bluuebunny/crossref_metadata_2025 huggingface dataset:
Seat Belt Education Program—A Model for Public Health Settings
Authors: Saunders Stephen , Pine Jeffrey
Published: February 2007

A cohort of 268 low-income mothers participating in the Women, Infants, and Children (WIC) Supplemental Food Program was enrolled in a seat belt education and motivation program. The goal of the study was to determine whether seat belt use could be increased by incorporating a brief educational intervention into an existing public health program. Seat belt use was monitored by an unobtrusive observer prior to and one month following the intervention. Seat belt use increased from a baseline of 4.9 to 12.6% one month following education (p < .01).
The Effects of Health Information in a Worksite Hypertension Screening Program
Authors: Zimmerman Rick S. , Safer Martin A. , Leventhal Howard , Baumann Linda J.
Published: February 2007

Two studies assessed the potential impact of health education messages at worksite blood pressure screenings. The messages sought to: (1) motivate hypertcnsives to enter or return to treatment, (2) motivate normotensivcs to improve health habits and (3) discourage inappropriate use of blood pressure screening by normotensives. A total of 473 participants in the two studies viewed slide/tapc shows about blood pressure and/or health promotion. Individuals with elevated readings at screening viewed either a show containing standard blood pressure information or an experimental show which emphasized the asymptomatic nature of high blood pressure and which described some concrete strategies for coping with high blood pressure. In both studies, individuals with normal readings at screening viewed a standard show or an experimental show which emphasized coping strategies for preventing high blood pressure. In addition, in Study 2, some normotensive individuals viewed one of several experimental shows which focused on health promotion. Results indicate that the experimental programs were significantly more effective than the standard programs in achieving appropriate followup of screening results for both normotensives and hypertensives. Implications for worksite blood pressure screenings are discussed.
Recent Sexually Transmitted Disease Prevention Efforts and Their Implications for AIDS Health Education
Authors: Solomon Mildred Zeldes , DeJong William
Published: February 2007

In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are cur rently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.
Health Education about AIDS among Seropositive Blood Donors
Authors: Cleary Paul D. , Rogers Theresa F. , Singer Eleanor , Avorn Jerome , van Devanter Nancy , Perry Samuel , Pindyck Johanna
Published: February 2007

The New York Blood Center is developing a health education and psychosocial sup port program for blood donors who are notified that they are HIV antibody positive. The goals of that program are: (1) to provide accurate and intelligible information about the test results to notified donors; (2) to encourage behavior that will reduce the likelihood of spreading the virus; (3) to encourage notified donors to behave in ways that will reduce the probability that they will develop AIDS; and (4) to provide sup port and facilitate functional coping responses. This article reviews the theoretical and empirical work which informs the intervention program, and it describes how the pro gram is being implemented.
AIDS Risk Reduction Recommendations and Sexual Behavior Patterns among Gay Men: A Multifactorial Categorical Approach to Assessing Change
Authors: Martin John L.
Published: February 2007

A sample of 745 New York City gay men, aged 20-65, were interviewed in 1985 as part of a longitudinal effort to determine the behavioral, psychological, and social impact of the AIDS epidemic on the non-ill but at-risk community. Detailed sexual behavior histories were taken for the year prior to the interview (1984-1985) and the year prior to when respondents first heard about AIDS (mode = July 1981). Parallel questions were asked for each annual time period allowing pre-AIDS/post-AIDS com parisons to be conducted. A multifactorial index of sexual behavior was constructed from three categorical variables: ( i) number of different sexual partners, (0, 1, and 2 or more); ( ii) engaging in sexual contact outside a private home, (0 vs. 1); and ( iii) engaging in sexual acts considered to be of higher risk for exposure to disease patho gens (0 vs. 1). These three factors, representing aspects of sexual behavior targetea for change by authors of risk reduction educational materials, were combined to form a seven-level typological index of sexual behavior. Analyses are based on comparisons between pre- and post-AIDS time periods on this index. Results indicate that both substantial change and substantial lack of change have occurred in gay male sexual be havior patterns, when sexual behavior measures are scaled to reflect complete absti nence from a particular type of sexual activity, as they are here. Results are discussed in light of previously reported findings on sexual behavior changes and the ambiguity surrounding the question of how much change is needed for significant risk reduction of AIDS.
Alcohol and Drug Use During Sexual Activity and Compliance with Safe Sex Guidelines for AIDS: The AIDS Behavioral Research Project
Authors: Stall Ron , McKusick Leon , Wiley James , Coates Thomas J. , Ostrow David G.
Published: February 2007

