bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship between Organizational Characteristics and the Adoption of Workplace Smoking Policies
Authors: Emmons Karen M. , Thompson Beti , McLerran Dale , Sorensen Glorian , Linnan Laura , Basen-Engquist Karen , Biener Lois
Published: February 2007

Organizational-level variables that are hypothesized to influence the level of smoking pol icy restrictions and the prevalence of smoking control activities were tested in a sample of 114 worksites that participated in the Working Well Trial, a national trial of worksite health promotion. Predictors related to more restrictive policies included smaller size, larger percentage of white-collar workers, larger number of complaints about environmental tobacco smoke, less complexity, more formalization, and having a CEO who valued health and employees’ well-being. The number of smoking control activities offered in a worksite was predicted by having a larger blue-collar workforce, a higher percentage of female employees, higher levels of workforce stability, and a CEO who valued health and employees’ well-being. Efforts to identify predictors of companies’ adoption and implementation of workplace-based policies and interventions are an important part of tobacco control efforts and will enhance future intervention and research efforts.
Sex Workers’ Perspectives on Condom Use for Oral Sex with Clients: A Qualitative Study
Authors: Lian Wong Mee , Chan Roy , Wee Sharon
Published: February 2007

The authors conducted in-depth interviews with 46 female brothel-based sex workers to explore their perceived barriers and approaches in getting clients to use condoms for oral sex. Reasons given by sex workers for not using condoms for oral sex as compared to vaginal sex included self-perception of low vulnerability to AIDS and sexually transmitted infections, misconceptions on transmission of the HIV virus, lack of negotiation skills, lack of support from brothel keepers and peers, and unpleasant taste and smell of condoms. Some sex workers could get all their clients to use condoms for oral sex by using negotiation skills, including the positive approach, the fear approach, the emotional appeal approach, and the assertive approach. Findings from this study would help design more appropriate messages and improve negotiation skills of sex workers to increase consistent condom use for oral sex.
Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women
Authors: Wingood Gina M. , DiClemente Ralph J.
Published: February 2007

Developed by Robert Connell, the theory of gender and power is a social structural theory based on existing philosophical writings of sexual inequality and gender and power imbalance. According to the theory of gender and power, there are three major social structures that characterize the gendered relationships between men and women: the sexual division of labor, the sexual division of power, and the structure of cathexis. The aim of this article is to apply an extended version of the theory of gender and power to examine the exposures, social/behavioral risk factors, and biological properties that increase women’s vulnerability for acquiring HIV. Subsequently, the authors review several public health level HIV interventions aimed at reducing women’s HIV risk. Employing the theory of gender and power among women marshals new kinds of data, asks new and broader questions with regard to women and their risk of HIV, and, most important, creates new options for prevention.
Emergency Department Staff Responses to a Protocol of Care for Abused Women
Authors: Loughlin Sue , Spinola Carla , Stewart Liz , Fanslow Janet , Norton Robyn
Published: February 2007

While there is increasing recognition by health care providers of the need to identify and intervene in cases of partner abuse, there has been little evaluation of the interventions that have been implemented. This article documents emergency department staff responses to a five-step protocol of care on partner abuse implemented in a public hospital. It draws on in-depth interviews with a range of emergency department staff members, undertaken as part of the project’s process evaluation. Findings suggest protocol training provided staff members with an opportunity to gain a greater awareness and understanding of partner abuse. Protocol use improved and consolidated existing practices; however, staff members were concerned about screening all women for abuse and highlighted areas in which further support and resources are required. Taking these factors into account may assist the appropriate and effective introduction of such protocols in other health care settings.
Readiness to Change: Newspaper Coverage of Tobacco Farming and Diversification
Authors: Smith Mark H. , Altman David G. , Strunk Brad
Published: February 2007

Diversification, like tobacco use prevention and cessation, is an important public health concern. The multilevel patterns of tobacco dependency suggest the need for public health approaches to the “tobacco problem.” To understand how newspaper and wire service journalists cover issues involving diversification among tobacco farmers, the authors performed a content analysis of a subset of 100 articles on diversification and tobacco farming. Prochaska and DiClemente’s stages of change model was applied to the “problem behavior” of tobacco farming. Among news accounts relating to tobacco farmers or tobacco farming, print media accounts gave relatively little attention to the issue of diversification. Farmers in the sample of news accounts were generally cognizant of pressures to diversify away from reliance on tobacco cultivation but were frustrated due to obstacles to diversification such as limited diversification options and relative absence of infrastructure supports. Community leaders and policy-relevant sources generally supported diversification.
The Social and Cultural Context of Risk and Prevention: Food and Physical Activity in an Urban Aboriginal Community
Authors: Thompson Samantha J. , Gifford Sandra M. , Thorpe Lisa
Published: February 2007

