bluuebunny/crossref_metadata_2025 huggingface dataset:
Media Advocacy: A Strategy for Advancing Policy and Promoting Health
Authors: Wallack Lawrence , Dorfman Lori
Published: February 2007

The purpose of media advocacy is to promote public health goals by using the media to strategically apply pressure for policy change. It provides a framework for moving the public health discussion from a primary focus on the health behavior of individuals to the behavior of the policymakers whose decisions structure the environment in which people act. It addresses the power gap rather than just the information gap. Media advocacy focuses on public policy rather than personal behavior. This article uses two case studies to illustrate key aspects of media advocacy. The first is a 5-year statewide violence prevention initiative for young people in California. The second focuses on the activities of a mothers' group working to improve public housing. The "new public health," with its focus on participation, policy development, and political processes, could benefit from incorporating media advocacy.
Using Mass Media to Prevent Cigarette Smoking Among Adolescent Girls
Authors: Worden John K. , Flynn Brian S. , Solomon Laura J. , Secker-Walker Roger H. , Badger Gary J. , Carpenter Joseph H.
Published: February 2007

This article describes the development of a mass media smoking prevention intervention targeted primarily toward adolescent girls at increased risk for smoking and assesses its outcomes. A cohort of 5,458 students was surveyed at baseline in Grades 4-6 and annually for 4 years. Through diagnostic and formative research, media messages were created to appeal especially to girls. Students beginning in Grades 5-7 received the 4-year media intervention and a school program in two communities, while students in two matched communities received the school program alone. Media targeting techniques resulted in high levels of message appeal and exposure consistent with effects on mediating variables and 40% lower weekly smoking at Grades 8-10 for girls receiving the media and school interventions compared to school alone. Smoking behavior effects were maintained at Grades 10-12. These results indicate that mass media interventions targeting specific audience segments can reduce substance use behavior for those segments.
Using the Theory of Reasoned Action (TRA) to Understand the Decision to Use Condoms in an STD Clinic Population
Authors: Baker Sharon A. , Morrison Diane M. , Carter William B. , Verdon Michael S.
Published: February 2007

The theory of reasoned action (TRA) provides useful information when designing health education interventions. In this study, 703 heterosexual STD clinic clients responded to a TRA-based survey. With steady partners, social norms and attitudes toward condom use were significant predictors of intention for both men and women. The interaction of attitude and norm increased prediction for men (R = .64, p < 0.001) and women (R = .70, p < 0.001). With casual partners, attitude was a predictor for men and social norm was a predictor for women. Prior use of condoms increased prediction for men (R = .38, p < 0.001) and women (R = .47, p < 0.001). Findings suggest that, in addition to traditional TRA model variables, the relationship between sexual partners and the individual's prior experience with condom use should be incorporated into attempts to understand this complex, dyadic behavior. Examining specific outcome and normative beliefs also provides important information for intervention design.
Introducing Technology into the Public STD Clinic
Authors: Conlon Richard T.
Published: February 2007

Review of the literature on public health services shows that virtually no information is available on how the state-supported networks of STD clinics now function, what the possibilities are for achieving efficiency in service delivery, or the implications of local, state, and federal funding and staffing changes. This article describes models of STD services now offered and thus allows one to project impending changes in the public health STD clinic system. The description includes a brief recount of how the imposition of HIV testing and counseling has taxed clinic resources and has sharpned the need for more efficient, technology-supported management. The status of federal staff is also summarized, with consideration of how decreases in staff will affect partner notification, the cornerstone of traditional STD-clinic-based services. Data on clinic function and staffing trends frame suggestions for the placement of computer technology in the system.
Computerized Health Assessment and Education for Adolescent HIV and STD Prevention in Health Care Settings and Schools
Authors: Paperny David M. N.
Published: February 2007

This report summarizes a number of computer applications from a decade of experience with computerized adolescent health assessments and automated health education in a large health maintenance organization, military adolescent clinics, detention facilities, health fairs, and public schools. Feedback from over 5,000 adolescents is given for patient responses to and acceptance of computerized health assessments and preferences for automated health education modalities, including multimedia. Implications of the computerized approach to assessment of adolescent health risk behaviors and the provision of automated health education and HIV/STD prevention are considered in terms of efficiency, reliability, and access to health screening and educational services.
Development and Evaluation of a Sexual Decision-Making and Social Skills Program: "The Choice is Yours-Preventing HIV/STDs"
Authors: Noell John , Ary Dennis , Duncan Terry
Published: February 2007

