bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Health Belief Model and Decision Making Regarding Amniocentesis in Women of Advanced Maternal Age
Authors: French Beatrice N. , Kurczynski Thaddeus W. , Weaver Michael T. , Pituch Martha J.
Published: February 2007

The Health Belief Model (HBM) was developed as an attempt to explain an individual's decision regarding obtaining preventive health care. This model was applied to predict the decisions of women of advanced maternal age regarding their obtaining amniocentesis in a one-year study conducted in Toledo, Ohio.

A questionnaire based on the HBM was administered to a sample of 98 pregnant women of advanced maternal age. A total of 96 questionnaires were eligible for inclusion in the study. Sixty-one women reported that they would have amniocentesis, 22 would not, and 13 were unsure.

A multivariate analysis of variance among amniocentesis decision groups was performed using the health belief components (perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier) and knowledge as variables. There was a significant difference (Wilks' criterion, p < .0001) among the three decision groups, but the differences were in the health belief components and not in knowledge. A stepwise discriminant function analysis was used to classify subjects on the amniocentesis decision.

Of the variables examined, only the HBM component perceived benefit factor was a significnat discriminant ( p = .0001). It is not necessarily the lack of knowledge that prevents women who are at risk because of advanced maternal age from having amniocentesis but their perceptions regarding amniocentesis. Genetic counselors need to focus more on exploring the perceptions of amniocentesis benefits in this population to facilitate the decision making process.
The Role of Community Organizations in AIDS Prevention in Two Latino Communities in New York City
Authors: Freudenberg Nicholas , Trinidad Urayoana
Published: February 2007

Black and Latino community organizations can play a major role in acquired immunodeficiency syndrome (AIDS) prevention. Their ongoing relationships with their constituents, knowledge of relevant cultural values and channels of communication, and commitment to safeguard the well-being of their neighborhoods are an important resource for AIDS prevention campaigns.

In order to better understand the process by which community groups have taken on the issue of AIDS, investigators conducted in-depth interviews with a convenience sample of 47 neighborhood organizations in two primarily Latino communities in New York City. Researchers also attended community meetings, interviewed AIDS educators, and conducted focus groups with respondents.

More than half the groups had already sponsored some AIDS prevention activities prior to the first interview. More active groups were more likely to have multiple missions, previous experience with the target population, and prior experience working with people with AIDS.

Respondents reported a variety of obstacles to more active involvement in AIDS prevention at the community, organizational, and individual levels. To strengthen the role of community organizations in AIDS prevention, more resources should be provided to grass roots groups, AIDS should be linked to other urgent social problems facing black and Latino communities, and funders and AIDS organizations should respond more flexibly to the needs of neighborhood organizations.
A Health Belief Model-Social Learning Theory Approach to Adolescents' Fertility Control: Findings from a Controlled Field Trial
Authors: Eisen Marvin , Zellman Gail L. , McAlister Alfred L.
Published: February 2007

We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program ( p < 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled ( p < 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.
Attitudes, Norms, and Self-Efficacy: A Model of Adolescents' HIV-Related Sexual Risk Behavior
Authors: Basen-Engquist Karen , Parcel Guy S.
Published: February 2007

Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.
Theory in Health Education Practice
Authors: Hochbaum Godfrey M. , Sorenson James R. , Lorig Kate
Published: February 2007

Although social and behavioral science theories are claimed to be able to contribute greatly to the effectiveness of health education programs, most practitioners in the profes sion seem to doubt this, and very few ever deliberately use theories in their work. Some reasons for such diverse views reside in the nature of the theories, in the very different roles they play in the worlds of theory-minded and practice-oriented health educators, respectively, in widespread unrealistic expectations of what theories can and cannot contribute to practice, and in lack of appropriate training in theories and their uses. Suggestions are offered to both practicing and academic health educators on ways to bridge the gap between the two camps, to render theories more useful to practitioners, and to train practitioners and health education students to appreciate the potentials of theories and to acquire skills needed to utilize such potentials.
What's the Use of Theory?
Authors: van Ryn Michelle , Heaney Catherine A.
Published: February 2007

The barriers to the use of theory in health education practice are addressed by exposing common misperceptions of the nature and usefulness of theory. First, the mystique of theory is addressed through a discussion of theory development and the roots of theory in everyday experience. Two characteristics of theory, generalizability across settings or situations and testability, are described and linked to benefits for practice. Second, a guide for practitioners in applying theory to each stage of the intervention process is provided. A case example illustrates how theory can guide practice as well as the benefits to be gained by applying theory to program development. Finally, the bases for common negative misperceptions of theory are identified and clarified, and the beneficial nature of theory reviewed.
The Uses of Theory in Health Advocacy: Policies and Programs
Authors: Howze Elizabeth Harper , Redman Linda J.
Published: February 2007