One of the key public health challenges facing indigenous and other minority communities is how to develop and implement effective, acceptable, and sustainable strategies for the prevention of noninsulindependent diabetes mellitus (NIDDM). In this article, the authors describe how an ethnographic approach was used to contextualize the behavioral risk factors for NIDDM and applied to the development of a more meaningful and appropriate epidemiological risk factor survey instrument for an urban Aboriginal population in Australia. The overall research design comprised a mixture of qualitative and quantitative methods. The ethnographic study showed that the complex web of meanings that tie people to their family and community can and should be taken into account in any social epidemiology of health and illness if the findings are to have any effective and long-term potential to contribute to successful public health interventions targeting these behavioral risk factors.
Assessing Community Change at Multiple Levels: The Genesis of an Evaluation Framework for the California Healthy Cities Project
Authors: Kegler Michelle C. , Twiss Joan M. , Look Vivian
Published: February 2007

More than 40 cities have participated in the California Healthy Cities Project since its inception in 1988. Because Healthy Cities efforts are community driven, these cities address diverse health and social issues using a wide variety of strategies. This complexity, in addition to the usual difficulties associated with evaluating community interventions, creates many challenges for evaluation. Given the community building and process orientation of Healthy Cities, it may be most appropriate to measure intermediate community changes that have been linked to health outcomes in previous research or, at a minimum, theoretically. The California Healthy Cities evaluation framework conceptualizes change at five levels: individual, civic participation, organizational, interorganizational, and community. The framework, developed collaboratively with Healthy Cities participants, attempts to synthesize current thinking and practice on evaluation of community projects by applying concepts from community capacity/competence, social ecology, and urban planning.
Guarding against Threatening HIV Prevention Messages: An Information-Processing Model
Authors: Blumberg Stephen J.
Published: February 2007

Previous research has suggested that fear-provoking HIV prevention messages can lead to defensive coping strategies among sexually active students who encounter such messages. An information-processing model of defensive responses is proposed that identifies and operationally defines four mediating processes—attention avoidance, blunting, suppression, and counterargumentation—that may lead to the rejection or denial of threatening health messages. Attention avoidance occurs when people indiscriminately avoid all messages; blunting is the use of distraction to avoid only threatening information in the message. Suppression occurs when people try to stop thinking about the information and avoid forming inferences about its self-relevance; counterargumentation is the biased assessment that follows comprehension and arises along with self-relevant elaboration. Situational influences on people’s choice of defensive coping strategy are considered, and implications for researchers and practitioners are discussed.
Factors Associated with Army Obstetricians-Gynecologists’ Practice of HIV Prevention Education during Routine Gynecologic Care
Authors: Goldschmidt Michele H. , Jenkins Richard A.
Published: February 2007

The authors evaluate obstetricians-gynecologists’ (OB-GYNs’) anxiety about clinical uncertainty and patient, physician, and organizational factors associated with their selection of HIV-related educational activities for high-risk and low-risk written case simulations. A total of 117 U.S. Army OB-GYNs completed a mailed, anonymous questionnaire. Overall, informants were much less likely to educate in response to the low-risk simulation; however, more informants who were anxious about uncertainty were more likely to do so in a model that included supportive institutional policies, willingness to educate despite patient barriers, and comfort with the topic. OB-GYNs were more likely to educate in response to the high-risk simulation given greater willingness to discuss HIV despite organizational barriers, supportive policies, and comfort. Findings suggest a need to better understand the role that anxiety about uncertainty plays in HIV prevention and the need to promote organizational policies that support and remove barriers to clinically based education.
Sources Influencing Patients in Their HIV Medication Decisions
Authors: Meredith Karen L. , Jeffe Donna B. , Mundy Linda M. , Fraser Victoria J.
Published: February 2007

The authors surveyed 202 patients (54.5% male; 62.4% African American) enrolled at St. Louis HIV clinics to identify the importance of various sources of influence in their HIV medication decisions. Physicians were the most important source for 122 (60.4%) respondents, whereas prayer was most important for 24 respondents (11.9%). In multivariate tests controlling for CD4 counts, Caucasian men were more likely than Caucasian women and African Americans of both genders to select a physician as the most important source. African Americans were more likely than Caucasians to mention prayer as the most important source. Caucasians and those rating physicians as the most important source were more likely to be using antiretroviral medications. Respondents identified multiple important influences—hence the potential for conflicting messages about HIV medications. These findings have implications for health education practices and behavioral research in the medical setting.
Hispanic Cultural Norms for Health-Seeking Behaviors in the Face of Symptoms
Authors: Larkey Linda Kathryn , Hecht Michael L. , Miller Katherine , Alatorre Carlos
Published: February 2007