A series of interactive videodisc programs designed to reduce HIV/STD risk behaviors was developed and evaluated. Separate programs were developed for each of three race/ethnicities (African American, Hispanic, and Caucasian) at each of two age levels (middle school and high school) using extensive formative procedures. Each program uses scenarios with extensive branching story lines to teach decision-making skills and socially appropriate responses to potentially risky sexual situations. In a randomized experiment with 827 students, significant changes were observed at posttest for the four constructs assessed: (1) belief that sex occurs as a result of decisions (vs. "it just happens"), (2) belief that even a single incident of unprotected sex can result in an STD or pregnancy, (3) intentions and attitudes toward use of condoms, and (4) self-efficacy in remaining abstinent (i.e., avoiding sex). At 30-day follow-up, three of the four measures remained significant.
An HIV/AIDS Prevention Project for Mexican Homosexual Men: An Empowerment Approach
Authors: Zimmerman Marc A. , Ramirez-Valles Jesus , Suarez Enrique , de la Rosa Graciela , Castro Marco A.
Published: February 2007

In this intervention, participants design and implement an HIV/AIDS prevention project for Mexican homosexual men. The intervention is consistent with, and contributes to, empowerment theory because it enhances collective action, provides opportunities to develop knowledge and skills, creates needed resources, and includes shared control with professionals and among participants. The intervention described provides an illustration of an empowering process and distinguishes itself from empowerment outcomes. An evaluation of the project is also described, but the outcomes were HIV/AIDS-related behaviors rather than psychological empowerment of the participants. The results suggest that the participants' HIV/AIDS knowledge and preventive behavior improved when compared to individuals who did not participate in the intervention. In addition, the intervention generated community change initiated by participants. Implications for designing interventions using an empowerment approach are discussed.
A Self-Help Smoking Cessation Program for Inner-City African Americans: Results from the Harlem Health Connection Project
Authors: Resnicow Ken , Vaughan Roger , Futterman Robert , Weston Raymond Eric , Royce Jacqueline , Parms Clifford , Hearn Marsha Davis , Smith Matt , Freeman Harold P. , Orlandi Mario A.
Published: February 2007

The authors develop and test a culturally sensitive, low-intensity smoking cessation intervention for low-socioeconomic African Americans. African American adult smokers were randomly assigned to receive either a multicomponent smoking cessation intervention comprising a printed guide, a video, and a telephone booster call or health education materials not directly addressing tobacco use. The results of the study were mixed. Although no significant effects were observed for the entire treatment cohort, the results of post hoc analyses suggest that culturally sensitive self-help smoking cessation materials plus a single phone contact can produce short-term cessation rates similar to those reported for majority populations. This conclusion should be tempered by the low completion rate for the booster call and several design limitations of the study.
Rethinking Perceived Risk and Health Behavior: A Critical Review of HIV Prevention Research
Authors: Kowalewski Mark R. , Henson Kevin D. , Longshore Douglas
Published: February 2007

Perceived risk of infection, one factor influencing HIV-related behavior decisions, has been the focus of expanding research efforts. A body of research now exists examining factors related to risk perceptions and the relationship between risk perceptions and behavioral decision making. This article examines 60 quantitative studies of HIV-related risk perceptions, identifies methodological and theoretical limitations or gaps in current knowledge, and suggests ways future research might better assess the role of risk perceptions and facilitate the adoption and maintenance of HIV-related health protective behaviors. The authors argue that mixed findings in the quantitative literature are due to (1) cross-sectional study designs that constrain or confound the interpretation of findings, (2) construct confusion and measurement inconsistencies, (3) insufficient consideration of specific subgroup or behavioral differences, and (4) inattention to situational norms and other contextual factors that influence risk perceptions and behavior.
Photovoice: Concept, Methodology, and Use for Participatory Needs Assessment
Authors: Wang Caroline , Burris Mary Ann
Published: February 2007

Photovoice is a process by which people can identify, represent, and enhance their community through a specific photographic technique. As a practice based in the production of knowledge, photovoice has three main goals: (1) to enable people to record and reflect their community's strengths and concerns, (2) to promote critical dialogue and knowledge about important issues through large and small group discussion of photographs, and (3) to reach policymakers. Applying photovoice to public health promotion, the authors describe the methodology and analyze its value for participatory needs assessment. They discuss the development of the photovoice concept, advantages and disadvantages, key elements, participatory analysis, materials and resources, and implications for practice.
Lay Health Advisors: A Strategy for Getting the Word out about Breast Cancer
Authors: Earp Jo Anne L. , Viadro Claire I. , Vincus Amy A. , Altpeter Mary , Flax Valerie , Mayne Linda , Eng Eugenia
Published: February 2007