This paper illustrates the utility of theory for health educators who advocate for health promotion policies and programs. It describes how diffusion of innovation and other social science theories were employed by a statewide coalition called the Health Pro motion and Education Council of Virginia in its effort to reduce premature and pre ventable death and disability in the state. To this end the Council sought legislative action to accelerate the diffusion of health promotion throughout the state. Discussing elements of diffusion theory such as working through opinion leaders, creating information-ex change relationships, and tailoring the attributes of the innovation to achieve its objec tives, the paper reviews the process through which the Council became an effective advocate, and the strategies it devised to communicate the innovation of health promotion to legislators. The legislation that was generated by the work of the legislative study committee and future uses of theory are also discussed.
Theory and the Empowerment of Health Education Practitioners
Authors: D'Onofrio Carol N.
Published: February 2007

Both the nature of theory and the way it is taught can overpower health education practitioners. As a consequence, myths which maintain theory and practice in separate realms may develop. This paper argues that to remedy this situation, practitioners must be helped to gain greater control of theory. Specific suggestions for accomplishing this goal are offered in a three-part prescription. First, concepts and teaching methods are introduced to dismantle myths about theory and to help practitioners understand its origins, nature, and functions. Second, health educators are encouraged to acknowledge limitations in theories currently guiding their practice. Third, they are shown ways they can exert leadership in developing theory to fill these gaps and build a more adequate knowledge base for confronting contemporary practice problems. Through this exercise of power, health educators will gain control over theory and expand the boundaries of practice, while also enhancing their professional status.

The boundaries of professional practice are made and changed by the relation ship between the discourse of scientific knowledge and the exercise of profes sional power. 1 Turner
Mammography Usage and the Health Belief Model
Authors: Stein Judith A. , Fox Sarah A. , Murata Paul J. , Morisky Donald E.
Published: February 2007

Regular screening mammograms for asymptomatic women are the most effective method for early detection of breast cancer. This study assessed the relative influence of Health Belief Model (HBM) constructs on prior mammography usage and the intention to obtain mammograms with data from a sample of 1,057 women over the age of 35 years residing in an urban community in the United States. Covariance structure analysis with latent variables was used initially to perform a confirmatory factor analysis of indicators of Socioeconomic Status (SES), Perceived Susceptibility, Perceived Barriers, Perceived Benefits, Cues to Action, Prior Mammography, and Future Intentions. Once a plausible factor structure was confirmed, a predictive path model was tested with Future Intentions and Prior Mammography as the outcome variables. Cues to Action, operationalized as a physician influence variable, particularly impacted Prior Mammography, and Perceived Susceptibility was the most powerful predictor of Future Intentions. SES only related significantly to Perceived Barriers, and Cues to Action, and did not directly influence Prior Mammography and Future Intentions. HBM predictor variables alone accounted for the relationship between previous mammography experience and intentions to obtain mammograms in the future. Health education implications and an applied outreach program are discussed.
Patient Attitudes Concerning Health Behaviors during Pregnancy: Initial Development of a Questionnaire
Authors: Tiedje Linda Beth , Kingry Margaret J. , Stommel Manfred
Published: February 2007

The major determinant of infant mortality in the United States is low birthweight (LBW). Health behaviors related to LBW are inadequate prenatal care, poor nutrition, smoking, and moderate to heavy alcohol use. Before interventions can be designed to assist women in modifying these health behaviors, more must be understood about their causes. The Health Belief Model (HBM) is a framework for analyzing beliefs that motivate health behaviors and is well established as a model for understanding health behavior decisions. The chief aim of this study was to develop an instrument to assess women's health beliefs during pregnancy. Questions for the instrument were generated around the four major constructs of the HBM: perceived susceptibility, seriousness, benefits, and barriers. Four focus group interviews, a literature review, and consultation with an HBM expert provided content for questions. The questionnaire was administered to a convenience sample of 127 women. The measurement models were tested using confirmatory factor analysis. Parsimony was achieved by reducing the original 106-item scale to 64 items. The final instrument provides support for the HBM but not for all of its discrete constructs.
Arthritis Education: Opportunities and State of the Art
Authors: Daltroy Lawren H. , Liang Matthew H.
Published: February 2007

