bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Depression After Stroke
Authors: Hackett Maree L. , Anderson Craig S. , House Allan O.
Published: April 2005

Background and Purpose—

Although depression may affect recovery and outcome after stroke, it is often overlooked or inadequately managed, and there is uncertainty regarding the benefits of antidepressant therapy in this setting. We aimed to assess the effectiveness of antidepressants for the treatment and prevention of depression after stroke.

Methods—

We undertook a systematic review using Cochrane methods of randomized placebo-controlled trials of antidepressants for the treatment or prevention of depressive illness and “abnormal mood” after stroke. Treatment effects on physical and other outcomes were also examined.

Results—

Outcome data were available for 7 treatment trials including 615 patients and 9 prevention trials including 479 patients. Because of the considerable variation in research design, trial quality, and method of reporting across studies, we did not pool all the outcome data. In the treatment trials, antidepressants reduced mood symptoms but had no clear effect on producing a remission of diagnosable depressive illness. There was no definitive evidence that antidepressants prevent depression or improve recovery after stroke.

Conclusions—

There is insufficient randomized evidence to support the routine use of antidepressants for the prevention of depression or to improve recovery from stroke. Although antidepressants may improve mood in stroke patients with depression, it is unclear how clinically significant such modest effects are in patients other than those with major depression. There is a pressing need for further research to better define the role of antidepressants in stroke management.
Intra-Arterial Thrombolytic Therapy in Peri-Coronary Angiography Ischemic Stroke
Authors: Zaidat Osama O. , Slivka Andy P. , Mohammad Yousef , Graffagnino Carmelo , Smith Tony P. , Enterline David S. , Christoforidis Greg A. , Alexander Michael J. , Landis Dennis M.D. , Suarez Jose I.
Published: April 2005

Background—

Intra-arterial thrombolysis (IAT) for peri-coronary angiography (CA) stroke may be safe and efficacious. However, IAT may increase the risk of intracranial hemorrhage (ICH).

Methods—

A retrospective study was performed involving 3 university hospitals. All peri-CA IAT-treated cases were identified. Patient demographics, stroke severity, angiographic findings, thrombolytic use, modified Rankin Scale (mRS), ICH, and mortality were determined.

Results—

A total of 21 patients with post–left CA stroke were treated with IAT (mean age 71.8±12.3 years). Arterial occlusion was found in 14 (66.7%) and 7 (33.3%) of the anterior and posterior circulation, respectively. Mean time-to-therapy was 36±12 minutes from the time the neurological deficit was noted. mRS ≤2 occurred in 10 of 21 (48%) patients. Patients with younger age and shorter time-to-IAT had more complete arterial recanalization and clinical recovery. Symptomatic ICH occurred in 3 (14%) cases, and 4 (19%) patients died.

Conclusions—

Peri-CA IAT appears to be feasible and safe without increased risk of symptomatic ICH and death when compared with the previously reported IAT literature.
Differential Diagnosis of Stroke in a Setting of High HIV Prevalence in Blantyre, Malawi
Authors: Kumwenda J.J. , Mateyu G. , Kampondeni S. , van Dam A.P. , van Lieshout L. , Zijlstra E.E.
Published: April 2005

Background and Purpose—

The differential diagnosis of stroke in Africa in areas with high HIV prevalence includes brain infections. We studied causes of stroke in Blantyre, Malawi, where HIV prevalence among medical inpatients is 70%.

Methods—

In a descriptive study of 8-month duration, all patients presenting at Queen Elizabeth Central Hospital, Blantyre, with central neurological deficit of acute onset (<24 hours) had baseline investigations, including full blood count, blood glucose, serology for toxoplasmosis, syphilis, and HIV, ECG, echocardiogram, ultrasound of the carotid arteries, and computerized tomography scan of the brain. A lumbar puncture was performed unless contraindicated.

Results—

Ninety-eight consecutive patients (49 males) were studied. In those who were HIV positive (48%), the mean age was 37.5 years; ischemic stroke was the commonest diagnosis (n=25; 58%), followed by infection (n=11; 23%; including tuberculous [n=4] and cryptococcal [n=2] meningitis; toxoplasmic encephalitis [n=1]; neurocysticercosis [n=1]; brain abscess [n=1]; and progressive multifocal leucoencephalopathy [n=2]). No clinical or laboratory parameters could be identified as predictors for infection, but 3 of 5 patients with fever on admission had tuberculous meningitis. In HIV-negative patients (mean age 58.6 years), 55% had ischemic stroke and 31% had intracerebral hemorrhage; no brain infection was diagnosed. Presence of vascular disease correlated with age but not with HIV status.