This study examines factors that contribute to the delayed use of medical care among Hispanics when chronic disease–related symptoms (warning signs) occur. As an adjunct to a larger project funded by the National Cancer Institute, this study accessed a population of primarily Hispanic, mostly male employees at public work sites in two Arizona counties. Through focus groups and a survey of employees, a model describing the factors underlying health care use was tested. Seriousness of symptoms has the most effect on visits to doctor, with more serious symptoms leading to prompter visits. Faith in God and seriousness of symptoms both are related to the search for a doctor one can trust. Also, a cluster of variables describing past bad experiences, practical barriers, and emotional avoidance are related to the desire to get advice or medical help from someone who is close; these influence the search for a trusted doctor, which in turn leads to prompter visits to doctor.
Peer and Parent Influences on Smoking and Drinking among Early Adolescents
Authors: Simons-Morton Bruce , Haynie Denise L. , Crump Aria D. , Eitel Patricia , Saylor Keith E.
Published: February 2007

Social influences can promote or discourage adolescent substance use. The authors surveyed 4,263 sixth- to eighth-grade students to assess the effect of peer and parent influences on adolescent substance use. The authors conducted separate multiple logistic regression analyses for smoking and drinking, controlling for grade, sex, and race. Positive independent associations with smoking and drinking were found for direct peer pressure and associating with problem-behaving friends. Independent negative associations with smoking and drinking were also found for parent involvement, parent expectations, and parent regard. In an analysis of interactions, peer pressure was positively associated with drinking for girls but not for boys and problem-behaving friends was positively associated with drinking for both boys and girls. The findings are consistent with the hypothesis that associating with deviant peers promotes and that authoritative parenting protects against smoking and drinking.
Researcher and Researched-Community Perspectives: Toward Bridging the Gap
Authors: Sullivan Marianne , Kone Ahoua , Senturia Kirsten D. , Chrisman Noel J. , Ciske Sandra J. , Krieger James W.
Published: February 2007

In the process of initiating a new community-based research project, the authors wanted to understand the experiences of community members and researchers in community-based research projects and to develop guidelines to improve future projects. They conducted qualitative, key informant interviews with 41 people involved at all levels of community-based research projects in Seattle. Respondents were identified using a snowball sampling technique. More problems than successes were discussed by informants, including dissatisfaction with the focus of research, which some said is marked by a lack of cultural appropriateness and relevance. Power imbalances, lack of trust, and communication difficulties impeded collaboration. According to respondents, many problems could be avoided if the community were involved from the beginning in setting research priorities and developing and implementing interventions. Meaningful collaboration between communities and researchers is characterized by early involvement of communities, power sharing, mutual respect, community benefit, and cultural sensitivity.
Schoolwide Effects of a Multicomponent HIV, STD, and Pregnancy Prevention Program for High School Students
Authors: Basen-Engquist Karen , Coyle Karin K. , Parcel Guy S. , Kirby Douglas , Banspach Stephen W. , Carvajal Scott C. , Baumler Elizabeth
Published: February 2007

Few studies have tested schoolwide interventions to reduce sexual risk behavior, and none have demonstrated significant schoolwide effects. This study evaluates the schoolwide effects of Safer Choices, a multicomponent, behavioral theory–based HIV, STD, and pregnancy prevention program, on risk behavior, school climate, and psychosocial variables. Twenty urban high schools were randomized, and cross-sectional samples of classes were surveyed at baseline, the end of intervention (19 months after baseline), and 31 months after baseline. At 19 months, the program had a positive effect on the frequency of sex without a condom. At 31 months, students in Safer Choices schools reported having sexual intercourse without a condom with fewer partners. The program positively affected psychosocial variables and school climate for HIV/STD and pregnancy prevention. The program did not influence the prevalence of recent sexual intercourse. Schoolwide changes in condom use demonstrated that a school-based program can reduce the sexual risk behavior of adolescents.
Privatization of Local Health Department Services: Effects on the Practice of Health Education
Authors: Bibeau Daniel L. , Lovelace Kay A. , Stephenson Jennifer
Published: February 2007