Transforming natural helpers into lay health advisors (LHAs) is a complex undertaking. Using the North Carolina Breast Cancer Screening Program (NC-BCSP) as a case study, this article describes the steps involved in developing, implementing, and evaluating an LHA intervention, considering factors that make the LHA approach appropriate for the NC-BCSP's population, setting, and health focus. The authors review five phases of implementation (start-up, training, LHA activities, follow-up, resource mobilization) and discuss the NC-BCSP's evaluation strategies and tools in light of difficulties involved in assessing natural helping processes and impact. Program challenges related to resource needs, identification of natural helpers, and LHA monitoring and support also are considered. The authors describe ways in which one large group of older, rural, African American LHAs are helping establish countywide partnerships between health care providers, agencies, and local communities that support and sustain individual changes in health behavior.
Developing Capacities of Youth as Lay Health Advisors: A Case Study with High School Students
Authors: Berkley-Patton Jannette , Fawcett Stephen B. , Paine-Andrews Adrienne , Johns Lori
Published: February 2007

Youth lay health advising, a form of support or helping, is an important potential resource for preventive intervention. This article describes a case study of a youth lay health advising program designed to provide high school students with support and guidance to handle challenges and concerns related to their health and quality of life. First, the planning, program development, and implementation of the approach are described. Second, a rapid formative evaluation presents quantitative and qualitative information on adolescent issues faced, the types and content of interactions, and peer helper satisfaction with the program. Third, the strengths and challenges of the peer helping program and the role of youth as lay health advisors are discussed. The article concludes with a discussion of the implications for practitioners on this approach to building the capacity of adolescents as lay advisors for community health.
Health Communication in the Prevention of Alcohol, Tobacco, and Drug Use
Authors: Simons-Morton Bruce G. , Donohew Lewis , Davis Crump Aria
Published: February 2007

Research on substance abuse prevention programs indicates that effectiveness is greater when multiple intervention approaches that address the specific vocabulary, perceptions, and values of the target population are employed. The field of health communication provides unique perspectives on media that can be applied to increase the salience and effectiveness of substance abuse prevention programs. Well-designed and well-delivered health communications have the capacity for reaching remote audiences, changing health attitudes and behavior, shaping social norms, changing the way health issues are portrayed by the popular media, and influencing decisions about legislation and policies. Health communication approaches are generally employed within the broad context of health promotion programs, along with education, community development, empowerment, and social change approaches. This article describes the role of health communication in substance abuse prevention, reviews major conceptualizations of health communication, and introduces the unique features of the four articles included in this special section of Health Education & Behavior.
Right Turns Only: An Evaluation of a Video-Based, Multicultural Drug Education Series for Seventh Graders
Authors: Freimuth Vicki S. , Plotnick Courtney A. , Ryan Colleen E. , Schiller Scott
Published: February 2007

This study assessed the effectiveness of a video-based, multicultural drug education series for seventh graders. Right Turns Only (RTO) was produced by the Prince George's County Public School System in Maryland and funded by the Center for Substance Abuse Prevention. Knowledge, attitude, and behavioral intentions of 1,036 seventh-grade students who received the RTO curriculum alone or as a supplement to a traditional drug education curriculum (SMART) were measured to test the effects of this video series and its collateral print materials.
Jump Start: A Targeted Substance Abuse Prevention Program
Authors: Harrington Nancy Grant , Donohew Lewis
Published: February 2007

A substance abuse prevention and life skills program for economically disadvantaged, high sensation seeking African American teens was developed and tested in Cincinnati, Ohio. Formative research was conducted to determine program content and format. Over two implementations, 289 individuals in the target population were recruited as participants for the field test of the program. For the first implementation, participants were randomly selected from the city's summer youth employment program. For the second, a media campaign was designed to recruit participants. Process evaluation indicated that participants evaluated the program extremely positively. Outcome evaluation indicated that significant pretest differences between high and low sensation seekers were neutralized for liquor and marijuana in both years of the program and for attitude toward drugs in the first year of the program. These results suggest that sensation seeking is a useful message design and audience-targeting variable for substance abuse prevention program design. Implications and recommendations for future research are discussed.
Developing a Media- and School-Based Program for Substance Abuse Prevention among Hispanic Youth: A Case Study of Mirame!/Look at Me!
Authors: Ramirez Amelie G. , Gallion Kipling J. , Espinoza Renato , McAlister Alfred , Chalela Patricia
Published: February 2007

