patricia
Published: February 2007

CINCH (Consortium for the Immunization of Norfolk's Children) is an urban coalition that was developed in 1993 to improve childhood immunization rates in Norfolk, Virginia. CINCH involves diverse citizens and institutions in effective community-based assessment, planning, and action. A needs assessment from 1993 found that only 49% of Norfolk 2-year-olds were adequately immunized. Using this data, CINCH developed a plan focused on education and communication, support for at-risk families, increased access to immunizations, and improved immunization delivery. After federal funding ended in 1995, members voted to expand the scope of the coalition to address additional child health needs and to broaden the membership. CINCH is a model for a sustainable city-citizen learning environment that intervenes to "help families help themselves to better health." The coalition is presented as an organization that focuses on community empowerment and development. The stages of coalition development and implications for coalition implementation in other sites are discussed.
Identifying and Defining the Dimensions of Community Capacity to Provide a Basis for Measurement
Authors: Goodman Robert M. , Speers Marjorie A. , Mcleroy Kenneth , Fawcett Stephen , Kegler Michelle , Parker Edith , Smith Steven Rathgeb , Sterling Terrie D. , Wallerstein Nina
Published: February 2007

Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities.
Radon Awareness and Reduction Campaigns for African Americans: A Theoretically Based Evaluation
Authors: Witte Kim , Berkowitz Judy M. , Lillie Janet Mckeon , Cameron Kenzie A. , Lapinski Maria Knight , Liu Wen-Ying
Published: February 2007

Radon gas is a significant health threat linked to thousands of preventable deaths each year. One population that may be at increased risk from harm from radon exposure is African Americans. However, little is known about what African Americans think or know about radon. A theoretically based evaluation of radon awareness and reduction campaigns was conducted with African Americans. The knowledge and perceptions results indicate that African Americans often hold inaccurate beliefs regarding radon (e.g., confusing it with carbon monoxide gas), perceive it to be a serious threat, and perceive recommended responses to be inadequate in averting harm. The campaign materials evaluation shows that campaign materials often promote perceptions of threat but not perceptions of efficacy regarding recommended responses. Recommendations are given for public health practitioners.
The Authoritative Parenting Index: Predicting Health Risk Behaviors Among Children and Adolescents
Authors: Jackson Christine , Henriksen Lisa , Foshee Vangie A.
Published: February 2007

Public health research demonstrates increasing interest in mobilizing parental influence to prevent health risk behaviors among children and adolescents. This research focuses on authoritative parenting, which previous studies suggest can prevent health risk behaviors among youth. To evaluate the reliability and validity of a new survey measure of authoritative parenting, data from studies of (1) substance use in a sample of 1,236 fourth and sixth-grade students; (2) weapon carrying and interpersonal violence in a sample of 1,490 ninth- and tenth-grade students, and (3) anger, alienation, and conflict resolution in a sample of 224 seventh- and eighth-grade students were analyzed. The Authoritative Parenting Index had a factor structure consistent with a theoretical model of the construct; had acceptable reliability; showed grade, sex, and ethnic differences consistent with other studies; and identified parenting types that varied as hypothesized with multiple indicators of social competence and health risk behaviors among children and adolescents.
Factors That Contribute to Effective Community Health Promotion Coalitions: A Study of 10 Project ASSIST Coalitions in North Carolina
Authors: Kegler Michelle Crozier , Steckler Allan , Mcleroy Kenneth , Malek Sally Herndon
Published: February 2007