Conclusions—

Ischemic stroke was found in half of patients irrespective of HIV status. In those who are HIV positive, brain infection should be considered for which the presence of fever and examination of cerebrospinal fluid seem most useful in diagnosis.
Assessment of Dural Arteriovenous Fistulae by Transcranial Color-Coded Duplex Sonography
Authors: Harrer Judith U. , Popescu Octavian , Henkes Hans H. , Klötzsch Christof
Published: April 2005

Background and Purpose—

To study hemodynamic changes and to determine the value of contrast-enhanced transcranial color-coded sonography (TCCS) for the evaluation of dural arteriovenous fistulae (DAVF) before and after transcatheter embolization.

Methods—

Twenty-four patients (mean age 61±11 years) with occipitally located DAVF were studied with contrast-enhanced TCCS using the transtemporal bone window in transverse-axial and coronal insonation planes. Blood flow velocity measurements of all depictable basal cerebral veins and sinuses were obtained before and after transcatheter embolization. Pretreatment and post-treatment flow velocity values were compared. Results of digital subtraction angiography (DSA) were compared with sonographic findings.

Results—

Four of the 24 patients (17%) could not be studied because of an insufficient temporal bone window. In all remaining patients (n=20), draining veins/sinuses could be identified because of pathologically increased blood flow velocities with peak systolic flow velocities of >50 cm/s. Of the 27 draining vessels depicted by DSA, TCCS correctly identified 25 (93%): the basal vein (3 of 3), the straight sinus (3 of 3), the superior sagittal sinus (1 of 3), the transverse sinus (9), the sigmoid sinus (4), and the superior petrosal sinus (5/5). However, TCCS failed to depict supplementary drainage via cortical veins. After transcatheter embolization, mean reduction of blood flow velocity was 44±18% (
P
<0.01) compared with pretreatment values.

Conclusions—

Contrast-enhanced TCCS is a promising technique for monitoring embolization of DAVF, follow-up after complete fistula occlusion, and may even be useful as a screening tool in patients with pulsatile tinnitus.
The Future of Adult Education in the Urban African American Church
Authors: Isaac E. Paulette
Published: April 2005

Throughout societal transformations and trends, adult education has been available, providing relevant and personal learning needs for adult learners. Such has been the case in urban communities. However, our urban communities have experienced a transformation of sorts. Once thriving with numerous businesses and churches, they no longer enjoy the advantages they once had. Despite transitions in urban centers, the African American church has remained a stronghold. Historically, the church has provided education in some form. In the face of continuous decay of some urban communities, it appears the church’s future adult educational role will not only continue but be enhanced for several reasons.
Teachers, Local Knowledge, and Policy Implementation
Authors: Smit Brigitte
Published: April 2005

How can teachers’ understandings of policy as local knowledge inform policy implementation in schools? This article investigates policy understanding and implementation in urban primary schools and locates the inquiry in the transitional South African context. The author illustrates teachers’ understandings of policy in times of transition and shows how such local knowledge affects policy implementation. She argues that although teachers play an important role in our education system, more often than not, they are a silent voice during policy formulation, which implies that local knowledge might be underplayed, discounted, or simply ignored. She discusses the contextual background and how qualitative inquiry can shape and inform policy implementation. The article presents a conceptual framework for policy implementation and thrashes out what policy may learn from teachers at the microlevels, that is, local knowledge. The author discusses the empirical data and the understandings of teachers of policy and concludes with a few implications for policy implementation.
Parent and Peer Attachment in Late Childhood and Early Adolescence
Authors: Nickerson Amanda B. , Nagle Richard J.
Published: April 2005

This study investigated child and early adolescent relationships with parents and peers within the theoretical framework of attachment. A cross-sectional sample of 279 fourth, sixth, and eighth graders completed two self-report measures assessing attachment to parents and friends. Fourth graders described more trusting and communicative relationships with parents than sixth or eighth graders. Older early adolescents turned to peers to fulfill attachment functions of proximity seeking and safe haven more often than children, although all participants reported that parents primarily served secure base functions. Females reported more trust, communication, and overall attachment to peers than males. Grade, sex, and views of attachment relationships to parents and peers predicted the introduction of friends into the attachment hierarchy. Participants who viewed relationships with parents as less secure were more likely to select peers to fulfill attachment functions. The important and complementary roles of parents and peers and their implications are discussed.
Leadership, Empowerment, and Public Organizations
Authors: Pitts David W.
Published: April 2005

Empowerment has emerged as a component of recent public management reforms and a trend in both public and private organizations. This study builds on research on empowerment by creating a model that explains why some managers empower their employees and others do not. Hypotheses about the role of both individual and organizational variables are tested, and the results provide evidence for connections among race, education, organizational resources, task difficulty, and empowerment. Findings reject hypotheses related to empowerment as a trend, leading to the conclusion that empowerment may be nothing more than a recycled version of Theory Y and people-oriented leadership.
Explaining Disability
Authors: Jenks Elaine Bass
Published: April 2005