This article describes the association between drug and alcohol use during sexual activity and high-risk sex for AIDS. Data to test this association are drawn from a pros pective study of the behavioral changes made by gay men in San Francisco in response to the AIDS epidemic. Findings drawn from the May, 1984 and May 1985 waves of data collection are described. The cross-sectional analysis showed that use of particular drugs during sex, the number of drugs used during such activity, and the frequency of combining drugs and sex are all positively associated with risky sexual activity for AIDS. The retrospective data showed that men who currently abstained from com bining drug use with sexual activity were likely to have been at no risk for AIDS over two measurement points during the previous year. The men who currently combined drug use with sex were most likely to have a history of high-risk sexual activity over the previous year. These findings show a strong relationship between drug and alcohol use during sex and non-compliance with safe sex techniques to prevent the spread of AIDS. Implications of this relationship for AIDS health education efforts are dis cussed.
AIDS Health Education for Intravenous Drug Users
Authors: Friedman Samuel R. , Des Jarlais Don C. , Sotheran Jo L.
Published: February 2007

Intravenous (IV) drug users are the second largest risk group for AIDS and the main source of infection for heterosexual partner and pediatric AIDS cases. IV drug users have an addiction and a subculture that make risk reduction difficult; for example, to refuse to share needles can endanger personal relationships, and carrying clean works (rather than renting them in a shooting gallery) risks arrest. In New York City, at least, knowledge about AIDS transmission is widespread among IV drug users, and most drug injectors report having changed their drug use practices to reduce their risks. The main functions of health education in areas where IV drug users have this level of knowledge are to disseminate news of new discoveries; reach those drug users who have not yet learned AIDS basics; reinforce what is already known; and provide in formation about new programs to help drug users deal with AIDS-related problems. To encourage behavior change requires going beyond simple education, however; it entails trying to change IV drug user subculture. Drug user groups in the Netherlands and in New York City are attempting to do this from within the subculture. Outside intervention requires repeated messages from multiple sources; face-to-face, interactive communication; and perhaps the use of ex-addicts as health educators.
Health Educators in the Workplace: Helping Companies Respond to the AIDS Crisis
Authors: Bauman Laurie J. , Aberth John
Published: February 2007

As the number of cases of AIDS increases, more and more companies will have to decide how to handle employees with AIDS and those at high risk. AIDS creates medi cal, legal, and ethical issues in the workplace, all of which are emotional and complex; managers need expert assistance to guide their decision-making and policy develop ment.

This article identifies various dimensions of the AIDS-related issues emerging in corporations nationwide, including: confidentiality, the right of patients to work, ben efits and insurance, HTLV-III screening, fears of contagion among workers, needs of companies to avoid financial and legal exposure, and effects on worker productivity. Health educators are in a unique position to contribute to the satisfactory resolution of AIDS-related problems in the workplace through their training and experience in education, policy development and the relevant legal and ethical issues in the health care field. However, they will have to initiate discussions with corporation executives themselves in order to reach this most important audience.
Who Should be Blamed for Being Sick?
Authors: Wikler Daniel
Published: February 2007

That individuals are responsible for staying healthy is becoming a truism of health promotion and health policy. However, it is unclear what the slogan means, whether it is true, and what the consequences would be or should be if it is. A careful examina tion of the contexts in which the notion of personal responsibility for health occurs re veals a number of distinct arguments for different policy ends, each relying in turn on key unstated assumptions whose validity is doubtful. There is no disputing the minimal claim that most of us would be healthier if we took better care of ourselves. However, assignment of responsibility for health to the individual is usually part of a more far- reaching reassessment of obligations and entitlements in health care and health policy. A assessment of the concept of personal responsibility for health should precede any attempt to draw broad conclusions on rights and duties in maintaining health.
Selling Health Promotion to Corporate America: Uses and Abuses of the Economic Argument
Authors: Warner Kenneth E.
Published: February 2007

Economic considerations constitute a significant factor in businesses' interest in adopting health promotion (HP) programs and in the wellness community's attempts to sell such programming to business. Substantial elements of both the business and wellness communities believe that HP programs are financially profitable, in addition to, and as a result of, improving employees' health. Examination of the foundation of this belief, however, leads to the conclusion that underlying analyses have been techni cally flawed and have ignored important costs of HP programs. This article discusses the limitations of these analyses and outlines the framework of a model that could provide a sound assessment of the economics of workplace HP programs. In general, it is expected that resultant analyses would find less direct profit potential in work place HP programs but would emphasize the cost-effectiveness of many such efforts. The latter would force recognition that health, and not profit, is the principal benefit of health promotion programming. The distinction between the cost-effectiveness and cost-saving potential of health promotion is one that all interested parties should master.
Ethics in Worksite Health Programming: Who is Served?
Authors: Roman Paul M. , Blum Terry C.
Published: February 2007