Mirame!/Look at Me! is a substance abuse prevention program for low-income Mexican American youth 9 to 13 years of age. The theory-driven curriculum, developed for mass distribution via a satellite television network, features social models who demonstrate cognitive-behavioral skills and display conservative norms regarding substance abuse. An 18-session curriculum contains 5-minute videos that are assigned to be followed by discussion and social reinforcement from a teacher or volunteer. This case study reports the program development process and experiences in the initial dissemination of the program through national networks for schools and cable television subscribers.
Self-Management of Cystic Fibrosis: Short-Term Outcomes of the Cystic Fibrosis Family Education Program
Authors: Bartholomew L. Kay , Czyzewski Danita I. , Parcel Guy S. , Swank Paul R. , Sockrider Marianna M. , Mariotto Marco J. , Schidlow Daniel V. , Fink Robert J. , Seilheimer Dan K.
Published: February 2007

This study tested the efficacy of the Cystic Fibrosis Family Education Program, a cystic fibrosis self-management program, on improving participants' knowledge, self-efficacy, self-management behavior, health, and quality of life. A quasi-experimental pretest-posttest nonequivalent comparison group design was employed. Participants made up 104 patient-primary caregiver dyads from the intervention site cystic fibrosis center and 95 from the usual care comparison center. The intervention, a self-paced print curriculum based on social cognitive theory, targeted behavioral capability, self-efficacy, and outcome expectations and was implemented as an integral part of medical care. Parents, early childhood, middle childhood, and adolescents received separate materials on respiratory, nutrition and malabsorption, communication, and coping issues. Significant intervention effects were found on the knowledge scores for caregivers, adolescents, and children; caregiver and adolescent total self-management scores; Child Behavior Checklist total score; one parent coping scale score; the modified NIH score; NIH pulmonary factor 1; and the Brasfield total score. Significant interaction effects were evident in the self-efficacy scores for caregivers and children.
Poverty: The Main Cause of III Health in Urban Children
Authors: de la Barra Ximena
Published: February 2007

Being poor is in itself a health hazard; worse, however, is being urban and poor. Much worse is being poor, urban, and a child. But worst of all is being a street child in an urban environment. This article will provide some background on the status of street children on a global basis, make linkages between street children and their frequent condition as working and exploited children, and detail the health impacts of the increasing poverty concentrated in poor urban slums and squatter settlements. Although some specific information on street children is provided, the social and economic factors that have a negative impact on the well-being of the broader population of poor, urban children are analyzed. The division between street children and their urban poor counterparts still living within some sort of family support system cannot be sharply defined. Programs and strategies that have been successful in improving the health and well-being of poor children in general and street children in particular are discussed.
Disease Prevention and Health Promotion in Urban Areas: CDC's Perspective
Authors: Speers Marorie A. , Lancaster Brick
Published: February 2007

The mission of the Centers for Disease Control and Prevention (CDC) is to prevent disease, injury, and premature death and to promote quality of life. This mission applies to all Americans, especially to the poor and underserved. As so many people who are impoverished live in America's urban areas, the CDC has a unique and specific interest in the health problems of our urban population. The CDC has established five priorities: (1) strengthen essential public health services, (2) enrich capacity to respond to urgent threats to health, (3) develop a nationwide prevention network and program, (4) promote women's health, and (5) invest in our nation's youth. Each of these priorities will contribute to improving the health of people living in urban areas. The CDC has recently undertaken numerous initiatives to address health promotion and disease prevention issues in the urban setting. Future directions for the CDC lie in better understanding the role of socioeconomic and cultural factors in promoting health and how resources within urban areas can be used to promote health. The CDC needs to explore potential relationships with various types of partners. Solving urban health problems requires actions from many federal agencies as well as from state and local organizations.
Sociopsychological Correlates of Motivation to Quit Smoking Among Low-SES African American Women
Authors: Manfredi Clara , Lacey Loretta Pratt , Warnecke Richard , Petraitis John
Published: February 2007

This article examines correlates of desire and plans to quit smoking among 248 young, low-socioeconomic status African American women, using variables derived from the health belief model (HBM) and the theory of reasoned action. Consistent with these theoretical models, stronger concern about the effect of smoking on one's health and having close others who want the smoker to quit increased motivation to quit smoking. However, motivation was not associated with specific HBM components regarding lung cancer. Heavier smoking and stronger perceptions regarding the functional utility of smoking decreased motivation to quit, but not as much as expected in this study population. Consistent with a process of change approach to smoking cessation, the factors that moved smokers from not planning to planning to ever quit were different from factors associated with further motivation level among the smokers who did plan to ever quit.
A Health Priorities Model: Application to Mammography Screening
Authors: Meischke Hendrika , Andersen Robyn , Bowen Deborah , Kuniyuki Alan , Urban Nicole
Published: February 2007