Local health departments (LHDs) are changing service delivery mechanisms to accommodate changes in health care financing and decreased public support for governmental services. This study examined the extent to which North Carolina LHDs privatized and contracted out services and the effects on the time spent on core functions of public health and activities of health educators. Questionnaires were mailed to the senior health educators in all LHDs. Sixty-nine responded, and 68% of LHDs had not privatized any services other than laboratory and home health. Clinical services were more commonly privatized than nonclinical services. Respondents perceived that privatization produces more time for LHDs to address the core public health functions and for health educators to engage in appropriate professional activities. Health educators in LHDs that had not privatized were more likely to be concerned about potential negative effects. This study suggests that privatization has generally had a positive effect on the roles of health educators in North Carolina LHDs.
Tobacco Control Advocacy in Australia: Reflections on 30 Years of Progress
Authors: Chapman Simon , Wakefield Melanie
Published: February 2007

Australia has one of the world’s most successful records on tobacco control. The role of public health advocacy in securing public and political support for tobacco control legislation and policy and program support is widely acknowledged and enshrined in World Health Organization policy documents yet is seldom the subject of analysis in the public health policy research literature. Australian public health advocates tend to not work in settings where evaluation and systematic planning are valued. However, their day-to-day strategies reveal considerable method and grounding in framing theory. The nature of media advocacy is explored, with differences between the conceptualization of routine “programmatic” public health interventions and the modus operandi of media advocacy highlighted. Two case studies on securing smoke-free indoor air and banning all tobacco advertising are used to illustrate advocacy strategies that have been used in Australia. Finally, the argument that advocacy should emanate from communities and be driven by them is considered.
Increasing the Practice of Health Promotion Initiatives by Licensed Premises
Authors: Wiggers John , Considine Robyn , Hazell Trevor , Haile Melanie , Rees Maria , Daly Justine
Published: February 2007

Licensees of all licensed premises in the Hunter Region of New South Wales, Australia, were offered free services to encourage adoption of health promotion initiatives relating to responsible service of alcohol, environmental tobacco smoke, healthy food choices, breast and cervical cancer prevention, and the prevention of HIV/AIDS. A total of 239 premises participated in the follow-up survey. Increases in prevalence ranged between 11% and 59% for alcohol-related initiatives. The prevalence of smoke-free areas and healthy food choices increased from 32% to 65% and 42% to 96%, respectively, and the provision of cancer prevention information increased from 3% to 59%. Licensed premises represent a particularly challenging sector for health promotion practitioners to work in. The results of this study suggest that the adoption of health promotion initiatives by licensed premises can be increased. A considerable opportunity therefore exists for health promotion practitioners to become more actively involved in facilitating the adoption of such initiatives in this setting.
Creating Smoke-Free Environments in Recreational Settings
Authors: Giles-Corti Billie , Clarkson Johanna P. , Donovan Robert J. , Frizzell Shirley K. , Carroll Addy M. , Pikora Terri , Jalleh Geoffrey
Published: February 2007

To facilitate the banning of tobacco industry sponsorship, Australian health promotion foundations were established to provide health sponsorship to sport, arts, and racing organizations. Health sponsorship dollars procure health sponsorship benefits such as naming rights, signage, personal endorsement of a (health) product by a performer or player, and structural controls such as smoke-free policies. Data are presented from surveys and observations of spectators attending events sponsored by the West Australian Health Promotion Foundation (Healthway) and surveys of Healthway-sponsored organizations and the community. The results demonstrate that by using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies. There was evidence of good compliance with smoke-free policies, thus reducing exposure to environmental tobacco smoke. The introduction of smoke-free policies in recreational settings has involved working collaboratively with sectors outside of health, taking an incremental approach to change, and gaining the support of stakeholders by communicating evaluation results.
Advancing Health Promotion in Australian General Practice
Authors: Raupach Jane , Rogers Wendy , Magarey Anne , Lyons Graham , Kalucy Libby
Published: February 2007

Health promotion activities, while having the potential to prevent disease and decrease the burden of ill health, often play a minor role in the health care offered by general practitioners. There are several identified barriers to the involvement of Australian general practitioners in health promotion. These include structural barriers and barriers within the practice setting, individual practitioner and patient factors, and difficulties in evaluating the outcomes of health promotion activities. This article explores the barriers to the engagement of Australian general practice with health promotion and reviews several recent initiatives that have the potential to increase the health promotion activities of general practitioners. These initiatives act at the level of the individual practitioner, the practice, and in the community. Despite the lack of a coordinated national approach, these strategies form an important development in general practice.
Building Capacity for System-Level Change in Schools: Lessons from the Gatehouse Project
Authors: Bond Lyndal , Glover Sara , Godfrey C. , Butler Helen , Patton George C.
Published: February 2007