As relatively new innovations in the workplace, employee assistance and wellness/ health promotion programs have not yet established clear identities. Thus ethical prac tices have not been fully considered or discussed. Based on extensive research exper ience with employee assistance programs, ethical issues are considered at three levels. Of primary concern are ethical issues affecting the individual employee, of which the scope of perceived or expected service relationships between employees and EAP coordinators is critical. There are tendencies to transfer models of community or private practice to the worksite, but the relationships both prescribed and implied at the worksite require that a different pattern of clinical relationships obtain. At the organizational level, it is critical for the worksite practitioners to be conscious of their authority in translating scientific data into recommended practices at the worksite and in transforming equivocal data and health practices into organizational norms. Finally, at the level of interorganizational relationships the worksite health program practi tioner needs to be aware of the risks of becoming drawn into overly intimate relation ships with external organizations who may come to benefit by special treatment that such relationships generate.
Effectiveness and Cost Effectiveness of Persuasive Communications and Incentives in Increasing Safety Belt Use
Authors: Simons-Morton Bruce G. , Brink Susan , Bates Deana
Published: February 2007

The Safety Belt Connection Project was a worksite health promotion project con ducted at a medical school and hospital complex to test the effectiveness and cost effectiveness of four treatment conditions (TCs): TCl, Persuasive Communications (PCs) alone; TC2, PCs plus overt monitoring; TC3, PCs plus incentives; and TC4, PCs plus incentives and prompts. Parking lots were randomized to treatment condition. A community traffic intersection served as a comparison group. Trained observers re corded safety belt use rates (SBURs) of subjects (front seat occupants) over a two- week period at baseline and after a four-week period of intervention. Results were analyzed by chi-square comparisons of pre-treatment and post-treatment SBURs. At baseline, significant differences in SBURs between treatment groups were observed. Significant pre-to-post differences were found for TC3 and TC4: the SBUR in TC3 went from 18.3% - 38.4% (p < 0.001) and the SBUR in TC4 went from 16.9%- 44.8% (p < 0.001). Both TC3 and TC4 were effective, but TC4 cost 2.6 times more per person influenced to wear their safety belt.
Determinants of Participation in Worksite Health Promotion Activities
Authors: Davis Keith E. , Jackson Kirby L. , Kronenfeld Jennie J. , Blair S.N.
Published: February 2007

A model of risk factors and psychosocial variables that should enhance the predic tion of participation in worksite health promotion programs was evaluated in a sample of 357 States employees in South Carolina. Degree of satisfaction with one's current health status, intent to change it, and participation in a relevant program were assessed in four health areas: weight, exercise, alcohol consumption, and the handling of stress and tension. In each area, a known risk factor was used to predict intent to change and participation during a one-year interval. Variables from the psychosocial model were added in a step-wise regression procedure. The key variables in the psychosocial model were personal efficacy, job stress, and trait anxiety. Neither intent to change a health relevant behavior nor degree of satisfaction with the health area were consistently asso ciated with subsequent participation in a relevant health promotion program. The re gression model was a statistically significant predictor of actual participation in two cases: exercise and weight control. For exercise, participators tended to be persons whose job stress was high ( r = 0.15) and whose anxiety was high ( r = 0.16). In the case of weight control, those who were high in the body mass index ( r = 0.22) and in job stress ( r = 0.15) were more likely to participate. Participants in stress management also had higher levels of job stress.
Susceptibility to Peer Pressure, Self-Esteem, and Health Locus of Control as Correlates of Adolescent Substance Abuse
Authors: Dielman T.E. , Campanelli Pamela C . , Shope Jean T. , Butchart Amy T.
Published: February 2007

As part of a school-based alcohol misuse prevention study, questionnaires were ad ministered to 2,589 fifth and sixth grade students to determine levels of use of alcohol, marijuana, and cigarettes, intentions to use these substances, and problems resulting from alcohol misuse. The questionnaire also included 45 items concerning susceptibil ity to peer pressure, self-esteem, and health locus of control. These 45 items were factor analyzed separately for two groups formed by random assignment. Six factors were identified which were both internally consistent and replicable, and indices were constructed. The indices measuring susceptibility to peer pressure, self-esteem, and internal health locus of control were significantly and negatively correlated with most of the substance use, misuse, and intention items, and an external health locus of con trol index was not significantly related to most of the substance use, misuse, and inten tion items. The "Susceptibility to Peer Pressure" index correlated more highly with the adolescent substance use, misuse, and intention items than the self-esteem or the health locus of control indices, and it had the highest alpha coefficient. Implications for the design of school-based substance abuse prevention programs are discussed.
A School Health Education Program for Children with Asthma Aged 8-11 Years
Authors: Evans David , Clark Noreen M. , Feldman Charles H. , Rips Jill , Kaplan Deborah , Levison Moshe J. , Wasilewski Yvonne , Levin Bruce , Mellins Robert B.
Published: February 2007