Health education research in arthntis and musculoskeletal disease experienced extraordinary growth in the 1980s. In this article we discuss opportumties for health education in arthritis and musculoskeletal disease, and the effectiveness of evaluated programs to influence knowledge, behavior, and health status of persons with arthritis. Additionally, we review developments in theory and trends in research that we expect to be influential in the next decade. Educational opportunities for primary prevention of arthritis are limited. However, a large variety of organized programs, planned according to commonly accepted principles of education, psychology, and psychotherapy, and applied consistently by personnel with some kind of training, have been able to produce desirable changes in knowledge, behavior, and health outcome in arthritis patients, over and above the medical treatment and incidental education to which they have already been exposed. As a result, national dissemination of programs and standards for arthritis patient education is in progress. In the next decade, researchers will increasingly turn to new populations and methods of delivery, investigation of conditions less well studied, such as osteoporosis, education of patients in generic communication and coping skills, and development of arthritis-specific applications of theory, especially m areas such as social support, control and helplessness, cognitive processing, and pain management.
A Walking Education Program for Patients with Osteoarthritis of the Knee: Theory and Intervention Strategies
Authors: Allegrante John P. , Kovar Pamela A. , MacKenzie C.Ronald , Peterson Margaret G. E. , Gutin Bernard
Published: February 2007

This work was supported by NIH Multipurpose Arthritis Center Program grant no. 1 P60 AR38520-01A1, and in part by a predoctoral research fellowship grant to Dr. Kovar from the Arthritis Foundation. We thank Dr. Kate Long of the Stanford Arthritis Center, for providing numerous helpful suggestions m the early stages of developing this program; our colleagues at the Cornell Arthritis and Musculoskeletal Diseases Center, Dr. Mary Charlson and Dr. Mark Kasper, for reading and commenting on several drafts of the manuscript; and Dr. Lawren Daltroy, of the Multipurpose Arthritis Center at the Bngham and Women's Hospital, and the anonymous reviewers, whose helpful comments and editorial guidance enabled us to improve the manuscript. Portions of this paper were presented at the Northeast Arthritis Health Professions Association, May 19, 1990, New York, NY, and the 41st Annual Meeting of the Society for Public Health Education, October 5, 1990, New York, NY.
Exercise Maintenance of Persons with Arthritis after Participation in a Class Experience
Authors: Minor Marian A. , Brown James D.
Published: February 2007

This study investigated factors related to an initial exercise experience to explain exercise maintenance in 120 adults with rheumatoid arthritis or osteoarthritis. Integral secondary analysis was used to incorporate data from a prospective, controlled trial of exercise (Minor et al.: Arthritis Rheum 32:1396, 1989) with data collected at 18 months follow-up. The dependent variable was self-directed exercise (min/wk) reported at 3, 9, and 18 or more months after exercise class participation. Predictor variables included physical, psychosocial, disease, and programmatic factors. The all possible regressions search procedure resulted in three explanatory models (p = .0001). At 3 months the model (R2 = .45) included initial aerobic capacity, depression, and anxiety; and changes in depression and social activity. The 9-month model ( R2 = .35) consisted of initial anxiety and physical activity, change in depression, support of friends for exercise, and exercise behavior at prior assessment. At 18 or more months (R2 = .42), model variables were initial aerobic capacity, change in pain, and exercise behavior at the two prior assessments. Neither disease nor program factors appeared as significant. This limited study indicates that factors associated with exercise behavior in this sample are similar to those in the general population; explanatory factors change over time, and changes ascribed to a trial behavior may influence subsequent decision making.
Coping with Rheumatoid Arthritis: Is One Problem the Same as Another?
Authors: Blalock Susan J. , McEvoy DeVellis Brenda , Holt Kathleen , Hahn Patricia M.
Published: February 2007

This study examined how individuals with rheumatoid arthritis (RA) cope with illness-related problems in four different areas: daily activities, leisure activities, work, and social relationships. Eighty-five people with RA took part in the study. They participated in an in-depth interview that focused on the types of changes they had experienced in their lives as a result of their arthritis and how they had coped with these changes. Audiotapes of the interviews were transcribed and content analyzed to assess participants' coping behavior. In addition, standardized measures of psychological and physical functioning were administered shortly following the original interview and at a 4-month followup. Three major findings emerged. First, people relied less heavily on behavioral coping strategies when dealing with problems involving social relationships than when dealing with problems involving daily activities, leisure activities, or work. Second, there was little consistency in individuals' use of either cognitive or behavioral strategies across different problem areas. Finally, individuals who exhibited limited flexibility in their coping responses experienced poorer psychological functioning compared with more flexible copers. Implications of these findings for health education practice and future research on coping with RA are discussed.
Changing Adolescent Propensities to Use Drugs: Results from Project ALERT
Authors: Ellickson Phyllis L. , Bell Robert M. , Harrison Ellen R.
Published: February 2007

