bluuebunny/crossref_metadata_2025 huggingface dataset:
Six Steps towards Cultural Competence: A Clinician’s Guide
Authors: Narayan Mary Curry
Published: April 2003

In December 2000, the Office of Minority Health published the “National Standards on Culturally and Linguistically Appropriate Services in Health Care,” making cultural competence in home health clinical practice a critical competency. This article describes a six-step model that clinicians—nurses or therapists—can apply to provide culturally competent care to home care patients.
Cultural Influences on Pain Perceptions and Behaviors
Authors: Callister Lynn Clark
Published: April 2003

The perception of pain and behaviors associated with pain are influenced by the sociocultural contexts of the individuals experiencing pain. This article provides an overview of the literature on these cultural influences. With the increase in global migration, nurses need to develop increased sensitivity to the influence of culture on pain perceptions and behaviors. In the provision of home health care, it is essential that nurses are sensitive to such influences in the delivery of culturally competent care in the assessment and management of both acute and chronic pain.
Independent Nursing Interventions for Pain Management
Authors: Christiaens Glenda
Published: April 2003

A brief review of benefits and basic concepts of four independent nursing interventions for the management of pain is presented. Relaxation, imagery, music, and touch are simple to learn and implement for the nurse and require limited energy expenditure for the patient.
The Medication Management Model: An Effective Tool for Home Health Providers
Authors: Frey Dennee
Published: April 2003

Home health patients are at substantial risk for medication problems and errors. A medication management model designed specifically for use by home health agencies proved effective in a recent study conducted by Vanderbilt University: Medication use improved in 50% of intervention participants compared with 38% of controls. The model uses a structured collaboration between a clinical pharmacist and a home health nurse. It can help providers meet federal standards for medication review and improve clinical outcomes by identifying and preventing medication errors in their patients. This article presents findings from the study and strategies for implementation so other home health providers can adopt the model for use in their practices.
Integrating Joint Commission on Accreditation of Healthcare Organizations Standards Into Pain Management Practices
Authors: Kelly Anne Marie
Published: April 2003

Although recent medical research has provided tremendous advances in pain relief, the wealth of knowledge and techniques available is underused by health care providers. Inadequate pain management was thought to be such a wide problem that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) published new standards for the assessment and management of pain in 1999. All health care organizations are required to adhere to these guidelines, which recognize the patient’s right to appropriate pain management. The overall goal is to relieve pain and suffering, maintain the patient’s dignity, and improve quality of life. This article focuses on how health care professionals can integrate the JCAHO standards into pain management practices that will positively affect the quality of patient care on a day-to-day basis.
Linking Social Systems Analysis To The Industrial Ecology Framework
Authors: Hoffman Andrew J.
Published: April 2003

In theory, industrial ecology is a powerful analytical tool that challenges us to think beyond a mechanistic, fragmented view of environmental problems (and solutions). Indeed, it provokes thinking about the holistic industrial system. Presently, however, the field tends to focus primarily on technical processes and quantitative, material-oriented analysis. This article invites a discussion about expanding industrial ecology's models by considering social systems analysis. Its purpose is not to argue for dismantling or replacing extant industrial ecology. Instead, by advocating that industrial ecologists link their perspectives with perspectives from social science, it is hoped that the existing strengths of the discipline can be augmented with an emphasis on social and broader systemic factors. This direction is consistent with more holistic thinking and the roots of the discipline.
The Emerging Consensus on Surface Transportation
Authors: Orski C. Kenneth
Published: April 2003

This article discusses the issues confronting Congress as it prepares to authorize the federal surface transportation programin 2003. Unlike the last reauthorization cycle, there is a large degree of consensus among the stakeholders on what the reauthorization should accomplish.
Locating Major League Stadiums Where They Can Make a Difference
Authors: Nelson Arthur C.
Published: April 2003

The louder policy analysts complain about using public resources to subsidize the construction of new major league sports stadiums, the more subsidies are made, despite empirical evidence showing that public investments in stadiums to lure or keep major league teams have considerable opportunity costs. Policy analysts should consider shifting the emphasis of their work to evaluate where building stadiums would minimize opportunity costs or maximize economic interactions among locations. This article uses time-series analysis of 25 metropolitan areas to show that in terms of capturing share of economic activity, the best location for professional sports stadiums appears to be the downtown (including the central business district and nearby “edge” areas), followed by other locations in the central city. Suburban locations appear to be associated with the least amount of economic activity. This analysis has broad implications for all major public investments aimed at attracting people to sports, recreation, culture, and public assembly venues.
Public Works Policy and Outcomes in Japan and the United States
Authors: Button Kenneth , Gifford Jonathan , Petersen John
Published: April 2003