It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; re duce school absences and improve school performance. The study population con sisted of 239 low-income, predominantly Hispanic and black children from 12 elemen tary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. The program emphasized
An Evaluation of Approaches to Asthma Self-Management Education for Adults: The AIR/Kaiser-Permanente Study
Authors: Wilson-Pessano Sandra R. , Scamagas Peter , Arsham Gary M. , Chardon Luis , Coss Stamatiki , German Donald F. , Hughes Gary W.
Published: February 2007

The purpose of the AIR/Kaiser-Permanente asthma project is to evaluate various approaches to the education of adults with asthma, identifying those types of patients for whom particular approaches are most cost effective. Critical self-management prac tices for adults with asthma were identified using the critical incident technique. An individualized and a group administered educational program are being developed to teach the identified critical skills, using the instructional models previously employed in AIR WISE and AIR POWER programs for children with asthma.

Three hundred patients with moderate to severe asthma from Northern California Kaiser-Permanente Medical Group clinics will participate in a trial of these programs. Patients will be randomly assigned to one of four conditions: One of two educational programs, an information/attention control, or a data-only control condition. Data will be collected on all patients for 15 months; health care utilization data covering a two-year period will be available from medical records. Program effectiveness will be evaluated in terms of pre-post changes in the patients' knowledge, attitudes, self-man agement practices, medical condition, daily functioning, and utilization of services. Cost effectiveness will be evaluated, paying specific attention to the cost effectiveness of different educational approaches for different types of patients.
Promoting Self-Management in Adults with Asthma: An Overview of the UAB Program
Authors: Bailey William C. , Richards James M. , Manzella Bryn A. , Windsor Richard A. , Brooks C. Michael , Soong Seng-Jaw
Published: February 2007

Most asthma self-management programs have focused on children, but the preva lence and impact, both personal and economic, of adult asthma is substantial. More over, failure to adhere to treatment regimens appears to be a significant problem in adult asthma. It appears important, therefore, to develop asthma self-management programs for adults. The UAB program is based on the Health Belief Model for health behavior and on the PRECEDE Model for patient education. A needs assessment and a review of existing educational materials were used to specify the content of a self- care workbook. This workbook seeks to increase cognitive skills, encourage daily self- assessment of asthma, demonstrate success in asthma self-management, and promote effective social support. The overall intervention integrates this workbook with sys tematic reinforcement of self-monitoring and self-management. A prospective con trolled study is comparing patients receiving this "special intervention" with "usual care" patients who receive only routinely available pamphlets providing information about asthma. Patients are randomly assigned to treatments by the closed envelope technique. Sample sizes were determined on the basis of statistical power. Outcomes in five areas are assessed: (1) health care utilization, (2) functional status, (3) knowl edge, (4) adherence, and (5) psychological reactions.
Health Education, Public Policy and Disease Prevention: A Case History of The New York City Coalition to End Lead Poisoning
Authors: Freudenberg Nicholas , Golub Maxine
Published: February 2007

How can health educators influence public policy so as to increase the resources for disease prevention? The following case history of the New York City Coalition to End Lead Poisoning (NYCCELP) describes how an advocacy group sought to educate parents, health workers and policy makers about a major urban health problem. Using health education techniques such as small group meetings, mass media coverage and community organizing, NYCCELP hoped to persuade city agencies to enforce more systematically existing laws for the prevention of lead poisoning and to allocate more resources for screening and education. By defining the problem of lead poisoning broadly, the Coalition was able to attract diverse constituencies including housing organizations, public health advocacy groups, public interest lawyers, elected officials and children's rights groups. In part as a result of NYCCELP's efforts, the city govern ment has screened more children for lead poisoning, hired additional health educators, enforced relevant sections of the housing code more often, and allocated new re sources for lead poisoning control.
The Impact of Parent Participation on the Effectiveness of a Heart Health Curriculum
Authors: Petchers Marcia K. , Hirsch Eugene Z. , Bloch Barbara A.
Published: February 2007