The purpose of this study was to identify factors that contribute to the effectiveness of community health promotion coalitions. Member survey data from 10 coalitions formed as part of North Carolina Project ASSIST were analyzed at the coalition level to identify factors related to member participation, member satisfaction, quality of the action plan, resource mobilization, and implementation. The results suggest that coalitions with good communication and skilled members had higher levels of member participation. Coalitions with skilled staff, skilled leadership, good communication, and more of a task focus had higher levels of member satisfaction. Coalitions with more staff time devoted to them and more complex structures had greater resource mobilization, and coalitions with more staff time, good communication, greater cohesion, and more complex structures had higher levels of implementation. Neither member participation nor member satisfaction correlated with the other measures of coalition effectiveness.
Kasdah B'Rosh Toy: A Description and Evaluation of the Israeli Bicycle Helmet Campaign
Authors: Ressler William Harris , Toledo Esther
Published: February 2007

In this article, the Israeli bicycle helmet campaign that began in 1993 and was accompanied both by increases in sales of helmets and by increases in their use by children is described and evaluated. Based on formative research, the authors designed a campaign by applying functional theories of attitudes. Evaluative research allowed testing the suitability of this application. Results supported functional predictions. Children's exposure to an initial pilot campaign was associated with changes in normative perceptions of helmet wearing and with increased willingness to wear a helmet. Their exposure to the subsequent comprehensive campaign was associated with changes in utilitarian beliefs but not with increased willingness to wear helmets. Parents' exposure to the comprehensive campaign was associated with changes in utilitarian beliefs, but their willingness to require their children to wear helmets was limited by their perceived ability to succeed in influencing their children's use of helmets.
Weight Loss Management: A Path Lit Darkly
Authors: Hawks Steven R. , Gast Julie
Published: February 2007

This article reviews recent research on the prevalence and virulence of obesity as a causal risk factor for mortality and morbidity. The prevailing assumption that obesity, by itself, is a chronic disease or a primary risk factor for health is challenged. A historical perspective is used to analyze the efficacy of various medical and educational approaches that have attempted to alter body size in the pursuit of enhanced physical health. The motivational discrepancies between society's media-induced desire for thinness and the health field's risk reduction approach to weight loss are outlined. Finally, ethical issues are raised in relation to current weight control measures, implications for future educational efforts are discussed, and potential guidelines for future weight management programs are presented.
Long-Term Effectiveness of Two Dutch Work Site Smoking Cessation Programs
Authors: Willemsen Marc C. , de Vries Hein , van Breukelen Gerard , Genders Ron
Published: February 2007

This article reports on one of the few experimental studies in Europe to examine work site smoking cessation. The study examined whether a comprehensive intervention (self-help manuals, group courses, a mass media campaign, smoking policies, and a second-year program) is more effective than a minimal intervention (self-help manuals only). Eight work sites participated in the study. The effect of treatment on smoking cessation depended on nicotine dependency levels: Heavy smokers had more success with the comprehensive smoking cessation intervention than with the minimal intervention (with respect to both 14-month quit rate and 6-month prolonged abstinence). For heavy smokers, exposure to mass media exhibitions or to group courses had a beneficial effect on prolonged abstinence. Comprehensive programs may be most appropriate in Dutch work sites with large proportions of heavily addicted smokers.
Impact of Work Site Health Promotion on Stages of Dietary Change: The Working Well Trial
Authors: Glanz Karen , Patterson Ruth E. , Kristal Alan R. , Feng Ziding , Linnan Laura , Heimendinger Jerianne , Hebert James R.
Published: February 2007

The stages of change construct has been applied to healthful dietary behavior in cross-sectional studies. This report examines associations of stages of change with diet prospectively and addresses whether (1) baseline stage of change predicts participation, (2) forward changes in stage movement were greater in treatment work sites, and (3) change in stage was associated with adoption of healthful diets, using data from a cohort of 11,237 employees. Findings indicate that persons in later stages of change reported higher participation levels. Employees from intervention work sites who were in preaction stages at baseline were much more likely to shift into action and maintenance stages than controls. Changes in dietary stage of change were associated with decreases in fat intake and increases in fiber, fruit and vegetable intake. Net change in diet due to the intervention was modest. Stage of change appears to be useful for understanding mediators of health promotion intervention effectiveness.