This article analyzes the pattern of public works spending in Japan and the United States from the perspective of recent thinking on the role of infrastructure in promoting economic growth. This is an important topic given the sluggish economic growth in Japan in the 1990s. There is renewed interest in the role of public infrastructure in shaping the economy’s fortunes in light of developments in the United States. The prolonged economic downturn, rising public works spending and public debt, and the election of the Koizumi government have motivated the reassessment of decades-old public works policies in Japan. The article begins by reviewing recent developments and findings in the literature regarding public works spending. This is followed by an analysis of patterns of public works spending in Japan and the outcomes of this policy. The later sections explore policies to reposition public works spending in favor of more productive sectors to best contribute to economic growth.
Infrastructure Planning in an Uncertain Environment
Authors: Mayer Henry J. , Greenberg Michael R.
Published: April 2003

Long-term infrastructure planning is an ongoing challenge to all public and private sector organizations and can be made even more difficult if one is responsible for a complex that has an uncertain future and erratic funding. The authors apply five long-term capital asset planning principles to a major infrastructure project under consideration at the U.S. Department of Energy’s former nuclear weapons production site at Savannah River Site, raise critical issues and questions that need to be addressed as part of this process, and provide a framework for planning and managing a facilities and infrastructure program in an uncertain environment. The objective is to use this project as a means of identifying the many issues and questions that need to be addressed within the scope of each of the planning principles put forth.
Risk of Terrorism to Cyber-Physical and Organizational-Societal Infrastructures
Authors: Haimes Yacov Y.
Published: April 2003

Since the attacks on the World Trade Center and the Pentagon on September 11, 2001, the subject of terrorism has finally receivedthe attention it deserves. In particular, the advancement in information technology, which has markedly increased the interconnectedness and interdependencies of our critical infrastructures, has made them vulnerable to terrorist attacks. Risk of attacks to critical cyber-physical infrastructures andto the organizational-societal infrastructures that enable and sustain democratic societies cannot be addressed on an ad hoc basis. To appreciate the needandimportance of a holistic risk assessment and management process for addressing terrorism, it is constructive to characterize it in three categories, which frequently overlap: (a) risk to critical cyber-physical infrastructures; (b) risk to organizational-societal infrastructures; and(c) risk to human lives andto individual property, liberty, and freedom.
The Economics of Traveler Information from Probes
Authors: Levinson David
Published: April 2003

This article examines the economics of traveler information from probe vehicles to understand how many probes are needed to provide useful information and how that probe information might be suppliedto travelers. Probes differ from permanently installed roadway detection devices both because they provide information that is less current andbecause an information system centeredon this technology can be organizedin the form of private clubs rather than a government agency. This article estimates travel time associatedwith various shares of probes among the fleet by simulating different levels of probes, information subscription, and congestion. It examines the travel time saving under both recurring and nonrecurring congestion. With the latter, a low frequency of probes is sufficient to detect the incident andenable information consumers to choose alternates. However, smoothing the stochastic nature of traffic under recurring congestion requires a relatively high share of probes, depending on the level of congestion.
Jobs, Jobs, Jobs
Authors: Taylor Brian D. , Samples Kelly
Published: April 2003

The most recent federal surface transportation legislation significantly increased the emphasis in U.S. public transit subsidy policy on capital projects, especially rail transit. This emphasis on capital investments arises largely from perceptions by electedof ficials that transit capital investments bring significant local economic (and, hence, political) benefit. While analyses of the economic effects of transit investments shouldpr operly emphasize their transportation effects, transit investments are more often judged in the political arena in terms of the expenditure effects of high-profile capital projects on local employment. This analysis uses a regional input-output model to show that, in general, the emphasis on transit capital expenditures is not an effective way to stimulate local employment. These findings call into question both the assumptions of many electedof ficials regarding employment effects of transit capital projects andthe perceptions of many transit officials regarding the relative benefits andcosts of capital andoper ating subsidies for transit.
California’s Electric Deregulation and Its Implications
Authors: Emerson Sandra M.
Published: April 2003

This article addresses the difficulties faced by states when they uncouple electric generation from distribution to foster industry competition. The complexities of restructuring became evident when California implemented its restructuring approach under Assembly Bill 1890. Prior to California’s difficulties, industry leaders dominated the energy agenda by promising additional power, competition, andlower prices. Using publications from the Department of Energy in tandem with state utility commission reports andmedia cover age, a pattern of implementation concerns, unique to electricity, becomes apparent. Whereas deregulation may provide all that has been promised, getting to deregulation may still be a process inadequately addressed.
Investigation of Subsurface Flow Constructed Wetland Designs
Authors: Cothren Gianna M. , Chen Shulin , Pardue John H.
Published: April 2003