Do successful drug prevention programs suppress the risk factors they were intended to modify? This paper addresses that issue for Project ALERT, a school-based program for seventh and eighth graders that has been shown to curb both cigarette and marijuana use. Evaluated with over 4,000 students in an experimental test that included 30 diverse California and Oregon schools, the curriculum seeks to help young people develop both the motivation to avoid drugs and the skills they need to resist pro-drug pressures. Using regression analyses, we examine the program's impact on the intervening (cognitive) variables hypothesized to affect actual use: adolescent beliefs in their ability to resist, perceived consequences of use, normative perceptions about peer use and tolerance of drugs, and expectations of future use. The analysis depicts program effects for perceptions linked to each target substance (alcohol, cigarettes, and marijuana), across all students and for those at different levels of risk for future use. Results show that the curriculum successfully dampened cognitive risk factors from each of the above categories for both cigarettes and marijuana, indicating that social influence programs can mitigate a broad range of beliefs associated with the propensity to use drugs. However, it had a limited impact on beliefs about alcohol, the most widely used and socially accepted of the three drugs. Implications for drug prevention programs and practitioners are discussed.
Relationship of Mothers' Food Choice Criteria to Food Intake of Preschool Children: Identification of Family Subgroups
Authors: Contento Isobel R. , Basch Charles , Shea Steven , Gutin Bernard , Zybert Patricia , Michela John L. , Rips Jill
Published: February 2007

This study investigated the relationship between potential criteria mothers use to select foods for their children, their food knowledge, and food consumption of their children. Participants were 218 predominantly Latino mothers and their 4 to 5-year-old children. Mothers rated 17 foods in terms of 10 food attributes (how tasty specific foods were to their child, whether they were convenient to prepare, etc.). Within-person correlation coefficients were then calculated between these ratings and reported frequency of consumption of these same 17 foods. These correlations were then used in a k-means cluster analysis to identify six distinct subgroups of families, who had different orientations ranging from "high health" to "high taste." Children in the "high health" groups had diets significantly lower in calories, fat, saturated fat, and sucrose and higher in fiber and vitamin A from 24-hour dietary recalls reported by mothers. Mothers' health knowledge was also correlated with nutrient takes of children. These data indicate that families can be segmented according to the importance of beliefs about healthfulness of foods and that this segmentation predicts quality of diet of children. This study suggests that interventions should be designed to increase mothers beliefs in the importance of health in choosing foods. For those mothers whose food choices are dominated by children's tastes, interventions should be directed at how to prepare healthful foods to taste good to children.
A Meta-Evaluation of Nutrition Education Intervention Research among Pregnant Women
Authors: Boyd Neal Richard , Windsor Richard A.
Published: February 2007

Inadequate nutrition during pregnancy retards human fetal growth and increases the risk of delivering a low birthweight (LBW) infant. Some studies place particular emphasis on reducing LBW through improved nutrition. Consensus documents have strongly recommended intense nutrition education programs for patients at risk. Despite this well-defined need few methodologically rigorous studies have been conducted to evaluate the behavioral impact of nutrition education for pregnant patients. Criteria are recommended in the following areas: (1) research design, (2) sample size and power, (3) specification of population characteristics, (4) measurement quality, and (5) replication. The methodological quality of completed evaluations are reviewed using these criteria. The authors advocate guidelines for future investigators for conducting rigorous trials in this critical public health area.
Using Focus Groups to Develop Health Surveys: An Example from Research on Social Relationships and AIDS-Preventive Behavior
Authors: O'Brien Kerth
Published: February 2007

Focus group data can inform the choice of words or phrases in a questionnaire, the construction of items to measure a given concept, the formation of new hypotheses, and the development of survey procedures. To date, few examples exist to show researchers in health behavior and health education how they might use focus groups for these purposes. This paper provides an example of group discussions that were held with gay and bisexual men on the topic of their experiences of the human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) epidemic and illustrates the many ways that focus groups assist in questionnaire development.
Assessment of Adolescent Refusal Skills in an Alcohol Misuse Prevention Study
Authors: Shope Jean T. , Copeland Laurel A. , Maharg Ruth , Dielman Ted E. , Butchart Amy T.
Published: February 2007