This study describes and empirically tests a health priorities model. This model predicts underuse of regular mammography screening among adult women within the larger health context in which such decisions are made. The model incorporates women's comparative illness threats, comparative importance of health behaviors, and demographic variables. A telephone survey was conducted with a sample of women (N = 887) older than 50, in 40 rural communities in the state of Washington. Logistic regression analyses showed that women who perceived themselves at low risk for getting breast cancer and/or who perceived another disease (i.e. heart attack) as an equal or greater threat than breast cancer were less likely to be regular screeners of mammography. In addition, women who perceived other health behaviors as more important than regular mammography screening were less likely to be regular screeners than those women who perceived regular mammography screening as more important. Current or anticipated health problems were not related to screening behavior. The results are discussed in light of the practical, theoretical, and empirical implications.
A Longitudinal Study Predicting Patterns of Cigarette Smoking in Late Childhood
Authors: Jackson Christine , Henriksen Lisa , Dickinson Denise , Messer Lynne , Robertson Susan Bridges
Published: February 2007

Early initiation of cigarette smoking so strongly predicts future smoking that several investigators have advocated delaying the age of initiation as a prevention strategy. To complement retrospective studies of early initiation, this study assessed prospectively patterns of smoking behavior in a sample of401 children who were surveyed in the fifth, sixth, and seventh grades. The principal findings were (1) modeling of smoking by parents and friends is sufficient to influence children to initiate smoking, particularly when children also have low behavioral self-control, and (2) when modeling occurs in combination with poor adjustment to school, low parental monitoring, easy access to cigarettes, and other risk attributes, early initiators are significantly more likely to continue smoking. The results suggest that delaying initiation of smoking without also modifying child attributes and socialization factors that predict early initiation and persistent smoking is unlikely to reduce the proportion of children who become habitual smokers.
Weight Loss Education: The Challenge of a New Paradigm
Authors: Gast Julie , Hawks Steven R.
Published: February 2007

Health educators and others typically rely on three weight loss strategies to combat obesity. These include (1) medical intervention, (2) caloric restriction, and (3) fat gram restriction. The empirical evidence for these approaches in producing long-term weight loss is weak. However, much media attention has been given to a weight loss paradigm that seemingly does not fall into the aforementioned categories, which has been called the intuitive eating paradigm. Currently there is no empirical evidence to validate this paradigm. The focus of this article is to present an overview of this weight loss paradigm, discuss its potential benefits for health education in relation to current weight loss paradigms, and critically evaluate it in terms of the usefulness and ethical appropriateness for health education.
Intention to Have a Mammogram in the Future Among Women Who Have Underused Mammography in the Past
Authors: Allen Jennifer Dacey , Sorensen Glorian , Stoddard Anne M. , Colditz Graham , Peterson Karen
Published: February 2007

This study investigated associations between confidence in one's ability to discuss mammography with health providers and to obtain regular mammograms (self-efficacy), social network members' attitudes toward mammograms (social influence), mammography experiences, and intention to have a mammogram in the next 1 to 2 years among women who were not in adherence with screening guidelines. Data were collected as part of a baseline assessment for a work site intervention study. Women 52 years and older completed a selfadministered survey. Those not in compliance with screening guidelines (n = 194) were included in the analyses. Logistic regression revealed that self-efficacy and strong supportive social influences were significantly associated with mammography intention (odds ratio [OR] = 2.50, OR = 2.22, respectively), adjusting for prior mammography use. Findings suggest that interventions designed to promote mammography should build women's confidence in their ability to discuss mammography with health providers and to obtain regular mammograms. Intervention among social networks may also be an effective means of promoting mammography.
Psychosocial Factors Associated With Youth Involvement in Community Activities Promoting Heart Health
Authors: Altman David G. , Feighery Ellen , Robinson Thomas N. , Haydel K. Farish , Strausberg Laura , Lorig Kate , Killen Joel D.
Published: February 2007

This study examined factors that influence youth participation in heart disease prevention activities asmong 2,609 ninth graders in six inner-city public high schools. Constructs derived from social cognitive, empowerment, and community development theories informed the conceptual framework employed. Study participants were diverse with respect to gender, ethnicity, parent education, acculturation, and academic achievement. Perceived incentive value, self-efficacy, outcome expectancies, sense of community, and perceived policy control were all significantly associated with participation in community activities promoting heart health. In multivariate analyses, perceived incentive value, defined as the extent to which participants valued a heart-healthy environment, was most strongly associated with community participation, accounting for 11.9% of the total variance. These findings have implications for designing school curricula and after-school and community programs targeting adolescents' involvement in health advocacy activities.
Concerns and Dilemmas of Hispanic AIDS Information Seekers: Spanish-Speaking Callers to the CDC National AIDS Hotline
Authors: Scott Sheryl A. , Jorgensen Cynthia M. , Suarez Lourdes
Published: February 2007