Results of a bench-scale model investigation of the dispersion impact on Subsurface Flow ConstructedWetland(SFCW) designs are presentedin this arti cle. The research involved determining the dispersion number as interstitial velocity, a function of aspect ratio and flow rate, was varied. The range of dispersion numbers foundwas from 0.107 to 0.345. Results indicatedthat as the aspect ratio is decreased below 2:1, increased dispersion occurs. Additionally, an increase in dispersion number with increasing flow rate for larger aspect ratios (6:1, 3:1, 2:1) was revealed. Interstitial velocity was shown to control dispersion number for higher flow rates; however, aspect ratio controlledthe dispersion number when the ratio was reduced below 2:1. This research provides a valuable tool intended for estimating the dispersion impact when applying alternative models to the design of SFCWs.
Earthquake Planning,Response, and Recovery Research Needs
Authors: Wang Zhongren , Lum Wesley , Shantz Thomas , Roblee Cliff
Published: April 2003

This Article briefly summarizes research needs of the California Department of Transportation (Caltrans) for earthquake planning, response, andrecovery. It is basedon documentation stemming from the 1989 Loma Prieta andthe 1994 Northridge earthquakes, and a series of meetings with key Caltrans divisions including Structural Maintenance, District Traffic Operations, and Maintenance. This article serves to clarify research needs and contributes to the strategic planning process of the research program, thereby helping to foster partnerships between Caltrans and the research community.
Changes in Mitigation
Authors: Bushouse Brenda
Published: April 2003

This article explores the mitigation efforts of the Central Artery/Tunnel (CA/T) project andcompares them with Boston’s urban renewal history. The CA/T project, known as the Big Dig, replaces the elevatedhighway built during urban renewal with a tunnel under Boston Harbor, a 14-lane crossing of the Charles River, and an 8-to-10-lane undergroundexpressway. The project is expectedto be completedin 2004 andwill cost more than $14 billion. Of this price tag, an estimated$3 billion has been spent on mitigation, with considerably more mitigation costs off budget. The extensiveness of mitigation for the CA/T project represents a distinct difference between urban renewal andhighway projects of the 1950s and1960s. In the 1950s, federal urban renewal and highway programs allowed local governments to steamroll over cities without adequate representation of citizen interests. In the 1990s, participation requirements andenvironmental review has ledto a reversal to the extent that citizen, business, andenvironmental stakeholders holdcritical veto points that can effectively derail public works projects. Although there are undoubtedly gains by having a more inclusive planning process, the extensive costs to mitigate issues raisedby stakeholder groups, especially environmental stake-holders, raises the question of whether other cities with decaying highway systems will be able to replicate the Big Dig. Given the reality of mitigation requirements, the prospect for future megaprojects does not look promising.
Innovation in Public Finance
Authors: Price Willard
Published: April 2003

The Review section of Public Works Management & Policy (PWMP ) intends to provide readers with an opportunity to examine the proceedings of professional meetings andthe results of research reports important to public works managers. Reviews capture the essence and insights of these documents and guide the reader to further pursuit of the topics. This review examines a roundtable discussion on innovation for public infrastructure finance conducted at the University of Southern California (USC), Sacramento Center, in December 2000. Coordinated by USC’s National Center for Innovations in Public Finance, the Roundtable focused on public/private partnerships andinnovative models andtools for developing and operating infrastructure systems.
Does Organization Matter? Effects of Administrative Reform on Pipeline Siting
Authors: Hornbaker Margaret H.
Published: April 2003

Scholars generally assume that administrative forms matter. Whether organizational structure and administrative procedures substantially influence the end results of administrative decisions, however, remains a controversial question. In specifying agency design, legislators have attempted to control bureaucratic agents and, by extension, outcomes. This study’s comparison of pipeline siting decisions in Washington, Oregon, and Montana examines how different administrative schemes can affect siting outcomes. The results are counterintuitive. Findings suggest that those who attempt to regulate a complex technology may well encounter difficulty in determining future outcomes through organizational reform and that although form matters, exogenous events may exert even greater influence over outcomes.
Creating Customers
Authors: Giglio Joseph M.
Published: April 2003

The purpose of this article is to emphasize the importance of attracting customers. That is the first order truth of any enterprise. Leveraging technology is a key in resuscitating the transportation industry, and the public transit systems are an attractive opportunity to implement several rather low-end technologies. Indeed, the real challenges to applying technology to all modes of transportation are institutional. We can use similar existing technology to change the pricing of highway services and begin to price what were perceived as public goods as private goods.
Privatization In State Agencies
Authors: Morris Elizabeth D. , Travis Rick L.
Published: April 2003