Although many substance abuse prevention programs seek to enhance the ability of adolescents to refuse offers of alcohol and other drugs, few report assessments of refusal skill ability or its relationship to substance use. This report describes a procedure to assess the ability of adolescents to refuse the offer of a beer, and presents the findings of those assessments as well as their relationships to alcohol misuse prevention knowledge, susceptibility to peer pressure, internal health locus of control, self-esteem, and alcohol use and misuse. A one-third random sample (n = 1012) of 10th graders participating in a longitudinal evaluation of an alcohol misuse prevention curriculum was assessed individually. Students rated their own refusals, which were also rated by trained female and male raters. The results indicated that adolescents refuse the offer of a beer only somewhat convincingly. Those adolescents with better refusal skills had higher levels of alcohol misuse prevention knowledge, especially regarding resisting pressures to use alcohol and the application of knowledge to typical alcohol-related situations. They also reported less susceptibility to peer pressure, greater internal health locus of control and self-esteem, and less alcohol use and misuse. The results provide support for teaching refusal skills in substance abuse prevention programs and for assessing refusal skills in the evaluation of such programs.
Participation in Worksite Health Promotion: A Critique of the Literature and Recommendations for Future Practice
Authors: Glasgow Russell E. , McCaul Kevin D. , Fisher K. John
Published: February 2007

One of the major rationales for conducting health promotion/disease prevention activities at the worksite is the potential to reach a high percentage of employees, including many who would otherwise be unlikely to engage in preventive health behaviors. Most studies of worksite health promotion do not report participation data, but among those that do, definitions of participation and participation rates vary dramatically. In general, men and blue-collar employees appear less likely to participate, but little is known about other employee variables related to participation. There have been few studies of worksite characteristics associated with participation and even fewer experimental evaluations of interventions to increase participation. In this paper we review what is known about participation in worksite health promotion programs and recommend procedures for defining participation for different types of programs, for reporting determinants of participation, and for increasing participation. We conclude that participation is both an important process measure and an outcome that should be reported routinely. Participation data have important implications for generalizability of results, feasibility of interventions, and health outcomes.
Factors Associated with AIDS-Related Behavioral Intentions among High School Students in an AIDS Epicenter
Authors: Walter Heather J. , Vaughan Roger D. , Gladis Madeline M. , Ragin Deborah F. , Kasen Stephanie , Cohall Alwyn T.
Published: February 2007

Using data from a cross-sectional survey of 531 predominantly black and Hispanic 10th graders in two New York City schools, the explanatory power of predictors of intentions to engage in sexual intercourse, to have multiple intercourse partners, and to use condoms was compared. Theoretically derived predictor variables (i.e., susceptibility, severity, benefits, barriers, self-efficacy, values, norms) were derived from the health belief model, social cognitive theory, and a model of social influence. One half of sampled students definitely intended to have sexual intercourse in the next year, one tenth definitely intended to have multiple partners, and two thirds definitely intended to use condoms. In multivariate analyses, variables derived from the model of social influence and from social cognitive theory were most strongly associated with the three investigated behavioral intentions; however, certain background and health belief variables also contributed to the explained variance in intercourse and multiple partner intentions.
Use of Focus Group Methodology to Develop an Asthma Self-Management Program Useful for Community-Based Medical Practices
Authors: Kohler Connie L. , Dolce Jeffrey J. , Manzella Bryn A. , Higgins Darlene , Brooks C. Michael , Richards James M. , Bailey William C.
Published: February 2007

Health education programs developed in academic medical centers are not optimally disseminated to community clinical settings. Strategies are needed to translate the findings of research on health education programs into programs useful in a wide range of health care settings. Focus group techniques were used to provide data for revising a successful university-based asthma self-management program to make it more practical for use by community physicians. Physicians representing a variety of specialties attended the sessions and provided feedback on the utility of various components of the original program. The discussions revealed that many physicians felt they did not have the time or resources to conduct the original program and identified elements viewed as impractical. This
Assessing the Stages of Change and Decision-Making for Contraceptive Use for the Prevention of Pregnancy, Sexually Transmitted Diseases, and Acquired Immunodeficiency Syndrome
Authors: Grimley Diane M. , Riley Gabrielle E. , Bellis Jeffrey M. , Prochaska James O.
Published: February 2007