The Gatehouse Project is an innovative, comprehensive approach to mental health promotion in secondary schools. It sets out to promote student engagement and school connectedness as the way to improve emotional well-being and learning outcomes. The key elements of the whole-school intervention are the establishment and support of a school-based adolescent health team; the identification of risk and protective factors in each school’s social and leaning environment from student surveys; and, through the use of these data, the identification and implementation of effective strategies to address these issues. The project evaluation used a cluster-randomized controlled trial design involving 26 schools with initial results demonstrating considerable success in reducing smoking rates among Year 8 children. This article describes and accounts for how system-level changes have been made in schools through a process of capacity building. This encourages teachers, parents, and students to view the core business of education differently.
Managing Healthy Eating: Definitions, Classifications, and Strategies
Authors: Falk Laura Winter , Sobal Jeffery , Bisogni Carole A. , Connors Margaret , Devine Carol M.
Published: February 2007

This study sought to enhance understanding of how people conceptualize and manage healthy eating. An interpretivist approach employed the constant comparative method to analyze 79 open-ended interviews with individuals about food choices and eating behaviors for health-related themes. Participant reports depicted cognitive systems for defining healthy eating, where personal meanings evolved through ongoing exposure to a variety of experiential and informational sources. Participants’ definitions of healthy eating clustered around seven themes for relating food and eating to their personal health. Healthy eating definitions shaped how participants categorized food and eating situations as healthy and unhealthy. Participants described healthy eating strategies that were differentially associated with various healthy eating themes. These findings provide an emic perspective of how a diverse sample of adults conceptualize and manage healthy eating. Exposing the implicit and multiplistic nature of healthy eating conceptions provides information useful to health educators promoting behavior changes.
A Critical Examination of Community-Based Responses to Household Food Insecurity in Canada
Authors: Tarasuk Valerie
Published: February 2007

Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the “First World.” In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and communitybased nature of the initiatives, and their origins in publicly funded health and social service sectors.
Intraclass Correlation for Measures from a Middle School Nutrition Intervention Study: Estimates, Correlates, and Applications
Authors: Murray David M. , Phillips Glenn A. , Birnbaum Amanda S. , Lytle Leslie A.
Published: February 2007

This article presents the first estimates of school-level intraclass correlation for dietary measures based on data from the Teens Eating for Energy and Nutrition at School study. This study involves 3,878 seventh graders from 16 middle schools from Minneapolis–St. Paul, Minnesota. The sample was 66.8% White, 11.2% Black, and 7.0% Asian; 48.8% of the sample was female. Typical fruit and vegetable intake was assessed with a modified version of the Behavior Risk Factor Surveillance System questionnaire. Twenty-four-hour dietary recalls were conducted by nutritionists using the Minnesota Nutrition Data System. Mixed-model regression methods were used to estimate variance components for school and residual error, both before and after adjustment for demographic factors. School-level intraclass correlations were large enough, if ignored, to substantially inflate the Type I error rate in an analysis of treatment effects. The authors show how to use the estimates to determine sample size requirements for future studies.
Reconciling Concept and Context: The Dilemma of Implementation in School-Based Health Promotion
Authors: MacDonald Marjorie A. , Green Lawrence W.
Published: February 2007

The researchers used grounded theory methodology to study the implementation of a school-based alcohol and drug prevention project in secondary schools in British Columbia, Canada. Preventionworkers (PWs) were responsible for working with school and community personnel in a collaborative process to develop, implement, and evaluate prevention strategies in the school using an adaptation of the Precede-Proceed Model for health promotion planning. Before they could begin to do this, PWs had to establish their credibility in the school. Once accepted, the focus of the PWs’workwas to reconcile the goals, values, and philosophy of the project with those of the school. In doing so, PWs encountered many practical dilemmas. The challenges in resolving these dilemmas are presented, and the implications for policy and practice are discussed.
A Model of Self-Regulation for Control of Chronic Disease
Authors: Clark Noreen M. , Gong Molly , Kaciroti Niko
Published: February 2007

Chronic disease poses increasing threat to individual and community health. The day-to-day manager of disease is the patient who undertakes actions with the guidance of a clinician. The ability of the patient to control the illness through an effective therapeutic plan is significantly influenced by social and behavioral factors. This article presents a model of patient management of chronic disease that accounts for intrapersonal and external influences on management and emphasizes the central role of self-regulatory processes in disease control. Asthma serves as a case for exploration of the model. Findings from a 5-year study of 637 children with asthma and their care-taking parents supported that the self-regulation elements of the model were reasonably stable over time and baseline values were predictive of important disease management outcomes.
Improving Attendance in Weight-Control Programs
Authors: Mullen Patricia D. , Culjat Dorothy
Published: February 2007