This article examines the question of why state governments choose to privatize goods and services. After reviewing the literature, to explore the question, the authors devised their own model of state privatization. Although the existing literature describes in great detail the benefits and disadvantages of privatization at all levels of government, it does not address why governments privatize. Using the Clean Water State Revolving Fund (CWSRF) program, the authors test their model of privatization use by state government using political, economic, and administrative variables. They find support for political and cultural influences and state economic conditions as explanations for why privatization is chosen as an option by state governments.
The Value Of Pricing The Use Of Roads
Authors: DeCorla-Souza Patrick , Whitehead Rosalynn E.
Published: April 2003

Value pricing is a market-based approach to reduce the waste associated with traffic congestion. It typically involves charging tolls for road use but can encompass a variety of other market-based approaches. The Federal Highway Administration (FHWA) encourages the use of value pricing strategies to reduce congestion, improve transportation system performance, and promote mobility through its Value Pricing Pilot Program. The FHWA is currently working with partners in 12 states to demonstrate the feasibility and benefits of value pricing. Successfully implemented projects exist on highway facilities in California, Texas, Florida, New York, and New Jersey. Additionally, several feasibility studies, preimplementation studies, and pilot simulation tests are under way in these and other states. This article describes various types of value pricing projects and presents what we have learned from those projects that have already been implemented. The article concludes with a discussion of proposals for the future.
Achievements Of Zero-Tolerance Drug Testing
Authors: Fain Herbert , Celinski Laura C.
Published: April 2003

Drug use in the workplace can seriously affect safety and productivity. Employee drug testing is one means to reduce employee substance abuse; however, policies that allow drug users, whether casual or habitual, second chances after positive drug tests do not do enough to combat this problem. The City of Houston implemented zero-tolerance drug testing almost 10 years ago. This policy was carefully designed to meet legal standards and has been consistently enforced. Since the effects of the program were last reported, the city has continued to have a positive drug-testing rate that is well below the national average. Additionally, the city has maintained other positive trends, such as lower injury rates and workers’ compensation claims.
Costs And Benefits Of Mitigating Radon In Drinking Water
Authors: Vitaliano Donald F.
Published: April 2003

The Environmental Protection Agency (EPA) is considering regulating radon, a naturally occurring soil gas dissolved in drinking water, because it poses a lung cancer risk. Benefits and costs of compliance are estimated for 29 water systems with radon above the proposed maximum contaminant level. The estimated cancer risk is three times higher than assumed by EPA, making it likely that a national regulatory standard of 300 picocuries per liter of water would pass a cost-benefit test. Site specific estimates of compliance costs are also substantially greater than EPA estimates. Nevertheless, the estimated cost per avoided death is only about $1 million.
Citizen-Based Priorities In Transportation
Authors: Orndoff Cynthia J. Wilson
Published: April 2003

Significant efforts in identification and management of transportation assets ranging from the infrastructure to the effect of transportation on society are under way to improve quality service delivery. The challenge for Highway Transportation Asset Management (HTAM) is to identify which areas of transportation the public would like to receive prompt investment and attention. This article studies a recently improved two-lane highway corridor in rural Illinois to determine how well highway transportation asset management (HTAM) are meeting stakeholder needs. Only by knowing what the customers consider an asset and what influences the performance measure of that asset can HTAM actually be customer focused. Customer focus (CF) has historically not been the goal, particularly for highways that already exist. The results of this preparatory study provide recommendations to help transportation agencies develop programs and service delivery to improve the effectiveness in meeting the needs and goals of customers.
The Impact of Right-to-Carry Concealed Firearm Laws on Mass Public Shootings
Authors: Duwe Grant , Kovandzic Tomislav , Moody Carlisle E.
Published: April 2003

Right-to-carry (RTC) laws mandate that concealed weapon permits be granted to qualified applicants. Such laws could reduce the number of mass public shootings as prospective shooters consider the possibility of encountering armed civilians. However, these laws might increase the number of shootings by making it easier for prospective shooters to acquire guns. We evaluate 25 RTC laws using state panel data for 1977 through 1999. We estimate numerous Poisson and negative binomial models and find virtually no support for the hypothesis that the laws increase or reduce the number of mass public shootings.
Beyond the Statistics
Authors: Scott Lori J. , Davies Kim
Published: April 2003