Hispanic communities suffer disproportionately from the impact of human immunodeficiency virus infection (HIV). Each year, thousands of Spanish-speaking Hispanics call the Centers for Disease Control and Prevention National AIDS Hotline to ask questions about HIV. During 1995 alone, Spanish line staff answered more than 29,000 calls. This article presents a profile of callers and their concerns based on a systematic sample of these calls (N = 6,933) and qualitative data. The authors triangulated quantitative and qualitative results to provide a deeper understanding of the issues and dilemmas discussed with callers. Males and females called in equal numbers, but significant gender differences were observed in both situational and content variables. Gender roles, cultural values, and anxiety strongly affect the way that callers approach information and prevention. Findings suggest that health educators need to carefully examine whether prevention programs will reinforce or challenge traditional gender roles, sexual norms, and cultural values.
The Impact of Computer-Tailored Feedback and Iterative Feedback on Fat, Fruit, and Vegetable Intake
Authors: Brug Johannes , Glanz Karen , Van Assema Patricia , Kok Gerjo , van Breukelen Gerard J. P.
Published: February 2007

A randomized trial was conducted to study the impact of individualized computer-generated nutrition information and additional effects of iterative feedback on changes in intake of fat, fruits, and vegetables. Respondents in the experimental group received computer-generated feedback letters tailored to their dietary intake, intentions, attitudes, self-efficacy expectations, and self-rated behavior. After the first feedback letter, half of the experimental group received additional iterative feedback tailored to changes in behavior and intentions. The control group received a single general nutrition information letter in a format similar to the tailored letters. Computer-tailored feedback had a significantly greater impact on fat reduction and fruit and vegetable intake than did general information. Iterative computer-tailored feedback had an additional impact on fat intake. The results confirm that computer-generated individualized feedback can be effective in inducing recommended dietary changes and that iterative feedback can increase the longer term impact of computertailored nutrition education on fat reduction.
Preventing the Spread of Genital Warts: Using Fear Appeals to Promote Self-Protective Behaviors
Authors: Witte Kim , Berkowitz Judy M. , Cameron Kenzie A. , McKeon Janet K.
Published: February 2007

A fear appeal campaign to decrease the spread of genital warts was conducted and evaluated. Theoretically guided by the Extended Parallel Process Model, this field study illustrated why fear appeal campaigns often appear to fail in public health arenas. Five hypotheses, which predicted when and under what conditions fear appeal campaigns would fail or succeed, were tested and supported. The results demonstrated that fear appeals can be powerful persuasive devices if they induce strong perceptions of threat and fear (which motivate action) and if they induce strong perceptions of efficacy with regard to a recommended response (which channels the action in a health protective direction). Recommendations to researchers and public health practitioners are offered.
Social Support and Coping Behaviors of Low-Income Families Experiencing Food Insufficiency in North Carolina
Authors: Ahluwalia Indu B. , Dodds Janice M. , Baligh Magda
Published: February 2007

The Food Research and Action Center estimates that approximately 12% of all families with children younger than 12 years old experience food insufficiency in the United States. The authors conducted 16 focus groups with 141 participants, who were either at risk or experienced food insufficiency, to learn about coping strategies. Individual and network-level coping mechanisms were used to manage insufficient food supply. Social networks included family, friends, and neighbors. The assistance provided included food aid, information, and emotional support. Not all networks were relied on or accessed by everyone. Most participants reported that they relied on family members first, followed by friends, and then neighbors. Parents found reliance on anyone as stressful and often threatening. In conclusion, as the social welfare system becomes constrained, more and more households may experience food insufficiency. Responsive policies are therefore needed to assist low-income families.
Practical Assessment of Adult Literacy in Health Care
Authors: Davis Terry C. , Michielutte Robert , Askov Eunice N. , Williams Mark V. , Weiss Barry D.
Published: February 2007