This field study evaluated the use of a food diary as a screen ing device for admission to a behaviorally oriented weight-reduction pro gram for its effectiveness in improving attendance. All study participants were required (1) to attend an orientation meeting where the program was described and questions were solicited and(2) to pay a $25, nonrefundable fee. During the orientation experimental-group attendees were told that a 2-week food diary was a requirement for admission to the series. It was ex pected the experimental requirement would decrease the number of less motivated enrollees, thereby reducing early termination and improving at tendance. Keeping the record was in itself expected to modify eating behavior. This would have the effect of adding 2 weeks to the program and, therefore, weight loss at the end of the program was expected to be greater. In general, the hypotheses were confirmed. A smaller proportion of those who had the food-diary requirement enrolled. A significantly larger propor tion of experimental-group women enrollees attended at least three-quarters of the sessions. The attendance records of control-group and experimental- group men were not significantly different. Mean weight loss at the end of the program was greater for those enrolled under the experimental condi tion. Achievement of a weight loss of at least 8 pounds was found to be positively related to attendance.
Society for Public Health Education: Survey of Membership
Authors: Patton Robert D. , Durel Lynn A. , McMahan Elizabeth L. , Murphy Earl P. , Wilson Cindy C.
Published: February 2007

The Society for Public Health Education, Inc. (SOPHE), through the Research and Evaluation Committee (REC) of the Tennessee chapter has surveyed its membership to determine characteristics of members, members' opinions of the organization and the benefits derived, usefulness of SOPHE publications, and the most important health educa tion issues and goals. Survey results provide an employment profile of the membership, and indicate the membership benefits which are most valued; they also suggest that the organization's goals and its activities be expanded in scope to include, in addition to other areas, greater attention to health education practice, to planning legislation, to funding, and to cooperation with the American Public Health Association in the general promotion of health education. REC presents recommendations based on these findings.
Channeling Health: A Review of the Evaluation of Televised Health Campaigns
Authors: Lau Richard , Kane Robert , Berry Sandra , Ware John , Roy Douglas
Published: February 2007

This article reviews efforts to assess the effectiveness of television programs on changing health behaviors. The relatively limited literature to date has featured primarily correlational studies which permit ted no causal conclusions. The few experimental studies available present a mixed picture. Numerous methodologic problems beset any effort at assess ment of effectiveness. Perhaps the greatest difficulty is operationalizing a design that permits true experimental manipulation on a relevant sample without contamination. The several methodologic problems and some potential means of surmounting them are discussed.
Nutrition-Education Research: An Interdisciplinary Evaluation and Review
Authors: Levy Susan R. , Iverson Barbara K. , Walberg Herbert J.
Published: February 2007

An interdisciplinary evaluation approach was developed to analyze and compare school nutrition education programs systematically. Theore tical models from education, preventive medicine, health education and statistical evaluation were applied to 22 studies published between 1968 and 1978 to judge program impact on nutrition knowledge, behavior, and attitudes. Six studies reported XS and SDs for control and experimental groups. Effect sizes, showing average treatment effect in standard devia tion units, were calculated for those six studies. It can be concluded that the more interdisciplinary criteria a study fulfills, the more likely it is to in fluence knowledge, behavior, and attitudes.
Mass Media in Health Promotion: An Analysis Using an Extended Information-Processing Model
Authors: Flay Brian R. , DiTecco Don , Schlegel Ronald P.
Published: February 2007

The information-processing model of the attitude and behavior change process was critically examined and extended from six to 12 levels for a better analysis of change due to mass media campaigns. Findings from social psychology and communications research, and from evaluations of mass media health promotion programs, were reviewed to determine how source, message, channel, receiver, and destination variables affect each of the levels of change of major interest (knowledge, beliefs, attitudes, intentions and behavior). Factors found to most likely induce permanent attitude and behavior change (most important in health promotion) were: presentation and repetition over long time periods, via multiple sources, at different times (including "prime" or high-exposure times), by multiple sources, in novel and involving ways, with appeals to multiple motives, development of social support, and provisions of appropriate behavioral skills, alternatives, and reinforcement (preferably in ways that get the active participation of the audience). Suggestions for evaluation of mass media programs that take account of this complexity were advanced.
Dimensions of Children's Health Beliefs
Authors: Dielman T.E. , Leech Sharon L. , Becker Marshall H. , Rosenstock Irwin M. , Horvath William J. , Radius Susan M.
Published: February 2007