In this article, we report the results of an extensive examination of the county homicide files on all the known cases ( N = 42) of homicide committed by females in Burke, Columbia, and Richmond Counties of Georgia between January 1, 1990, and September 24, 1999. We describe demographic information about victims and offenders, the victim-offender relationship, and the methods, circumstances, and roles of the accused female perpetrators. The details, which we have gathered from the files, add depth to the study, often bringing to light the more personal dynamics surrounding homicide incidents, which cannot be included in larger studies. We discuss our findings on the homicides committed by females in these less densely populated areas in light of former studies, which have focused on females in larger, more densely populated areas of the United States.
Comparative Patterns in Life Course Victimization
Authors: Lord Wayne D. , Boudreaux Monique C. , Jarvis John P. , Waldvogel Jerry , Weeks Hal
Published: April 2003

Culturally sanctioned child homicide practices and criminally motivated acts of child murder result in thousands of juvenile deaths each year. Whereas research elucidating the causes and mechanisms underlying child abuse and neglect has gained national recognition and prominence, studies specifically addressing child homicide have historically been scant. Recently, however, comprehensive empirical studies have facilitated the examination of child homicide as a successional, life course process of victimization. Although homicidal deaths occur in children of all ages, risks and dynamics are not uniform. Child homicide incidence is generally bimodal, peaking in early childhood and late adolescence, periods characterized by intense competition and social rivalry. Analogous patterns of conspecific lethality have also been noted in many nonhuman primates and other social vertebrates. Although not mitigating human responsibility, descriptive comparative analyses of the behavioral changes inherent in juvenile growth and development, childhood socialization, and social competition can provide valuable insights into the proximate and ultimate causation of child homicide.
Similarities in Homicide Trends in the United States and Canada
Authors: Sprott Jane B. , Cesaroni Carla
Published: April 2003

The decrease in the overall homicide rate in the United States during the latter 1990s has been explained in terms of changes in various factors such as the availability of guns, crack markets, and demographics. Although these are all plausible explanations, they do not explain why Canada has experienced similar declines in homicide rates during that same period. Homicides in Canada are qualitatively different from homicides in the United States, and thus changes in gun availability or crack markets are likely not behind the decrease in Canada’s homicide rate. However, changes in demographics might be one explanation behind Canada’s decreasing homicide rate. Analyses revealed that as in U.S. research findings, changes in demographics appear to account for roughly 14% of Canada’s decreasing homicide rate. Thus, although the homicides are qualitatively different from one another, demographics appear to account for similarly small proportions of the change in homicide rates in both countries.
Conflict Theory, Economic Conditions, and Homicide
Authors: Pratt Travis C. , Lowenkamp Christopher T.
Published: April 2003

Conflict theorists often specify an inverse relationship between economic conditions and crime. Empirical support for this contention in time-series analyses, however, has been inconsistently revealed in the literature, where positive, inverse, and null results have all been found. Part of the problem may be attributed to the inability of traditional measures of economic deprivation to fully capture the dynamics of a changing economic market. Accordingly, this article contains a specific empirical test of the economics-crime relationship using a different measure of economic conditions (a composite measure of coincidental economic indicators) and examining its relationship with homicides over time for total homicides, felony murders, and acquaintance homicides. Consistent with the tenets of conflict theory, the analysis reveals considerable support for an inverse relationship between economic conditions and homicide rates. Furthermore, although changes in economic conditions significantly predicted levels of both total and acquaintance homicides, the effect was strongest in the model predicting instrumental homicides (felony murders).
The Mass Murder as Quasi-Experiment
Authors: Carcach Carlos , Mouzos Jenny , Grabosky Peter
Published: April 2003

Few crimes command as much attention as mass murder. Depending on their magnitude and context, some of these incidents become enshrined as landmark historical events. Some give rise to substantial policy change. One such event in Australia was the Port Arthur Massacre that claimed 35 lives in 1996. Using a disaggregation strategy and intervention analysis, this article explores the impact of the Port Arthur massacre on subsequent homicides in Australia. The results of the analysis indicate that the Port Arthur incident appears to have had no lasting effect on homicide in Australia. However, there was an immediate increase in firearm homicides during the 5 days following the massacre. After this sudden increase, the incidence of homicide resumed its long-term downward trend. This sudden increase can be interpreted as evidence of a contagion effect, with the significant response by the Australian Government contributing to the incidence of homicide resuming its long-term trend, rather than continuing to increase.
Keeping the Public in the Dark
Authors: Steiner Benjamin D.
Published: April 2003

Drawing on a survey of parole board chairpersons in 45 of 50 states (90%) and the District of Columbia conducted between October 1997 and March 1998, this study focuses on the availability and ease of access of information concerning the parole of murderers to the public. Two important findings are reported: (a) The record-keeping systems of parole boards generally contain information that makes it possible to distinguish between prisoners convicted of various types of murder, and (b) the official publications and reports released by parole boards do not generally distinguish among categories of murder in reporting parole information and virtually never provide information on parole decisions with respect to capital murderers not sentenced to death.
Winter Is the Infanticide Season
Authors: Mccleary Richard , Chew Kenneth S. Y.
Published: April 2003