A synergistic approach was taken to examine contraceptive use adoption for two related behaviors: pregnancy prevention and the prevention of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). One hundred twenty-three young adults responded to questionnaire items based on two constructs from the Transtheoretical Model of Change, the Stages of Change and Decisional Balance, as well as other pertinent variables. In Phase 1, two Decisional Balance measures were developed: One for the prevention of pregnancy and one for disease prevention. Final versions of both measures consisted of two 10-item scales: one representing the positive aspects (PROS) and one representing the negative aspects (CONS) of contraceptive and condom use. In Phase 2, the same individuals were staged for both pregnancy and disease prevention according to their readiness to change for contraceptive and condom use. MANOVAs and ANOVAs indicated that the PROS and CONS for both measures were related to stage of change for both contraceptive and condom use. Results from this pilot study were consistent with prior applications of the Transtheoretical Model to the cessation of such problem behaviors as smoking and to the adoption of positive health behaviors such as exercise acquisition.
Predictors of Home Radon Testing and Implications for Testing Promotion Programs
Authors: Sandman Peter M. , Weinstein Neil D.
Published: February 2007

Four data sets (total N = 3,329) are examined to identify the predictors of home radon testing. The data, interpreted in terms of a stage model of radon testing behavior, reveal that the variables predicting transitions between stages change as people move from one stage to the next. Thinking about radon testing (vs. never having even considered testing) is best predicted by general radon knowledge and by knowing other people who are concerned or have tested. Once contemplating testing, the decision to test is most closely related to the perceived likelihood of a home radon problem. Finally, there are few differences between people who say they have decided to test and those who have already tested. Instead situational factors—including difficulties in locating and choosing among test kits—appear to constitute the final barrier to testing. The ways in which these findings might assist the design of radon outreach programs are discussed, and specific outreach recommendations are advanced.
Effect of Perceived Barriers on Compliance with Antihypertensive Medication
Authors: Richardson Mary Ann , Simons-Morton Bruce , Annegers John F.
Published: February 2007

Noncompliance with antihypertensive medication remains an obstacle to the management of hypertension, and despite research efforts over the past decade, the predictors of noncompliance remain unclear. According to values expectancy theory, individuals rationally choose noncompliance when the barriers or costs of treatment outweigh the expected benefits. Noncompliance, therefore, is likely to occur when net costs of treatment are high.
Findings from the Horizontes Acquired Immune Deficiency Syndrome Education Project: The Impact of Indigenous Outreach Workers as Change Agents for Injection Drug Users
Authors: Birkel Richard C. , Golaszewski Thomas , Koman Joseph J. , Singh B.K. , Catan Veronica , Souply Kassandra
Published: February 2007

A human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) intervention using indigenous outreach workers was implemented with Hispanic injection drug users (IDUs) and their sexual partners in three locations: Laredo, Texas; San Diego, California; and San Juan, Puerto Rico. A total of 2,169 subjects were contacted, given health education, HIV antibody testing, and follow-up counseling. This article reports on the 1,616 IDUs (75%) who completed the initial and follow-up interviews. The results indicated significant increases in health knowledge on AIDS, decreases in needle risk drug taking behaviors, some decreases in sex risk behaviors, and more realistic perceptions of personal AIDS risk. Using multivariate analyses, gender (male) and increasing age (older than age 25 years) were the strongest predictors of behavior change. Surprisingly, the identification of a positive HIV serostatus was not a significant predictor of behavior change. Although intended as a comparison study between contrasting levels of intervention, logistical and administrative problems undermined the use of a true quasi-experimental design. Nonetheless, the results from this research suggest that the use of indigenous outreach workers is an effective means of combatting the spread of HIV in this difficult to reach population. Some programmatic recommendations are provided for future efforts of this kind, particularly in relation to role conflicts experienced by outreach workers.
Breast Cancer Screening among Older Hispanic Women: Knowledge, Attitudes, and Practices
Authors: Saint-Germain Michelle A. , Longman Alice J.
Published: February 2007

A survey was conducted with 409 Hispanic and 138 Anglo women in Tucson, Arizona, to assess their knowledge of breast cancer and cancer screening tests, their attitudes toward breast cancer and cancer screening, and their use of screening tests. There were few differences between these two groups in use of breast cancer screening tests, with both groups falling well below the recommended levels of screening frequency. Clinical breast exam was most often used, followed by breast self-exam, with mammography a distant third. Levels of knowledge about the risks for breast cancer and the ways to detect it were also low. Comparison with national data show Arizona women to have lower rates of breast cancer screening than the national average; this may be due to the absence of the Medicaid program in Arizona. The rates for Tucson Hispanics, although lower than that for Anglos, are comparable with the findings of other studies. More needs to be done to alert all older women about breast cancer screening, but more specific attention needs to be paid to the population of older Hispanic women. We suggest some culturally relevant strategies to address this problem.
Development of the Adolescent Health Concerns Inventory
Authors: Weiler Robert M. , Sliepcevich Elena M. , Sarvela Paul D.
Published: February 2007