Low literacy is a pervasive and underrecognized problem in health care. Approximately 21% of American adults are functionally illiterate, and another 27% have marginal literacy skills. Such patients may have difficulty reading and understanding discharge instructions, medication labels, patient education materials, consent forms, or health surveys. Properly assessing the literacy level of individual patients or groups may avoid problems in clinical care and research. This article reviews the use of literacy assessments, discusses their application in a variety of health care settings, and cites issues providers need to consider before testing. The authors describe informal and formal methods of screening for reading and comprehension in English and Spanish including the Rapid Estimate of Adult Literacy in Medicine, the Wide Range Achievement Test-3, the Cloze procedure, the Test of Functional Health Literacy in Adults, and others. Practical implications and recommendations for specific use are made.
Improving Breast Cancer Control Among Latinas: Evaluation of a Theory-Based Educational Program
Authors: Mishra Shiraz I. , Chavez Leo R. , Magan∼a J. Raul , Nava Patricia , Valdez R. Burciaga , Hubbell F. Allan
Published: February 2007

The study evaluated a theory-based breast cancer control program specially developed for less acculturated Latinas. The authors used a quasi-experimental design with random assignment of Latinas into experimental (n = 51) or control (n = 37) groups that completed one pretest and two posttest surveys. The experimental group received the educational program, which was based on Bandura's self-efficacy theory and Freire's empowerment pedagogy. Outcome measures included knowledge, perceived self-efficacy, attitudes, breast self-examination (BSE) skills, and mammogram use. At posttest 1, controlling for pretest scores, the experimental group was significantly more likely than the control group to have more medically recognized knowledge (sum of square [SS] = 17.0, F = 6.58, p < .01), have less medically recognized knowledge (SS = 128.8, F = 39.24, p < .001), greater sense of perceived self-efficacy (SS = 316.5, F = 9.63, p < .01), and greater adeptness in the conduct of BSE (SS = 234.8, F = 153.33,p < .001). Cancer control programs designed for less acculturated women should use informal and interactive educational methods that incorporate skill-enhancing and empowering techniques.
The Religion-Health Connection: Evidence, Theory, and Future Directions
Authors: Ellison Christopher G. , Levin Jeffrey S.
Published: February 2007

The volume and quality of research on what we term the religion-health connection have increased markedly in recent years. This interest in the complex relationships between religion and mental and physical health is being fueled by energetic and innovative research programs in several fields, including sociology, psychology, health behavior and health education, psychiatry, gerontology, and social epidemiology. This article has three main objectives: (1) to briefly review the medical and epidemiologic research on religious factors and both physical health and mental health; (2) to identify the most promising explanatory mechanisms for religious effects on health, giving particular attention to the relationships between religious factors and the central constructs of the life stress paradigm, which guides most current social and behavioral research on health outcomes; and (3) to critique previous work on religion and health, pointing out limitations and promising new research directions.
Breast Cancer Screening Adherence: Does Church Attendance Matter?
Authors: Fox Sarah A. , Pitkin Kathryn , Paul Christopher , Carson Sally , Duan Naihua
Published: February 2007

Little is known about the health behaviors of church attendees. This article reviewed telephone interview data of 1,517 women who were church members from 45 churches located in Los Angeles County to determine their breast cancer screening status and to identify the key predictors of screening. Almost all of this sample (96%) reported attending church at least once a month. Key predictors of screening included physician-patient communication, ethnic background, and having medical insurance. Although church-related predictors were not significantly related to screening adherence, the authors compared community-based screening rates from another sample to their sample rates and found that, when controlling for income and education, church members fared better on mammography screening than women who were community residents. This finding suggests that frequent church attendance contributes to better mammography screening status and that the relationship between religious involvement and health behaviors needs further explanation.
Black Churches as Therapeutic Systems: A Group Process Perspective
Authors: McRae Mary B. , Carey Patricia M. , Anderson-Scott Roxanna
Published: February 2007

This article examines Black churches as therapeutic systems that provide psychological and physical support to African American communities. Systems theory and group relations theory are used as conceptual frameworks to discuss Black churches as indigenous community resources. Instrumental to a systems approach is an understanding of Black churches and the religious experiences they support as part of a dynamic process that may vary across churches while maintaining certain basic similarities. It is also important to explore how Black churches may function differently from one another in addressing the needs of their membership and surrounding community. Consequently, a group process perspective is used to examine how roles and functions of the church may vary as they relate to their particular congregation. Examining the role of Black churches as supportive networks provides invaluable information to professional health providers who are interested in working with Black churches as community-based organizations.
The Development of Faith Community Nursing Programs as a Response to Changing Australian Health Policy
Authors: van Loon Antonia (Anne)
Published: February 2007