This paper presents the findings of a 1982-83 study testing a) the impact of the Chicago Heart Health Curriculum on the behaviors and attitudes toward cardiovascular disease prevention of 647 sixth-grade students in northeast Ohio, and b) the impact of including a Parental Participation Component (N=322) in conjunction with the Chi cago health curriculum program. Using a pre-test/post-test four-group experimental design, data were gathered with a Student Health Questionnaire testing self-reported attitudes and behaviors regarding cardiovascular disease factors prior to and immedi ately after the implementation of the curriculum. A parental pre- and post-test survey evaluated parental levels of knowledge and current behavior regarding cardiovascular risk factors. Using a one-between-one-within ANOVA model, treatment effects were revealed for three outcome variables: 1) Health Knowledge with higher scores indicat ing greater heart-health information ( F=34.15, df=3/590, p<0.00005); 2) Attitude Toward Nutrition with higher scores indicating a positive attitude toward one's nutri tional intake (F=4.44, df=3/517, p<0.004); and 3) Shopping Behavior with higher scores indicating healthier food choices (F=4.27, df=3/590, p<0.005). Results of the Parent Participation Component on student performance revealed that parental in volvement had no effect on student knowledge or behavior with regard to cardio vascular disease prevention.
Social Network Characteristics and Psychological Well-Being: A Replication and Extension
Authors: Israel Barbara A. , Antonucci Toni C.
Published: February 2007

This article represents a replication and extension of a previous study by Israel and her colleagues that investigated the relationship between psychological well-being and social network characteristics. The present research included both a comparable sample of white women ( N=104) between the ages of 60 and 68 (as in the original study), and a more extensive adult population of men and women ( N=718) between the ages of 50 and 95. The network characteristics examined are categorized along three broad dimensions: Structure—linkages in the overall network (size and density); interaction-nature of the linkages themselves (frequency, geographic dispersion, and reciprocity); and functions that networks provide (affective support and instrumental support). The results indicate a predominance of comparable findings for both the replication and extension studies. Of the eight network characteristics examined, the results of five of the regression analyses were the same across all three studies. The network characteristics of size, density, geographic dispersion, reciprocal instrumental support, and instrumental support did not make a significant contribution to the variance in psychological well-being. Of the other three network characteristics, the effect of frequency of interaction varied across the studies, and a pattern of significant results was found for affective support and reciprocal affective support. A discussion of this evidence in light of current literature and implications for practice and research is included.
Schools as Agents for Achieving the 1990 Health Objectives for the Nation
Authors: Allensworth Diane D. , Wolford Cynthia A.
Published: February 2007

This article clarifies the capacity of the nation's public schools to act as powerful and effective agents to facilitate attainment of the 1990 Health Objectives for the Nation. Of the health promotion and disease prevention objectives established by the Department of Health and Human Services in 1980, Iverson and Kolbe have identified 67 that can be achieved directly or indirectly through comprehensive school health programming. This process, however, can best be expedited by expanding the tradi tional definition of comprehensive school health from one that includes health instruc tion, health services, and a healthful school environment coordinated by a school/ community health council to one that integrates additional programs and resources already in existence in most school and community environments: the physical educa tion program, the school food service program, the school counseling program, and a school site health promotion initiative for faculty and staff. All eight of these areas can be utilized as highly valuable resources to facilitate the attainment of the health objec tives for the nation. This schematic, first advanced by Kolbe, includes those diverse programs which have as their objectives the promotion of some aspect of health, either for students or staff, within the school setting. Specific suggestions for programming to attain those 1990 health objectives via an integrated school-based approach are discussed.
Heart Smart: A School Health Program Meeting the 1990 Objectives for the Nation
Authors: Butcher Ann H. , Frank Gail C. , Harsha David W. , Serpas Denise C. , Little Sharon D. , Nicklas Theresa A. , Hunter Saundra MacD. , Berenson Gerald S.
Published: February 2007

The importance of health promotion is recognized throughout the nation. The Sur geon General's report of 1980, Promoting Health/Preventing Disease, delineates objec tives for intervention in 15 health priority areas. Approximately one-third of the objectives relate directly to the health of children, and many are addressed by a comprehensive cardiovascular (CV) health promotion program for elementary school children—Heart Smart. Priority areas addressed by this program are high blood pres sure control, nutrition, fluoridation and dental health, smoking, misuse of alcohol and drugs, physical fitness and exercise, and control of stress and violence. Heart Smart is a cognitive behavioral intervention designed to address health enabling and reinforcing factors within the school environment. It is based on data from the Bogalusa Heart Study which clearly document the need for CV health intervention beginning early in life. Heart Smart includes a longitudinal classroom curriculum, an aerobic fitness program taught within physical education classes, a school lunch program offering CV healthy foods, and a teacher staff development program. The goal is to reduce CV risk factors in children. With health-enhancing behavior change of the students, family, and elementary school staff, objectives for CV risk reduction in our nation can be achieved.
School Worksite Wellness Programs: A Strategy for Achieving the 1990 Goals for a Healthier America
Authors: Maysey Dorothy L. , Gimarc Jerry Dell , Kronenfeld Jennie J.
Published: February 2007