This study investigates the circannual pattern of U.S. child homicide rates. Analyses of 23,067 child homicide records extracted from 1976 to 1998 FBI Supplemental Homicide Reports reveal a winter peak for infants and toddlers (age less than 2 years) and a summer peak for primary and middle school children (ages 5 to 14). Logistic regressions find distinct risk factors for the two peaks that support the prevailing developmental risk theory. The risk factors suggest guidelines for a more rational allocation of prevention resources both across the year and among different developmental subpopulations.
Killed in the Act
Authors: Copes Heith , Kerley Kent R. , Carroll Anne
Published: April 2003

By disaggregating homicide into group-specific measures, insight may be gained into the many forms of lethal violence. In this article, the authors provide a descriptive analysis of a specific type of homicide that they refer to as “crime-precipitated homicide.” They argue that this categorization is distinct from both felony homicide and victim-precipitated homicide. Crime-precipitated homicides are those in which the victim was killed while participating in illegal behavior including predatory crimes, vice crimes, or narcotics dealing. Using the Homicides in Chicago, 1965-1995 data set, the authors describe the characteristics of crime-precipitated homicide offenders and victims including age, race, gender, and criminal histories. They also report on characteristics of the homicide event including where the homicides occur, when they occur, the type of weapon used, and the relationship between offenders and victims. Results suggest that crime-precipitated homicide is a distinct type that warrants further study.
Identifying the Structural Correlates of African American Killings
Authors: Kubrin Charis E. , Wadsworth Tim
Published: April 2003

The present study extends the understanding of the structural determinants of African American killings by analyzing the impact of key socioeconomic and demographic factors on disaggregated Black homicide rates in St. Louis neighborhoods. The findings reveal that (a) there is significant variation within Black homicides in terms of motive, victim and offender characteristics, victim-offender relationship, and type of death; (b) concentrated disadvantage is significantly associated with some but not all types of Black killings; and (c) residential instability is not significantly related to most Black killings but has a small negative effect on gang homicide. The findings reinforce the necessity of disaggregating homicide rates to understand the race-violence relationship. The theoretical, methodological, and policy implications of the findings are discussed.
Predictors of Intention to Promote Family Planning: A Survey of Protestant Seminarians in the United States
Authors: Goodson Patricia
Published: April 2003

The purpose of this study was to examine Protestant seminary students’ intention to promote family planning. Intention to promote family planning and its predictors were examined by testing a conceptual model based on the theory of planned behavior and social cognitive theory. A nonrepresentative sample of 635 seminarians (90.5% Anglo; 66.5% male) from 10 theological schools in the United States completed a mailed survey. Students were classified according to their religious beliefs as conservative (61.9%) and nonconservative (38.1%), and group differences in intention (and its correlates) were examined. Structural equation modeling was used to assess relationships among attitudes toward sexuality, attitudes toward family planning, subjective norms, knowledge, self-efficacy, and intention for both conservative and nonconservative students. Results indicated that the relationships among predictors of intention were essentially similar for both conservative and nonconservative seminarians, with attitudes and self-efficacy for promoting family planning exhibiting the strongest direct effects on intention.
Perspectives of Pregnant and Postpartum Latino Women on Diabetes, Physical Activity, and Health
Authors: Kieffer Edith C. , Willis Sharla K. , Arellano Natalia , Guzman Ricardo
Published: April 2003

Impaired glucose tolerance and diabetes are prevalent among Latino women of childbearing age. Physical activity during and after pregnancy may contribute to weight control and improved metabolic status, but recommended activities may not be perceived as appropriate or feasible. To plan realistic and acceptable interventions, pregnant and postpartum Latino women in Detroit met in a focus group series to discuss their beliefs about diabetes and factors influencing their participation in regular physical activity during pregnancy and postpartum. Women believed that diabetes was primarily related to heredity and diet but not to physical activity. Exercise was believed to reduce stress and improve general health. Women suggested an organized group intervention, in a respected location, that offered safe physical activities within the context of a variety of activities for women and children. This strategy reduced concerns about safety and social acceptability while addressing their primary interest in social support.
Infant Birth Weight as a Measure of Harm Reduction During Smoking Cessation Trials in Pregnancy
Authors: Secker-Walker Roger H. , Vacek Pamela M.
Published: April 2003