This article discusses the context of Australian health care and the policy directions being implemented to meet current challenges. It demonstrates why and how faith community nursing/nurses (FCN) programs commenced within Australia as an innovative response to health policy, changing health needs and altering social and economic trends. The FCN demonstration project is described, and the unfolding FCN role and its relationship to the evolving health care continuum is discussed. Faith community (parish/pastoral) nursing fosters community participation in health and promotes whole person health, within the supported social and culturally specific context of a faith community. The FCN provides individuals and communities with health promotion and illness prevention activities, as well as care management services, and helps clarify and nurture the relationship between faith and health.
Adolescent Abstinence and Condom Use: Are We Sure We Are Really Teaching What is Safe?
Authors: Haignere Clara S. , Gold Rachel , McDanel Heather J.
Published: February 2007

This article reviews existing research on condom and abstinence method and user-failure rates, and the use of this research in determining sexuality education curricula. Latex condoms effectively prevent pregnancies and most sexually transmitted diseases or infections (STIs), with method-failure rates between 0.5% and 7%, but with user-failure rates between 12% and 70%. Total abstinence presumably has a method-failure rate of zero, but research on periodic abstinence indicates user-failure rates between 26% and 86%. No researchers have attempted to establish total abstinence user-failure rates. Abstinence-only curricula evaluations have demonstrated changes in adolescents’attitudes but little change in sexual behaviors. Comprehensive sexuality education curricula have demonstrated attitudinal changes and delays in adolescents’sexual activity. Since inconsistent use of either condoms or abstinence threatens adolescents’ health, this article urges more scientific research on total abstinence user-failure rates, better and clearer dissemination of research findings, and encourages funders to require educators to show thorough knowledge of research findings.
Staging of Dietary Patterns among African American Women
Authors: Haire-Joshu Debra , Auslander Wendy F. , Houston Cheryl A. , Williams James H.
Published: February 2007

This article describes the development of a behavioral staging algorithm for use in the Eat Well, Live Well Nutrition Program, a peer-delivered community-based program for African American women ( N = 301). The authors examined whether increased frequency in performing low-fat eating behaviors and lower percentage calories from fat intake resulted as a participant moved through five stages of readiness to change each of five low-fat dietary patterns. Frequency of performing low-fat dietary behaviors was significantly different ( p < .05) between four stages for the pattern of avoid fried foods, three stages for modify meats, and two stages for the patterns of substitution, avoid fat as seasoning, replacement. Percentage calories from fat were significantly different ( p < .05) between four stages for the pattern of replacement, three stages for avoid fried foods and modify meats, and two stages for substitution and avoid fat as seasoning. Implications of these findings for the tailoring of community-based dietary programs are presented.
Monitoring the Dissemination of an Educational Protocol on Pediatric Asthma in Family Practice: A Test of Associations between Dissemination Variables
Authors: Mesters Ilse , Meertens Ree M.
Published: February 2007

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.
Collaborative Community Research Consortium: A Model for HIV Prevention
Authors: Sanstad Katherine Haynes , Stall Ron , Goldstein Ellen , Everett Wendy , Brousseau Ruth
Published: February 2007

In 1991, the Center for AIDS Prevention Studies (CAPS) at the University of California, San Francisco, set out to develop a model of community collaborative research that would bring the skills of science to the service of HIV prevention and the knowledge of service providers into the domain of research. Essential elements of the model were training for community-based organizations (CBOs) in research protocol writing, partnership between CBOs and CAPS researchers, program research funding, support to implement studies and analyze results, and a program manager to oversee the effort and foster the relationships between CBOs and researchers. In this article, the authors describe the CAPS model of consortium-based community collaborative research. They also introduce a set of papers, written by researchers and service providers, that describes collaborative research projects conducted by research institutions and CBOs and illustrates how collaboration can change both HIV prevention research and service.
Targeting “Risky” Gender Ideologies: Constructing a Community-Driven, Theory-Based HIV Prevention Intervention for Youth
Authors: Laub Carolyn , Somera Donnovan M. , Gowen L. Kris , Díaz Rafael M.
Published: February 2007

Since the beginning of the HIV epidemic, school-based HIV prevention education targeting youth has taken many forms. Although there has been some success, educators continue to be challenged by situations in which youth are knowledgeable about HIV but continue to engage in risky sexual behavior. In this article, the authors propose that the underlying or implicit theories about teenagers’ sexual risk behavior that guide most of these prevention activities are not accurate descriptions or valid explanations of sexual risk in this population. The article is divided into three major sections. First, the authors articulate the theories underlying HIV prevention activities that are typically found in standard school-based prevention curricula, discussing both their limitations and strengths. Second, they discuss their increased awareness of the role of gender ideologies and sexual scripts in the sexual lives of youth. Finally, the authors describe their current HIV prevention activity (“The Game”) as it emerges and is shaped by their increasing understanding of the critical role of gender-based ideolo gies and sexual scripts in young people’s sexual risk behavior.