This article is a comparison of the narratives told by and about parents of children who are blind or visually impaired. The narratives in this article come from the author’s own experience raising a child who is visually impaired, from conversations the author has had with other parents of blind and visually impaired children, and from published accounts of parents’ experiences of raising visually impaired children. In addition, this article synthesizes the metanarrative told in the social scientific literature about parents of visually impaired children. This narrative comparison demonstrates that disability is located in the interplay between individuals’ physical bodies and society’s constructed meanings of difference. This article posits that the lived experiences of parents who are raising visually impaired children in a sighted world do not mirror either the medical or the social models of disability, but lie somewhere in between.
“A Different Light”
Authors: Kelly Susan E.
Published: April 2005

This article explores narratives of parenting a child with impairments for insight into impairment as both a materially and socially meaningful phenomenon. Drawing from in-depth interviews with parents, a narrative approach is employed to explore the ambiguities of human impairment and embodiment as experienced by an intimate other. Parents’stories illustrate impairment as an intersubjective and intercorporeal accomplishment and illustrate multiple locations of meaning of impairment within the context of intimate social relationships. Narrative approaches have largely been identified with research on embodiment from the perspective of disabled people; it is argued that narrative accounts of embodied others may avoid dualisms of objective/subjective and social/natural that trouble current theoretical approaches to impairment.
Sisters and Friends
Authors: Davis Christine S. , Salkin Kathleen A.
Published: April 2005

This article takes the reader into a journey of family dynamics, as sisters— one with a physical impairment and the other the sibling of a woman with a physical impairment—try to sort out their feelings and experiences through in-depth interviewing, interactive interviewing, co-constructed narrative, and dialogic conversation. There is little research that looks at the relationship between the sibling with a disability and his or her nondisabled sibling as it is experienced by the two of them. This article engages the siblings, and, perhaps, the readers, into a dialogic conversation that is multivocal, inclusive, and accepting of differences.
Disability and (Auto)Ethnography
Authors: Couser G. Thomas
Published: April 2005

Disabled people have largely been ignored by ethnographers, arguably to the detriment of both disabled people and the discipline of anthropology. But although disability communities are ripe for ethnographic investigation, disabled people, long subjected both to marginalization and objectifying examination, may resent and resist such attention. Indeed, disability ethnography faces some of the same ethical challenges as ethnography involving populations subjected to classic Western imperialism. Although not ethnography by a strict definition, Rachel Simon’s Riding the Bus with My Sister, an account of sharing the life of her mildly retarded sister, who spends most of her waking hours riding the buses in her Pennsylvania hometown, exemplifies disability life narrative that approaches ethnography in its method and that suggests what disability and ethnography have to offer each other.
The Concept of Intentionality in Human Science Nursing Theories
Authors: Pilkington F. Beryl
Published: April 2005

Nursing as a human science focuses on life and health as humanly experienced. Intentionality is a philosophical idea of particular significance to nursing as a human science, particularly within Parse’s theory of human becoming and Watson’s theory of human caring. These two theorists’ interpretations of intentionality are explored in relation to their respective theories and the implications for research and practice. A persistent thread in nursing discourse positions nursing as a human science—that is, one that focuses on life and health as humanly experienced. In human science disciplines, human beings are viewed as the subjects of their own lives, rather than as mere objects or things, as is the case in the natural sciences. My purpose in this column is to explore intentionality as a philosophical idea of particular significance to theoretical accounts of nursing as a human science. Before beginning, it is important to note that not all nurse theorists whose works could be considered aligned with the human sciences explicitly address the notion of intentionality within their writings (see for instance, Newman, 1994; Rogers, 1970). However, the notion of intentionality is implied in, or at least, consistent with, their works and those of their disciples. As noted elsewhere (Pilkington, 2000), the word intentionality has been in use since medieval times and there are various definitions of the concept in the literature, reflecting different philosophical paradigms or worldviews. In this column, I explore the notion as it appears in two nursing perspectives, Parse’s (1981, 1998) theory of human becoming and Watson’s (1985, 1999, 2005) theory of human caring. Both of these theorists have spoken about how their theoretical thinking grew out of their own life experiences as well as through engaging with the world of ideas (Fuld Institute for Technology in Nursing Education, 1997a, 1997b). And so, I begin by identifying key theoretical influences that shaped their thinking about intentionality. In addition, I will explore
Feeling Respected-Not Respected: The Embedded Artist in Parse Method Research
Authors: Mitchell Gail J. , Halifax Nancy Davis
Published: April 2005

The purpose of this column is to present the plan of a research project involving researchers, artists, and research participants. The planned research project will explore with the Parse method eight universal lived experiences important to persons in community. It is anticipated that art works will complement story and text in order to enhance understanding. The authors here present the first attempt of including an embedded artist with Parse method involving one participant who spoke about her experience of feeling respected-not respected. Researcher text and artist works are shown to enhance meaning and understanding.
Scholarship in Nursing: Ethics of a Practice Doctorate
Authors: Milton Constance L.
Published: April 2005