During pregnancy, a reduction of 50% or more of a biochemical measure of smoking, among continuing smokers, has been proposed by Windsor and colleagues as a newbehavioral indicator of harm reduction because it was accompanied by greater infant birth weight compared with that of infants of smokers with lesser reductions. The purpose of the authors’ study was to replicate these observations. During a trial of smoking cessation during pregnancy, data on cigarettes per day, urinary cotinine, and infant birth weight were obtained from 240 women. There were no significant differences in average birth weight between infants ofwomen who continued to smoke but reduced their cigarette consumption by 50% or more and infants of women with lesser reductions. These results indicate that this birth weight comparison does not provide a valid estimate of the harm reduction associated with a reduction of 50% or more in cigarette consumption during pregnancy.
Integrating Quantitative and Qualitative Methods to Assess the Impact of Child Survival Programs in Developing Countries: The Case of a Program Evaluation in Ceara, Northeast Brazil
Authors: Lindsay Ana Cristina
Published: April 2003

In evaluating public health programs, the tradition has been to design quantitative approaches, relying on epidemiological and statistical techniques to determine if and to what extent a program has an effect on a predetermined targeted population. More recently, however, qualitative methods such as rapid ethnographic assessments and focus groups have been implemented more frequently. This article describes an outcome evaluation of a community health workers program that integrated quantitative and qualitative methods to assess the impact of child survival interventions in reducing infant mortality and inadequate weight gain in children among municipalities in the state of Ceara, Northeast Brazil. By using multiple methods that combine quantitative and qualitative components, researchers can broaden their understanding of complex public health issues and direct use of data for decision making.
Predictors of Participation in Two Different Smoking Cessation Interventions at School
Authors: Hublet Anne , Maes Lea , Csincsak Marika
Published: April 2003

Multinomial logistic regression was used to identify demographic and psychosocial characteristics of Belgian secondary school students ( N= 493), aged 16 to 20, to predict which students choose to participate in a group-based smoking cessation program (five 1-hour weekly sessions), requested self-help quitting material, or did neither (comparison group). The participation rate was 29% for requesting self-help material and 21% for participation in the group program. The analysis indicated that students choosing to participate in the smoking cessation program were more likely to be in the 12th grade, technical students, and daily smokers. They were more likely to believe that quittingwould be difficult and reported stronger intentions to quit nowand to participate in the group program. Students requesting the self-help materials were less likely to be general students but more likely to see the benefits of quitting; they also reported stronger intentions to participate in the group program.
The Effect of Maternal Depressive Symptomatology on Maternal Behaviors Associated With Child Health
Authors: Leiferman Jenn
Published: April 2003

National prevalence rates for depression among women are twofold compared with those of men, with women of childbearing age at greatest risk. Maternal depression not only negatively affects the health of the mother but may also influence the health and development of her offspring. This study examined the relationship between maternal depression and its influence on certain maternal behaviors associated with child health. Anationally representative, longitudinal data set with information on demographic, behavioral, and health care variables obtained fromwomen in 1988 and 1991was used. The results from logistic regression modeling indicate that maternal depression is associated with maternal behaviors (i.e., an increased likelihood of engagement in smoking, in not administering vitamins to a child, and not restraining children in appropriate car seats). Moreover, race differentials were found among these relationships. The implications of these results suggest the need to screen for depression among mothers of young children.
Supporting Community-Based Prevention and Health Promotion Initiatives: Developing Effective Technical Assistance Systems
Authors: Mitchell Roger E. , Florin Paul , Stevenson John F.
Published: April 2003

As research evidence for the effectiveness of community-based prevention has mounted, so has recognition of the gap between research and community practice. As a result, state and local governments are taking a more active role in building the capacity of community-based organizations to deliver evidence-based prevention interventions. Innovations are taking place in the establishment of technical assistance or support systems to influence the prevention and health education activities of community-based organizations. Several challenges for technical assistance systems are described: (1) setting prevention priorities and allocating limited technical assistance resources, (2) balancing capacity-building versus program dissemination efforts, (3) collaborating across categorical problem areas, (4) designing technical assistance initiatives with enough “dose strength” to have an effect, (5) balancing fidelity versus adaptation in program implementation, (6) building organizational cultures that support innovation, and (7) building local evaluative capacity versus generalizable evaluation findings.
Intergenerational Transmission of Health: The Role of Intrapersonal, Interpersonal, and Communicative Factors
Authors: Rimal Rajiv N.
Published: April 2003