Employee health promotion programs, first developed for private business and industry, are being extended to governmental employees. South Carolina established a pilot health promotion program in 1982 for 20,000 state employees in the area surrounding Columbia, the state capital. In 1985, the Carolina Healthstyle program was institutionalized as an employee benefit, extended statewide, and was broadened to include all school district employees and state retirees. This article describes the Carolina Healthstyle program in school worksites as it is being implemented by one pilot school district, with a briefer description of the organization, funding, and evaluation of the overall state employee wellness program. The article describes con tributions that schoolsite wellness programs can make to increase positive health be haviors of staff, parents, and community as part of the movement to achieve the health goals of the nation.
Mechanisms of Psychosocial Effects on Health: The Role of Social Integration, Coping Style and Health Behavior
Authors: Cwikel Julie M. Goldsmith , Dielman Ted E. , Kirscht John P. , Israel Barbara A.
Published: February 2007

To analyze the mechanisms by which psychosocial factors affect health, this re search investigated social integration and indicators of coping style and their relation to health behaviors and health status. The analysis was conducted using the results of a 1977 survey of 854 household interviews from a multi-stage probability sample of adult residents of Washtenaw County, Michigan. Physical-health status was evaluated by two indices: Self-rated global health and self reports of chronic disability. Mental health was assessed with the Center for Epidemiologic Studies Depression Scale. Over all, the effects of the psychosocial factors were stronger for mental health than physi cal health. Social integration was shown to have direct effects on both physical and mental-health status. Internal locus of control was associated with lower levels of de pressive symptoms. Chronic conditions were primarily affected by age, sex, and health behavior. Evidence from the path analyses suggested that part of the health benefit that women accrue from social integration and an active coping style is related to better health behavior. This mediation effect was not found for men.
Social Learning Theory and the Health Belief Model
Authors: Rosenstock Irwin M. , Strecher Victor J. , Becker Marshall H.
Published: February 2007

The Health Belief Model, social learning theory (recently relabelled social cognitive theory), self-efficacy, and locus of control have all been applied with varying success to problems of explaining, predicting, and influencing behavior. Yet, there is con ceptual confusion among researchers and practitioners about the interrelationships of these theories and variables. This article attempts to show how these explanatory fac tors may be related, and in so doing, posits a revised explanatory model which incor porates self-efficacy into the Health Belief Model. Specifically, self-efficacy is pro posed as a separate independent variable along with the traditional health belief var iables of perceived susceptibility, severity, benefits, and barriers. Incentive to behave (health motivation) is also a component of the model. Locus of control is not included explicitly because it is believed to be incorporated within other elements of the model. It is predicted that the new formulation will more fully account for health-related behavior than did earlier formulations, and will suggest more effective behavioral interventions than have hitherto been available to health educators.
Perceptions Held by Obese Children and their Parents: Implications for Weight Control Intervention
Authors: Uzark Karen C. , Becker Marshall H. , Dielman T.E. , Rocchini Albert P. , Katch Victor
Published: February 2007

The study was designed to identify some of the psychosocial barriers to compliance in a hospital-based weight control intervention program for adolescents. Forty obese adolescents, 10 to 16 years of age, and their parents were surveyed prior to participa tion in a behavioral change weight control program at a major teaching hospital. Significant correlations were obtained between weight loss outcome and six factors. In obese adolescents, weight loss was significantly associated with their beliefs regarding: (1) personal control over weight, (2) barriers or difficulty of losing weight, (3) medical problems as a cause of their obesity, (4) family problems as a cause of their obesity, and (5) perceived willingness of family members to diet. It is suggested that greater weight loss in children who perceived more barriers/difficulty and less family willing ness to diet may reflect the importance of having realistic expectations related to be havioral compliance. In addition, a positive parental attitude or expectation that the child was less likely to be overweight in the future was associated with greater weight loss compliance. Other parental health beliefs, however, did not generally predict the child's weight loss response to the intervention. The findings lend support to the sig nificance of the adolescent's beliefs regarding weight and family support in explaining weight loss response to a behavioral change intervention program.
Format and Quitting Instructions as Factors Influencing the Impact of a Self-Administered Quit Smoking Program
Authors: Cummings K. Michael , Emont Seth L. , Jaén Carlos , Sciandra Russell
Published: February 2007