The American Association of Colleges of Nursing recently adopted a position statement which gave approval for the development of a doctorate of nursing practice. What are possible ethics related to meaning and scholarship in providing this form of terminal degree in nursing? What are some questions that members of the discipline ought to be thinking about when pondering beginning such programs? When viewed from a nursing theoretical perspective, what are potential implications for initiating this degree? This column shall begin the discussion regarding the ethics and possible meanings for doing what is best for the discipline of nursing.
A Community of Scholars: What Is It?
Authors: Bunkers Sandra Schmidt
Published: April 2005

This column addresses the question, What is a community of scholars ? This question is explored through the writings of authors about genius—looking at such geniuses as Plato, Mahatma Ghandi, Queen Elizabeth I, and Christopher Columbus. The question is also explored through the writings of present day nurse scholars and their meanings of community of scholars.
Partnering of Researcher and Practicing Nurses for Transformative Nursing
Authors: Endo Emiko , Miyahara Tomoko , Suzuki Setsuko , Ohmasa Tomoe
Published: April 2005

The purpose of this praxis research was to address the process of a researcher’s partnering with practicing nurses to incorporate Newman’s theory of health as expanding consciousness as a guide for nursing practice. Initially the nurses were bound by their commitment to help clients within a philosophy of cure, but as they began to engage in a caring relationship of pattern recognition with clients, they experienced the clients’ transformations in a way that was transformative for them and that pervaded the total realm of their nursing practice. The process illustrates the immediate applicability of Newman’s theory.
Exploring the Lived Experience of Waiting for Persons in Long-Term Care
Authors: Mitchell Gail J. , Pilkington F. Beryl , Jonas-Simpson Christine , Aiken Fran , Carson M. Gail , Fisher Anne , Lyon Pat
Published: April 2005

The purpose of this study was to describe the meaning of waiting for persons who reside in long-term care settings. Parse’s theory of human becoming provided the nursing perspective and a qualitative descriptive-exploratory design was used. The 45 participants were residents in three different long-term care facilities affiliated with a university. Data were gathered through interviews. Three emergent themes formed the following unified description: The experience of waiting is intensifying ire while diversionary immersions reprieve amid unfolding becalming endurance. The themes are discussed in relation to participants’ descriptions, the human becoming theory, and related literature. Recommendations for practice and further research are presented.
Exploring Being: An International Dialogue
Authors: Baumann Steven L.
Published: April 2005

Nurses and other health professionals are in a privileged position in that they are called to be with people and their families at some of the most important moments in persons’ lives. In order to better prepare nurses for this awesome and challenging responsibility, a session of the 11th International Human Becoming Conference held in Niagara Falls, Ontario, Canada, on November 6, 2004, reflected on famous quotations on Being and related Being to nursing practice. The human becoming school of thought is unique in its willingness to face the important but difficult question, what is Being?
Quality of Life in Women Following Coronary Artery Bypass Graft Surgery
Authors: Penckofer Sue , Ferrans Carol Estwing , Fink Nancy , Barrett Maureen L. , Holm Karyn
Published: April 2005

The purpose of this study was to determine the effect of coronary artery bypass graft (CABG) surgery on the quality of life of women. Wilson and Cleary’s conceptual model of health-related quality of life, which examines five major outcomes (biological variables, symptom status, functional status, general health perceptions, perceived quality of life), was used. Participants included 61 women who provided information by self-report questionnaires before and three months after surgery. The major findings of the study are that women had significantly improved quality of life (p = .004) due to increased satisfaction with health and functioning (p < .001) at three months following CABG surgery. They experienced less angina (p < .001) and shortness of breath (p = .014), although fatigue was unrelieved for the majority of women. Psychological well being improved after surgery for most women (p < .001), with lower anxiety levels (p < .001), greater levels of well being (p = .021), feelings of health (p < .001) and vitality (p = .023). Women reported less use of emotive coping (p = .043), indicating less emotional distress. Nevertheless, 25% of the sample continued to experience severe psychological distress three months after surgery, indicating the need for continued follow-up.
Adolescents With Type 1 Diabetes: Family Functioning and Metabolic Control
Authors: Leonard Barbara J. , Jang Yuh-Pyng , Savik Kay , Plumbo Margaret A.
Published: April 2005

Families play central roles in the care of their adolescents with chronic illnesses. This study examined the relationship between family functioning and metabolic control in adolescents with Type 1 diabetes. The McMaster Family Assessment Device (FAD) measured family functioning; the Youth Self-Report Form (YSR) measured adolescent behavior. Older adolescents reported increased family dysfunction. Adolescents who reported family dysfunction on affective responsiveness had HbA1c levels greater than 9. Older adolescents, males, and adolescents who reported a greater number of behavior problems were significantly more likely to have HbA1c levels greater than 9. Considered together, older age and greater attention problems were most significantly associated with higher HbA1c levels. These findings suggest the importance of the relationship between the adolescent’s perception of family functioning and metabolic control in the adolescents with Type 1 diabetes.
Canadian Families Caring for Members With Mental Illness: A Vicious Cycle
Authors: Ward-Griffin Catherine , Schofield Ruth , Vos Sandra , Coatsworth-Puspoky Robin
Published: April 2005