A model of household dietary behaviors based on adults’ and children’s intrapersonal, interpersonal, and communicative factors is introduced and tested. To the extent that children’s health behaviors are influenced by adults’ health behaviors, it is hypothesized that children’s behavioral determinants, including self-efficacy, knowledge, and use of health information, will be affected by household adults’ behavioral determinants. Household communication is expected to affect the behaviors and the behavioral determinants of adults and children. Data come from the Stanford Five-City Project. Structural equation models revealed that adults’ dietary behavior was influenced by their self-efficacy, knowledge, and discussion between adults and children. Children’s dietary behavior was influenced by their self-efficacy, knowledge, and use of health information. Adults’ intrapersonal determinants of dietary behavior predicted corresponding children’s measures. Implications for health education efforts directed at children include encouraging household discussion about health and focusing on adults as agents of change as an integral campaign strategy.
Gender Differences in Young Adults’ Beliefs About Sunscreen Use
Authors: Abroms Lorien , Jorgensen Cynthia M. , Southwell Brian G. , Geller Alan C. , Emmons Karen M.
Published: April 2003

This study employs focus group methodology to explore gender differences in sunscreen use. Guided by the theory of reasoned action, males and females were found to differ on each of the following constructs: behavior, behavioral beliefs, and normative beliefs. Males and females differed in their sunscreen use, with females adopting a more preventive style of sunscreen use and males a more reactive style. Males and females differed in their salient beliefs that motivated their sunscreen use, many of which were related to traditional American gender roles. In addition, although males and females were aware of both positive and negative sources of normative beliefs regarding sunscreen use, females received more encouragement from their mothers and peers than males. Findings are discussed in terms of their implications for the design of future interventions.
A Content Analysis of Web Sites Promoting Smoking Culture and Lifestyle
Authors: Ribisl Kurt M. , Lee Rebecca E. , Henriksen Lisa , Haladjian Harry H.
Published: April 2003

The present study examined smoking culture and lifestyle Web sites listed on Yahoo!, a popular Internet search catalog, to determine whether the sites were easily accessible to youth, featured age or health warnings, and mentioned specific tobacco brands. A content analysis of photographs on these sites assessed the demographics of individuals depicted and the amount of smoking and nudity in the photographs. The sample included 30 Web sites, all of which were accessible to youth and did not require age verification services to enter them. Cigarette brand names were mentioned in writing on 35% of the sites, and brand images were present on 24% of the sites. Nearly all of the photographs (95%) depicted smoking, 92% featured women, and 7% contained partial or full nudity. These results underscore the need for greater research and monitoring of smoking-related Internet content by health educators and tobacco control advocates.
“If They Don’t Ask About Condoms, I Just Tell Them”: A Descriptive Case Study of Latino Lay Health Advisers’ Helping Activities
Authors: McQuiston Chris , Flaskerud Jacquelyn H.
Published: April 2003

Health care practitioners have increasingly turned to lay health advisers (LHAs) to deliver health promotion and disease prevention supportive activities to underserved populations. Yet, published evaluations of the LHA programs or the manner in which LHAs deliver information are rare. An important aspect of program evaluation includes understanding the role of the LHA in the community as described by the LHAs in the field. The purpose of this article is to report the results of a component of a larger evaluation of an LHA program for preventing HIV/AIDS among recently immigrated Mexicans in North Carolina. Specifically, the authors use a descriptive case study design to report on the perceptions of the LHAs related to program objectives. The findings suggest that the LHAs are meeting the program objectives and are confident in their role as LHAs.
Achieving Cultural Appropriateness in Health Promotion Programs: Targeted and Tailored Approaches
Authors: Kreuter Matthew W. , Lukwago Susan N. , Bucholtz Dawn C. , Clark Eddie M. , Sanders-Thompson Vetta
Published: April 2003

It is a truism of health education that programs and interventions will be more effective when they are culturally appropriate for the populations they serve. In practice, however, the strategies used to achieve cultural appropriateness vary widely. This article briefly describes five strategies commonly used to target programs to culturally defined groups. It then explains how a sixth approach, cultural tailoring, might extend these strategies and enhance our ability to develop effective programs for cultural groups. The authors illustrate this new approach with an example of cultural tailoring for cancer prevention in a population of lower income urban African American women.
“What Are They Going to Do With the Information?” Latino/Latina and African American Perspectives on the Human Genome Project
Authors: Schulz Amy , Caldwell Cleopatra , Foster Sarah
Published: April 2003

New developments in genetic science raise questions regarding their application and implications. Dialogue about these questions has not often included the perspectives of the general population and, in particular, the voices of labeled racial or ethnic groups. In this article, the authors present results from an analysis of data from focus group discussions that engaged African Americans and Latinos/Latinas in a discussion of genetic research and technology. In particular, the authors focus on questions of inequality that arose in those focus groups and their implications for public health professionals interested in addressing pervasive racial disparities in health. In addition, they present strategies for achieving a more equitable distribution of risks and benefits from genetic research and technology suggested by participants in these focus groups.