This article presents results from an experimental study designed to evaluate the effects of two features of self-help smoking cessation booklets, format (i.e., day-by- day plan for quitting versus a less structured menu format) and quitting instructions (i.e., "cold turkey" versus gradual reduction) on smoking cessation. Four separate self- help booklets were developed for comparison in this study. Each varied on a combina tion of the two study factors, but were similar in content, length, style, and readabil ity. The four booklets provided similar advice on how to quit smoking, emphasizing behavioral self-management principles. In addition to the experimental booklets, a fifth control booklet provided general information about smoking and its adverse effects, but no specific advice on quitting. Study subjects included 1,534 adult cigar ette smokers who called a stop smoking hotline in Buffalo, New York seeking informa tion on how to quit. Subjects were followed up by phone one month and six months after enrollment to assess changes in smoking behavior. Overall, 18% of subjects re ported being off cigarettes for at least one week at the time of the six month follow-up interview. The format of the booklet and quitting instructions had no effect on smoking cessation rates. In addition, the four booklets emphasizing behavioral self- management skills were no more effective than the control booklet (6 month non- smoking prevalence rate: 17% versus 19%). It is recommended that future self-help quit smoking booklets include information aimed at motivating cessation and focus less attention on teaching strategies for quitting.
Cigarette Advertisements in Magazines: Evidence for a Differential Focus on Women's and Youth Magazines
Authors: Albright Cheryl L. , Altman David G. , Slater Michael D. , Maccoby Nathan
Published: February 2007

Cigarette advertisements in eight popular magazines from 1960 to 1985 were exam ined. The magazines were selected to represent different market segments, particularly women and youth. Across all eight magazines, the average num ber of cigarette ads per issue increased substantially following the 1971 television ban on cigarette ads. More over, beginning in the late 1960s and early 1970s, proportionately more ads were placed in women's and youth-oriented magazines than in magazines which targeted other population segments. These data suggest that the tobacco industry may have responded to decreases in the number of smokers and the per capita consumption of cigarettes with an enterprising attempt to recruit new smokers—particularly young people and women.
Participation in Workplace Health Promotion Programs: The Contribution of Health and Organizational Factors
Authors: Sloan Richard P. , Gruman Jessie C.
Published: February 2007

Interest in workplace health promotion programs has raised important questions regarding these programs' ability to attract participants. Typically, participation has been examined as a function of personal characteristics of employees. But participa tion in a workplace health promotion program may be influenced as much by organi zational characteristics as by health-related characteristics of employees. This prelimin ary study, conducted at AT&T Communications, used path analysis, a statistical technique for controlling for the effects of causally prior variables, to develop a model of participation. The influence of three sets of factors was detected: (1) Sex of em ployee was significant, with women more likely than men to participate in the pro gram, (2) Increased perceived risk of illness led to decreased health satisfaction which in turn led to increased intention to change health habits culminating in increased participation, and (3) The organizational climate factor of perceived supportiveness of the supervisor contributed to participation. While several potential limitations require that these findings be replicated and extended, the study suggests that developers of workplace health promotion programs should attend to organizational work climate as well as personal health characteristics of employees in an effort to increase program impact.
Education for Job Safety and Health
Authors: Vojtecky Michael A.
Published: February 2007

The Federal Occupational Safety and Health Act of 1970 (OSHAct), while empha sizing the importance of engineering controls, explicitly recognizes the salience of worker behavior to the prevention of injury and illness by mandating training in job safety and health. Selected research findings from the published literature illustrate that: (1) reliable behavioral procedures that took advantage of existing engineering controls improved the health protection of workers, (2) changes in environmental con ditions were effected through changes in worker behavior, and (3) changes in the social environment favorable to the adoption of safe behavior resulted from training and motivation programs. At present individuals who are responsible for workplace health education rarely have appropriate training in this area. Until individuals with special training in health education enter this field it is unlikely that education will achieve its potential as a method for combatting occupational illness and injury.
A Meta-analysis of School-based Smoking and Alcohol Use Prevention Programs
Authors: Rundall Thomas G. , Bruvold William H.
Published: February 2007