The purpose of this qualitative, descriptive study was to explore the perspectives of individuals who were caring for a family member with a mental illness, with particular attention to housing, quality of supports, and formal care services. Eleven focus groups with family caregivers (N = 75) were conducted. Both individual and team thematic analyses were undertaken until interpretations of the experiences of the participants were inductively developed and conceptualized into a holistic interpretation. Findings revealed that family caregivers were part of a “circle of care,” supporting the independence of the individual with mental illness while attempting to protect their family member with mental illness. However, findings suggested that this circle of care led to a “vicious cycle” of caregiving. Three major themes were identified: witnessing inadequacies, working behind the scenes, and creating a better world. Health-promoting family nursing practice and policy implications, as well as areas for further research, are discussed.
Crossing Community Sectors: Challenges Faced by Families of Children With Special Health Care Needs
Authors: Lutenbacher Melanie , Karp Sharon , Ajero Gladys , Howe Dara , Williams Mamie
Published: April 2005

This article identifies unmet needs and challenges of 37 families caring for children with special health care needs (CSHCN). Data were collected in focus groups. Data saturation occurred in the third group. Another group was conducted to ensure adequate inclusion of rural participants. Mean age of participants was 36 years. Most participants were women (92%), Caucasian (65%), high school graduates (89%), and employed, with 38% from rural communities. All families had health care insurance, primarily Medicaid (87%). An interdisciplinary team used NVIVO software to facilitate content analysis. Seven areas emerged: family support systems, early intervention/school systems, coordination of care, lack of knowledge, provider/family relationships, parent roles, and insurance systems. Caregivers noted the critical role of nurses but a lack of nurse presence in community care systems. This study adds to the multidimensional nature of caring for CSHCN and highlights the importance of considering how families interface with multiple community sectors.
Measuring and Managing the Benefits of Customer Retention
Authors: Narayandas Das
Published: April 2005

Past research on the benefits of customer retention (BCR) has been characterized by the lack of a psychometrically adequate criterion. Research has primarily operationalized the BCR by using only repurchase intent or a factor score of several measures including repurchase intent, word of mouth, and price tolerance. In the process, it has ignored the possibility of a hierarchical ordering of the BCR measures that would lead to a unidimensional and cumulative BCR scale. In this article, the authors investigate this issue using a set of intent measures developed based on past work in customer retention, customer loyalty, brand loyalty, and satisfaction. As hypothesized, support is foundfor a unidimensional and cumulative BCR scale. The authors also investigate howfirms can use BCR along with satisfaction to monitor and manage customers. They propose that vendors use a customer management strategy that is based on managing both satisfaction and BCR.
Managing Dissatisfaction
Authors: Chu Wujin , Gerstner Eitan , Hess James D.
Published: April 2005

Previous research emphasizes the benefits of generous refunds as part of overall complaint management service policy, yet recent empirical evidence suggests that many retailers have concerns about abusive returns and hesitate to fully compensate dissatisfied customers. We present an analysis of three refund policies-no questions asked, no refunds, and verifiable problems only-and show that no questions asked is the most efficient way to handle consumer opportunism.
Growth through Product-Sharing Services
Authors: Johnson Michael D. , Herrmann Andreas , Huber Frank
Published: April 2005

The authors argue that product-sharing services, where companies offer customers the use ofa physicalproduct on a limited basis at a lower cost, offer an overlooked opportunity for growth. The primary advantage of productsharing services is that they leverage afirm 's core product development and production capabilities to expand their portfolio of offerings and market segments. A framework is developedfor distinguishing likely candidates for product sharing from unlikely candidates based on product, customer; and company-strategy considerations. An empirical study of a new car-sharing service at Daimler-Benz is then used to illustrate the development of such a service, its strategic advantages, and the challenges involved.
Evaluating Community-Based Collaborative Mechanisms: Implications for Practitioners
Authors: Kreuter Marshall W. , Lezin Nicole A. , Young Laura A.
Published: April 2005