Health beliefs interviews were conducted with 250 children aged 6-17 years. A factor analysis of the items resulted in six correlated fac tors which were interpreted as 1) specific health concerns, 2)general health concerns, 3) perceived parental concern, 4) perceived general susceptibility, 5) perceived susceptibility to specific conditions, and 6) perceived seriousness of and susceptibility to disease. Factor scores were computed and two-way analyses of variance (by age and sex of child) were conducted on six sets of factor scores. No significant sex differences or sex by age in teraction effects were noted. Younger children scored significantly higher on "specific health concerns"and "perceived general susceptibility,"while older children scored significantly higher on "perceived parental concern. " Tests of differences among variances showed a tendency for the variability to be greater among younger children. The results are interpreted as pro viding partial support for a model of children's health beliefs and as a basis for further operationalization of concepts which are central to an understand ing of motivated health behavior. Implications for practice are discussed.
Planning the Educational Component of a Hypertension Control Program: A Case Study
Authors: Cleary Helen P. , Kornacki Mary Jane , Grancio Susan
Published: February 2007

The failure to plan the health education component of a health service program together with the total planning effort has severely limited the contribution education could make to program goals. This case study illustrates the use of the systematic observation of behavior to identify factors which facilitated or hindered the development of a hyper tension control program in ambulatory facilities and boards of health. The relationship of these factors to the planning process is discussed. Al though this project deals with hypertension, the factors identified as facili tating or hindering change are applicable to any public health program.
Factors Influencing Successful Preventive Health Education
Authors: Ross Caroline K.
Published: February 2007

This paper examines factors which may influence successful preventive health education for all persons and especially poor persons. The discussion is organized within a tramework which includes cognitive factors, affective factors and skills. Types of health information and methods for information dissemination are discussed within the cognitive area. The discussion of emotional responses to preventive care examines organizational and individual factors which may be related to utilization. Finally, specific skills which enable an individual to utilize services are defined. Within each section a general presentation is followed by a discussion of implications for poor populations.
A Test of Interventions to Increase Adherence to Hypertensive Medical Regimens
Authors: Kirscht John P. , Kirscht Jennifer L. , Rosenstock Irwin M.
Published: February 2007

Low rates of adherence to hypertensive therapy limit patients' securing the full benefits of treatment. While some factors related to adherence have been identified, research on the effectiveness of interventions to increase adherence levels is sparse. The present study was designed to assess the impact of a series of different interventions on a group of some 400 patients, all under the care of private physicians in a small community. A factorial design was employed to deliver four, sequential educational interventions, about four months apart, to randomly selected sub-groups. Interviews before and after each intervention provided information concerning self-reported adherence, health status, health beliefs, and personal characteristics. Pertinent medical records and pharmacy data were also obtained. The first intervention—printed material—did not significantly affect adherence. The second and fourth interventions—nurse telephone calls and social support—each increased medication taking and the third intervention—self-monitoring—led to better weight control. There was no cumulative impact of the interventions and different aspects of regimens were not signiticantly related to one another.
Survey Findings of Health Education In Health Maintenance Organizations
Authors: Reilly Joseph J. , Sorensen Andrew A. , Saward Ernest W.
Published: February 2007

A questionnaire was mailed to all HMOs which were either federally qualified or applying for federal qualification, as of May 1978. The survey, which attained a 77% response rate, collected information on the frequency, providers, methods and health problem areas of health edu cation programs in HMOs as well as other health education information. Survey findings show that certain program areas such as nutrition educa tion and weight reduction programs have received greater emphasis than other patient education areas. Certain organizational factors are shown to be useful in describing differences in plans' commitments to health educations. Recommendations are made for further research to identify clearer relationships between health education and other HMO character istics. HMOs are recommended to assess the health education needs of their memberships and to educate staff regarding their own health risks, health education skills and member expectations and rights.
More Effective Living: A Partnership Approach to Health Education Programming
Authors: Di Berto Sarah Nasser
Published: February 2007