Health concerns of adolescents are important factors to consider when developing and implementing school health education programs. In addition, an understanding of adolescent concerns compared to their teachers' and parents' beliefs about adolescents' concerns may enhance communication between adolescents and adults. Despite the need to identify the health concerns of adolescents and beliefs about them among parents and teachers, few instruments exist. The inventory described in this article is one approach to assessing adolescent health concerns. Three forms of the Adolescent Health Concerns Inventory (AHCI) were developed to assess: (1) the health concerns of adolescents, (2) teachers' beliefs about adolescent health concerns, and (3) parents' beliefs about adolescent health concerns. The final version of the instrument contained 150 health-related items grouped into 12 topical subscales. Reliability estimates for the 12 subscales as measured by Cronbach's alpha ranged from .76 to .92. A panel of experts was used to assess content validity. Construct validity was assessed using principal components factor analysis. All items were positively loaded on factor 1. Readability was estimated at the eighth grade as measured by the SMOG readability formula. Psychometric characteristics of the instrument and recommendations for the use of the AHCI are presented.
Health Education: What Can It Look Like after Health Care Reform? 1993 SOPHE Presidential Address
Authors: Jorgensen Cynthia M.
Published: February 2007

In the fall of 1993 the plans for the Health Security Act were unveiled: health education was referenced no fewer than 18 times. This 1993 SOPHE Presidential Address examines the role of health education under the plans for and principles of health care reform. As Bill Clinton stated, "an intensified health education system must be designed to educate and encourage the American people to change behavior that results in ill health and high costs." It is argued that health education has been demonstrated to be effective at reducing risk behaviors associated with each of the leading causes of death. Likewise health education should, can, and does play a role in each of the health goals and objectives for the year 2000. Health reform provides new opportunities to invest in prevention, public health and health education—not only in medical care settings—but in schools, at worksites, and in the community. Health education in these settings can help create supportive environments that make healthy choices the easy choices, ensuring that health reform can succeed.
Condom Beliefs in Urban, Low Income, African American and Hispanic Youth
Authors: Norris Anne E. , Ford Kathleen
Published: February 2007

This article focuses on the condom beliefs of low income, urban African American and Hispanic youth living in the Midwest. The condom beliefs under investigation were derived from prior research with members of this population and through consultation with African American and Hispanic youth and service providers. Significant gender, ethnic, and acculturation differences were found among beliefs related to frequency of condom use in the past year (p < .05). These differences indicated that women, African American respondents, and Hispanic respondents high in acculturation tended to have more neutral or more positive views about condoms than other types of respondents.
Modifying Dietary and Tobacco Use Patterns in the Worksite: The Take Heart Project
Authors: Glasgow Russell E. , Terborg James R. , Hollis Jack F. , Severson Herbert H. , Fisher K. John , Boles Shawn M. , Pettigrew E. Lee , Foster Lyn S. , Strycker Lisa A. , Bischoff Sheri
Published: February 2007

This article describes the conceptual basis, design, and intervention approach for a worksite-based heart disease risk reduction project. Baseline characteristics of the 26 moderate size worksites participating in the Take Heart Project are also described. The trial is designed to produce changes at both the organization and employee level on tobacco use, dietary fat intake, and serum cholesterol. A key feature of the intervention is creation of employee steering committees to enhance ownership and involvement. From a menu of brief, low-intensity health education and environmental change activities, these committees select activities best suited to their worksite. The baseline characteristics of ogranizations randomized to intervention and control conditions were similar, and indicated a relatively high level of worksite activity related to cholesterol and smoking.
Authoritative Parenting, Child Competencies, and Initiation of Cigarette Smoking
Authors: Jackson Christine , Bee-Gates Donna J. , Henriksen Lisa
Published: February 2007

School-based social influence programs to prevent adolescent smoking are having limited success in the long term. Intervening earlier in the process of smoking onset, during the childhood years, may be required to prevent adolescent smoking. Child socialization variables, specifically parenting behaviors and child competencies, may be important to understanding the earliest phase of smoking onset. This study tested hypotheses of association between authoritative parenting behaviors, enhanced child competencies, and relatively low rates of initiation of cigarette smoking. Analyzing cross-sectional survey data from 937 students in Grades 3 to 8, we found general support for the study hypotheses: Authoritative parenting was positively associated with child competencies ; children's competency levels were inversely related to their rates of smoking intention, initiation, and experimentation; authoritative parenting was inversely related to rates of child smoking intention and behaviors; and authoritative parenting and parent smoking status had independent associations with child initiation of cigarette smoking. These results indicate that child socialization variables merit further investigation for their potential role in the development of early intervention programs for smoking prevention.
Children's Knowledge and Beliefs about AIDS: Qualitative Data from Focus Group Interviews
Authors: Hoppe Marilyn J. , Wells Elizabeth A. , Wilsdon Anthony , Gillmore Mary R. , Morrison Diane M.
Published: February 2007