This article examines the possible reasons why the published literature on community-based coalition strategies offers only marginal evidence that such approaches lead to health status/health systems change. Three possible explanations are proposed: (a) collaborative mechanisms are inefficient and/or insufficient mechanisms for carrying out critical planning and implementation tasks, (b) expectations of health status/health systems change outcomes are unrealistic, and/or (c) Health status/health systems changes may occur but may go undetected because it is difficult to evaluate and demonstrate a cause-and-effect relationship. The implications of each possible explanation are addressed through a review of the literature on stages of coalition building, focusing on key factors for success at each stage. The authors conclude that funders and practitioners may be expecting too much from these increasingly popular mechanisms and may not be asking the right questions when evaluating collaborative activity.
Getting off to a Good Start with Your Evaluation
Authors: Francisco Vincent T. , Capwell Ellen M. , Butterfoss Frances
Published: April 2005

There is no better way to get started with an evaluation than to develop an evaluation plan. Good evaluation planning involves identifying who the key audiences for the evaluation findings include, posing relevant and useful evaluation questions, and using evaluation measures and designs that will answer those questions to the satisfaction of key stakeholders. This article outlines some ideas on how to go about doing this work and discusses some of the broader issues relevant to the evaluation’s (and the program’s) success.
The National SAFE KIDS Campaign Child Safety Seat Distribution Program: A Strategy for Reaching Low-Income, Underserved, and Culturally Diverse Populations
Authors: Cruz Theresa H. , Mickalide Angela D.
Published: April 2005

This is a descriptive study to evaluate the process of establishing a child safety seat (CSS) distribution and training program for low-income, underserved, and culturally diverse children of CSS age and their parents or caregivers. National organizations serving the target population partnered with organizations proficient in motor vehicle occupant injury prevention to distribute CSSs at distribution sites nationwide. To ensure standardized recipient education, CSS training was provided to partner affiliate representatives. National CSS distribution programs involving partnerships with injury prevention specialists and national organizations already working with the target population can effectively reach low-income, underserved, and culturally diverse persons. Networking in local communities to identify and reach the target population is valuable. Maintaining good communications and standardized education and information is essential. The experience of this program can contribute to the success of future CSS distribution programs.
Camine Con Nosotros: Connecting Theory and Practice for Promoting Physical Activity among Hispanic Women
Authors: Soto Francisco G. , Kane William M. , Going Scott , Ford Earl S. , Marshall James R. , Staten Lisa K. , Smith Joan E.
Published: April 2005

Despite the popularity and widespread use of theory in health education, practitioners still find it difficult to design and implement theory-based interventions. This is especially true when working with ethnic/racial minority groups, including Hispanic groups. Practitioners working with Hispanic communities face additional barriers that may often discourage them from using theories when planning interventions. These barriers include the diversity that exists within the Hispanic population, lack of reliable data, and issues related to cross-cultural applicability of current behavior theories. However, the use of theory constitutes a valuable tool for developing more effective programs, and theorist researchers should be more sensitive to practitioners’ needs. By explaining the processes for selecting and applying theory in the same detail as outcome results, researchers will contribute to increasing practitioners’ interest in theory. This article describes Camine con Nosotros, a theory-based physical activity program for Hispanic women, and explains the process of selecting the theoretical framework of the program and connecting theory and practice.
Evaluation on a Shoestring: Key to Success for Virginia Prenatal Incentive Program
Authors: Alfers Deborah , Butterfoss Frances D.
Published: April 2005

This article recounts how a local cost-effective yet comprehensive evaluation of a prenatal incentive program called Beds and Britches, Etc. (BABE) was used to provide accountability and generate support from financial sources and from other community members. Both infant mortality and low birth weight are outcomes that have been linked to a lack of appropriate, early, and continual prenatal care. The BABE program provides coupon incentives for women who keep appointments for prenatal, postpartum, well baby, and immunizations visits and who attend educational classes. The coupons are exchanged for new and used infant and toddler clothing and equipment in a way that fosters self-esteem and responsibility. Results after 19 months of operation show that 783 women participated and 5,779 coupons were redeemed—twice the number that was originally projected. The clients enter care in the first trimester at a higher rate than the general population (88% versus 83%). Clients are satisfied, and the community continues to fund the program with personnel support ($18,000 in inventory and $7,954 in cash donations).
Safe Return: A Community-Based Initiative between Police Officers and the Alzheimer’s Association to Increase the Safety of People with Alzheimer’s Disease
Authors: Lachenmayr Sue , Goldman Karen Denard , Brand Frederick S.
Published: April 2005

A partnership initiated by an Alzheimer’s Association (AA) chapter and police departments in 11 New Jersey counties sought to increase enrollment of people with Alzheimer’s disease (AD) in a national registration program and expand community AD outreach efforts by training police officers about potentially dangerous wandering behavior in people with the disease. During the first 4 months of the program, almost 3,000 police officers learned how to reduce dangerous wandering behavior in people with AD, to make referrals to the national registration program, and to conduct Alzheimer outreach programs in their communities. Police-sponsored AD community outreach programs increased dramatically, as did enrollment in the national registration program. The authors provide a rationale for health education partnerships with police officers, describe the role of theory in the design, implementation, and evaluation of the officer training program, discuss the initiative and its impact, and offer recommendations for future programs and related research.
Linking Science and Practice: Toward a System for Enabling Communities to Adopt Best Practices for Chronic Disease Prevention
Authors: Cameron Roy , Jolin Mari Alice , Walker Rosemary , McDermott Nicky , Gough Myrna
Published: April 2005