In September, 1974, the Kaiser-Permanente Medical Center in Santa Clara, California, and the West Valley Community College District entered into cooperative planning for delivery of consumer health education. Two months later, the first five classes commenced with a total enrollment of 53 persons, all of whom were HMO members. Seven years later, this joining HMO-community college health education program entitled More Effective Living (MEL) contains over 50 different classs titles, is offered cooperatively by two Kaiser-Permanente facilities and three locally-based community colleges, is scheduled in three academic semester time periods spanning 12 months and, is expected to serve an estimated 760 HMO members and community residents in the Spring 1981 semester. Although this paper addresses the HMO-community college partnership primarily from an administrative perspective, some background information is given to explain the basic concepts of the program design. For health educators, particularly those working in medical care, partnership with a community organization can be an effective way to deliver health education to a target population at minimal cost.
Health Education Needs Assessment in an HMO: A Case Study
Authors: Howard Donna M.
Published: February 2007

Potential health education services for HMO subscribers are numerous and varied, ranging across the entire wellness to sickness spectrum. Because of cost consciousness and limited educational resources, careful needs assessment and selection of priorities are vital to the success of HMO health education efforts. The results of utilizing six needs assessment methodologies are presented in this case study. Consumer and provider involvement in the needs assessment process revealed five top priority health problems or opportunities for health education: membership education needs; overweight/obesity; self-care needs; hypertension; and smoking. These recommendations did not include perinatal and pediatric health education services as top priority needs, an outcome at variance with the results of the other needs assessment methodologies. This variance emphasizes the importance of employing multiple techniques in the needs assessment process. Problems in implementing various needs assessment methodologies are discussed as well as implications for health education practice.
Closing the Gap in Quality Assurance: A Tool for Evaluating Group Leaders
Authors: Miller Judith R. , Lewis Frances M.
Published: February 2007

A commitment to quality assurance means offering a cycle of feedback to those being evaluated. How to meet that commitment was the question asked by the Health Education Department of a large Health Maintenance Organization whose more than 70 facilitators annually provide instruction for over 3,000 enrollees. As part of the multi-faceted endeavor to develop a systematic quality assurance program for the department's offerings, a reliable participant-scored standardized tool had to be constructed. The staff of the department first identified two concepts as critical for quality instruction: interpersonal skills and technical competence. Based on these criteria a 49-item questionnaire was developed and tested during "pre-pilot" and pilot stages. By computer analysis, 27 items with an alpha-reliability coefficient of .94 remained to form the tool the department uses. The development of the evaluation tool and its use are described.
Preschool Health Education Program (PHEP): an Analysis of Baseline Data
Authors: Bruhn John G. , Parcel Guy S.
Published: February 2007

As part of the initial stage of a project to develop and field test a health education curriculum for preschool children, baseline data were collected for use in evaluating the impact of the curriculum as well as to determine the relationship of parental health variables and the devel opment of children's health behavior. Mothers of 202 children, 2, 3 and 4 years of age were interviewed to determine if parental health variables were related to their children's reported practice of health and safety behaviors. The analysis showed no relationship between health related background variables, mothers' health behavior, health locus control, value placed on health and the children's practice of health and safety behavior. There was no evidence to support a parental modeling effect for children's health behavior for the subjects participating in this study. The mothers will be interviewed yearly for three more years to observe changes over time and to determine the impact of the health education intervention.
Perceived Vulnerability in Children and Adolescents
Authors: Gochman David S. , Saucier Jean-Francois
Published: February 2007

University of Montreal
Parental and Child Health Beliefs and Behavior
Authors: Dielman T.E. , Leech Sharon , Becker Marshall H. , Rosenstock Irwin M. , Horvath W.J. , Radius Susan M.
Published: February 2007

Personal interviews concerning health beliefs and behav iors were conducted with a parent and child in each of 250 households. Index scores were constructed for parental and child health beliefs, and these scores were entered, along with demographic variables, in a series of multiple regression analyses predicting child health beliefs and behaviors. The age of the child was the variable most highly associated with three of four child health behaviors and four of six child health beliefs. The children's snacking between meals and cigarette smoking were related to several parental behaviors and, to a lesser extent, parental health beliefs. The children's health beliefs were less predictable than were their health behaviors, and the observed significant relationships were with parental health beliefs and demographics. The implications for the design of health education programs are discussed.
Adolescents' Health Beliefs and Acceptance of a Novel Preventive Dental Activity: Replication and Extension
Authors: Kegeles S. Stephen , Lund Adrian K.
Published: February 2007

The Health Belief Model is currently receiving substantial attention in the field of health education, not only because the Model attempts to explain health behavior but also because it specifies variables which are presumed to be modifiable. This article presents data from an adolescent population which contradict both of these assumptions. In addition, the data suggest that compliance with new preventive dental activities seems to be higher for children who have practiced similar activities before, with some minimal but not high level of parental involvement. However, in general, both health beliefs and acceptance of new activity were relatively unrelated to prior dental experiences and behavior among these children.