Focus groups were used as a qualitative technique to elicit knowledge and attitudes of children in Grades 3 to 6 about acquired immune deficiency syndrome (AIDS). Twenty-seven small groups of children responded to open-ended questions about general AIDS knowledge; transmission, causation, consequences, and prevention of AIDS; emotional response to AIDS; and susceptibility. Results indicate that children have a high level of awareness about AIDS and correct knowledge about the modes of human immunodeficiency virus (HIV) transmission. They understand that AIDS is a serious illness that cannot be cured and know the main ways of preventing HIV infection. Participants had more difficulty explaining causation and greatly overestimated the number of people their age and in high school that might be infected. They also had difficulty applying accurate knowledge to the hypothetical situation of encountering a child with AIDS in school. Misconceptions about AIDS exist at all grade levels, but appear more prevalent in lower grades, whereas increased complexity seems to characterize responses of older children. Recommendations for health educators are made.
Health Education and Community Empowerment: Conceptualizing and Measuring Perceptions of Individual, Organizational, and Community Control
Authors: Israel Barbara A. , Checkoway Barry , Schulz Amy , Zimmerman Marc
Published: February 2007

The fundamental conditions and resources for health are peace, shelter, edu cation, food, income, a stable ecosystem, sustainable resources, social justice, and equity. Improvement in health requires a secure foundation in these basic prerequisites.1
The Homeless Prenatal Program: A Model for Empowering Homeless Pregnant Women
Authors: Ovrebo Beverly , Ryan Martha , Jackson Kelle , Hutchinson Kimberly
Published: February 2007

The Homeless Prenatal Program (HPP) is one of the first programs in the country to provide comprehensive prenatal services to homeless pregnant women. A formative evaluation was conducted in 1992, indicating that HPP is achieving its program goals of improving birth outcomes and transforming the lives of its clients. Results of the quali tative evaluation are presented, including HPP's service model and approach to empow erment. In this model, empowerment has two central tenets, derived from the special needs of women who are pregnant and homeless: the "mother-child connection," and the principle of "giving back."
Measuring Community Competence in the Mississippi Delta: The Interface between Program Evaluation and Empowerment
Authors: Eng Eugenia , Parker Edith
Published: February 2007

If political dynamics are included in the definition of community, health promotion programs have a greater potential to recognize that assisting people to empower their communities is as important as assisting them to improve their health. This paper reports on the evaluation methods employed for a health promotion program in a rural poor county of the Mississippi Delta that chose to define community in this way. The evaluation took an action research approach so that the methods would not contradict or interfere with the program's empowerment agenda. The methods required a close and collaborative working relationship among evaluators and local service providers, community leaders, and program staff who defined and operationalized eight dimensions of community com petence, determined the units of analysis, and developed the data collection protocol. Emphasis was placed on using the data to engage the program and three communities in a dialogue on how to confront a system with the difficult issues they faced. The findings revealed that after 1 year of implementation, community competence moved from social interactions internal to communities to those more externally focused on mediating with outside institutions and officials. At the same time, measures of self-other awareness and conflict containment showed a decrease or virtual nonexistence.
Learner Developed Materials: An Empowering Product
Authors: Rudd Rima E. , Comings John P.
Published: February 2007

Freire used very specific materials in culture circles to support an empowering process that allowed learners to define the content and outcome of their own learning. However, the materials themselves were carefully crafted and developed by Freire and his co-workers. This article focuses on an extension of Freire's problem-posing educational methods to include participant involvement in the development and production of their own learning materials.
Health Promotion and the Discourse on Culture: Implications for Empowerment
Authors: Airhihenbuwa Collins O.
Published: February 2007

To invoke the primacy of culture in health education activities is not only to challenge approaches to health education that overlook or downplay this domain, but to also deepen and extend the possibilities of progressive approaches that focus on culture. Border pedagogy, which seeks to establish a countervoice to Eurocentrism and patriarchy, enhances and magnifies the possibilities that were opened up when critical pedagogy invoked the engagement of students in the production of knowledge. This process of engaging the teacher/interventionists and the students/audiences in the production of meaning, value, pleasure, and knowledge should be central to the mission of health education. It is only through such dialogue where varied cultural expressions are affirmed and centralized that the production of cultural identity can be legitimating and empowering relative to health promotion.