In this article, the development of a system for collecting and assessing best community-based health promotion practices for dissemination is described. The key system components are (a) a protocol for identifying meritorious practices, (b) criteria for assessing those practices, and (c) an assessment procedure. A key informant process was used to identify interventions, and interviews were conducted to acquire detailed information on them. Categories of criteria pertaining to (a) effectiveness, (b) plausibility, and (c) practicality were developed for assessing practices. Application of the criteria led to selected practices’ being designated as “best,” “promising,” or “to be tracked.”
Applying Research and Theory in Program Planning: An Example from a Nutrition Education Intervention
Authors: Lytle Leslie A. , Perry Cheryl L.
Published: April 2005

Public health practitioners often hear that effective interventions are theory-based and draw from practice and research. However, operationalizing this integration of theory, research, and practice to develop a concrete program that can be delivered in communities is a difficult task that many practitioners feel illequipped to accomplish. This article describes the steps and processes used in designing the Teens Eating for Energy at School (TEENS) study, a school-based nutrition education program. The goal of TEENS is to increase middle and junior high students’ intake of fruits, vegetables, and lower fat foods to reduce their future risk of cancer. In this article, the authors describe a 10-step process of creating health behavior change programs. The authors use examples from the TEENS study to illustrate how a very concrete, community-based intervention is developed from behavioral theory, research, and knowledge of practice and the target audience.
Process Evaluation Methods of a Peer-Delivered Health Promotion Program for African American Women
Authors: Williams James Herbert , Belle Gregg A. , Houston Cheryl , Haire-Joshu Debra , Auslander Wendy F.
Published: April 2005

The Eat Well, Live Well (EWLW) Nutrition Program was a community-based, dietary change program delivered by peer educators to low-income African American women. To ensure that the program was delivered as intended, a process evaluation was conducted to determine the extent to which the content was accurate and comprehensive. The methodology included developing checklists for each of the intervention sessions, audiotaping randomly selected sessions, and independently rating the audiotapes. Overall comprehensiveness of the content delivered by the peer educators was 91.42%. Cohen’s kappa () for each data collection interval ranged from 0.95 to 0.97. Overall accuracy of information delivered was 88.52%. A process evaluation as described for the EWLW program is essential for peer-led health promotion programs and necessary to ensure program integrity. Practice implications are discussed.
Are Parents in Favor or against School-Based Sexuality Education? A Report from the Midwest
Authors: Lewis Rhonda K. , Paine-Andrews Adrienne , Custard Carolyn , Stauffer Mary , Harris Kari , Fisher Jacqueline
Published: April 2005

A telephone survey was conducted in a midsized city in the Midwest to assess community members’ opinions about sexuality education being taught in school. Out of 566 people who were called, 350 completed the survey (61% response rate). The results showed that community members were supportive (91%) of sexuality education being taught in school. Other findings suggest that community members were helpful to the researchers by identifying the most appropriate time when sexuality education should begin and in which class sexuality education should be taught. The information from this survey has important implications that help health educators design age-appropriate sex education curriculum that fit community needs.
Perspectives on Adherence to Recommended Health Behavior among Low-Income Patients
Authors: Gregg Andrea C. , DeHaven Mark , Meires Jan , Kane Andrew , Gullison Gail
Published: April 2005

Although patient nonadherence with health care recommendations is a known barrier to controlling health care costs and improving health outcomes, little is known about variables that affect adherence to recommended health behaviors among low-income patients. Four focus groups were conducted among a sample of low-income patients, to examine their perceptions of adherence with recommendations for appointment keeping, special diets, and medications. Continuity of care and patient fears emerged as common themes contributing to adherence. Continuity of care consisted of having a positive interpersonal relationship with a single primary physician, and a system of coordinated care among multiple specialty physicians. Fear of dying, not living well, getting worse, and feeling bad again were strong promoters of adherence. Among low-income patients and care delivery systems with capitated funding, efforts are needed to improve continuity of care and increase provider awareness of the fears that patients bring to a care encounter.
Narrowcasting Risks of Drinking during Pregnancy among African American and Latina Adolescent Girls
Authors: Glik Deborah , Halpert-Schilt Elena , Zhang Weiying
Published: April 2005