Tobacco and alcohol use among adolescents continue at historically high rates, and school-based interventions designed to deter students from smoking and drinking are increasingly being implemented. This study reports a meta-analysis of 47 smoking and 29 alcohol school-based intervention programs published after 1970. Results indicate that, in general, smoking and alcohol interventions have equally modest effects on immediate behavioral outcomes. Smoking interventions, however, have been more successful than alcohol interventions at altering students' long term behavior. All of the alcohol programs and all but one of the smoking programs reviewed successfully increased knowledge regarding the risks of these behaviors. Attitude change appears to be more difficult to achieve. Twenty-nine of 33 smoking studies and only 19 of 31 alcohol studies successfully changed students' attitudes. Finally, the data indicate that for immediate smoking outcomes and long-term alcohol outcomes innovative interven tions relying upon social reinforcement, social norms, and developmental behavioral models are more effective than traditional "awareness" programs designed to inform adolescents about the health risks associated with tobacco and alcohol use. The impli cations of these findings for the future of school-based health promotion programs are discussed.
Empowerment Education: Freire's Ideas Adapted to Health Education
Authors: Wallerstein Nina , Bernstein Edward
Published: February 2007

Empowerment Education is proposed as an effective health education and preven tion model that promotes health in all personal and social arenas. The model suggests that participation of people in group action and dialogue efforts directed at commun ity targets enhances control and beliefs in ability to change people's own lives. The article is divided into three parts: a literature review demonstrating that powerlessness is linked to disease, and conversely, empowerment linked to health; an exposition of Brazilian educator Paulo Freire's empowering education theory with a comparison to traditional health education; and a case study of an empowering education substance abuse prevention project.

The Alcohol and Substance Abuse Prevention (ASAP) Program is a University of New Mexico School of Medicine, Emergency Center, and community and school-based prevention project for adolescents. The case study will present ASAP's theoretical underpinnings and social practice, evaluation results, preliminary understandings of the stages for an empowering process, and future questions for practitioners interested in this approach. Empowerment education with its emphasis on organizing is recom mended to be integrated into other prevention strategies of health promotion, disease prevention, and health policy.
Environmental Interventions to Promote Healthy Eating: A Review of Models, Programs, and Evidence
Authors: Glanz Karen , Mullis Rebecca M.
Published: February 2007

Environmental interventions are an important part of efforts to improve health in populations. With respect to strategies to encourage positive nutrition behavior, envi ronmental approaches help create opportunities for action by removing barriers to following a healthy diet. This article reviews the rationale, conceptual models, program examples, and recent empirical evidence regarding the extent and effects of environ mental interventions to promote healthy eating. The state of the art is described for five types of interventions: (1) changes in the food supply; (2) point of choice nutri tion information; (3) collaboration with private sector food vendors; (4) worksite nutrition policies and incentives; and (5) changes in the structure of health and medi cal care related to nutrition. Environmental approaches to dietary behavior change can reach large segments of the population through increased availability of nutritious foods, provision of quality nutrition services in workplace and health care settings, and accessible information about healthful food choices. Nutrition intervention can also serve as a model for other types of health promotion initiatives using multidimensional environmental and educational technologies.
The Role of Linking Agents in the Diffusion of Health Promotion Programs
Authors: Monahan Jennifer L. , Scheirer Mary Ann
Published: February 2007

This article examines the role of state health department dental offices as linking agents in the diffusion of an effective preventive health program, the fluoride mouth rinse program (FMRP) in public schools. The aim of this program is to prevent dental caries by a weekly mouthrinsing by elementary school students. In contrast to the tra ditional focus of diffusion research on characteristics of the innovation and character istics of the adopter, this study emphasizes an ecological approach, i.e., the transmittal mechanisms for diffusion. The state dental offices are examined as linking agents, which serve as program advocates or champions for diffusing the FMRP from the national level, where it was developed, to the thousands of local school districts and schools for adoption and continued delivery.

Using data from interviews with state dental directors and archival sources, a multi variate model was developed and used to explain the percent of a state's elementary schools using the mouthrinse program. The results support the key role of linking agents in disseminating effective health promotion programs into actual use. Implica tions are discussed for both research and practice.
Health Promotion: Integrating Organizational Change and Student Learning Strategies
Authors: Parcel Guy S. , Simons-Morton Bruce G. , Kolbe Lloyd J.
Published: February 2007

The background and conceptual support for a model for planned change in schools are presented to facilitate the adoption, implementation, and maintenance of health promotion innovations. The model proposes four phases of change: (1) institutional commitment, (2) alterations in policies and practices, (3) alterations in roles and actions of staff, and (4) student learning activities. The model can be applied to influ ence organizational change in multiple components of the school health program to predispose, enable, and reinforce student health behavior.