The risk of fetal alcohol syndrome among children is linked to women who drink alcohol during pregnancy. This article describes a social marketing intervention that used a “narrowcasting” approach to raise awareness of this issue among Latina and African American teenage girls in the Los Angeles area. The campaign created messages based on the input of priority populations. The basic media used were small posters and tear-off cards put in places teens frequent. A three-wave, repeated, cross-sectional survey was used to assess campaign impact, with samples drawn from local high school classes. African American teens’ knowledge scores increased significantly after the campaign, whereas Latinas’ did not; Latinas had high levels of knowledge initially. Lack of association between exposure to campaign materials and change in knowledge suggests campaign materials were processed peripherally, not centrally, by respondents. Findings are discussed with reference to communications theories and cultural differences between respondent groups.
Reducing Isolation among Inner-City Elders: An Outcome Evaluation
Authors: Greenwald Howard P. , Beery William L.
Published: April 2005

The research reported here evaluates outcomes of an intervention designed to reduce isolation and improve health and quality of life within a multiracial population of elders in Seattle. Carried out by a coalition of community groups, this intervention aimed at linking potentially isolated older people with individual peers, individuals outside their own age group, and social, volunteer, and community groups. A 3-year, longitudinal study was conducted on 87 elders. A statistically significant relationship was found between participation in the intervention and group attendance at least 1 year after the intervention; a near-significant relationship was found between participation in the intervention and contact with non-elders. No relationships were found between the intervention and health status or quality of life, although, such relationships may be detectable in longer term follow-up studies.
Understanding Teen Pregnancy from the Perspective of Young Adolescents in Oklahoma City
Authors: Kegler Michelle Crozier , Bird Sheryl Thorburn , Kyle-Moon Kristen , Rodine Sharon
Published: April 2005

As part of a needs and assets assessment for teen pregnancy prevention, university researchers and practitioners from community-based organizations collaborated to conduct focus groups with 102 young teens of diverse racial/ethnic backgrounds. Understanding ethnic and gender similarities and differences in teen views of adolescent preg-ancy helped neighborhood-based planning groups tailor their interventions to specific populations. There were many more similarities in themes than differences across both gender and racial/ethnic groups. Common themes included wanting a baby because of loneliness or a desire to be loved, wanting a baby to maintain a relationship, and viewing teen pregnancy as an unintended consequence of having sex. Differences tended to be gender based, with males viewing teen pregnancy as less of a problem than females. Implications for teen pregnancy prevention are discussed, with examples of how the information was used in a teen pregnancy prevention project in Oklahoma City.
Maryland Dentists’ Knowledge of Oral Cancer Risk Factors and Diagnostic Procedures
Authors: Canto María Teresa , Drury Thomas F. , Horowitz Alice M.
Published: April 2005

A questionnaire was mailed to 800 Maryland general practice dentists to assess their knowledge of risk factors and diagnostic procedures for oral cancer. Two indices were created based on 14 questions on knowledge of oral cancer risk factors and 9 questions on oral cancer diagnostic procedures. Data were analyzed statistically and evaluated with an alpha level of 0.05. Nearly all respondents identified use of tobacco, prior oral cancer lesions, and use of alcohol as risk factors. However, only 36% correctly identified that poor-fitting dentures are not a risk factor and 58% that poor oral hygiene is not a risk factor. Nearly 87% knew how to examine the tongue and surrounding areas, and 32% identified erythroplakia and leukoplakia as conditions associated with oral cancer. Appropriate knowledge about risk factors and diagnostic procedures is essential for dentists to counsel their patients and perform appropriate oral cancer examinations.
Talking Your Way to the Top with Style
Authors: Marcello-Serafin Gina
Published: April 2005

Health educators are communicators. The heart and soul of what we do is done through some form of communication. A recent survey of employers revealed that writing and public speaking were the top two most desirable skills for entry-level practitioners. Although a great resume, references, and interviewing skills may get you the job, being able to communicate effectively will go a long way in helping you keep the job and advance to a higher position. It probably would be safe to assume that most health educators, given a choice, would rather develop materials than give a speech or presentation. Public speaking creates anxiety for most people. However, by following a few basic principles of speech preparation and delivery, your level of anxiety can be diminished and your performance improved.
Teens as Advocates for Substance use Prevention: Strategies for Implementation
Authors: Tencati Elaine , Kole Sara L. , Feighery Ellen , Winkleby Marilyn , Altman David G.
Published: April 2005

Substance use by adolescents is a growing public health problem, especially among youth in low-income neighborhoods. School-based substance use prevention programs can be effective but are compromised by the alcohol, tobacco and other drug (ATOD) messages that saturate the community environments. The Teen Activists for Community Change and Leadership Education (TACCLE) program engaged ethnically diverse high school students from low-income communities in advocacy activities that addressed environmental influences related to ATOD in their schools and communities. The intervention took place during the 1996-1997 school year and involved 116 students in the 9th and 10th grades at six sites. Using social learning and empowerment theories, teens identified an ATOD advocacy issue on which to focus. The program succeeded in engaging teens from at-risk communities in advocacy projects that successfully modified negative ATOD influences in their schools and communities. Ten guiding principles and their implications for practitioners are presented and discussed.