bluuebunny/crossref_metadata_2025 huggingface dataset:
ACT-Asthma Control Y Tratamiento Para Ninos: A Progress Report
Authors: Lewis Mary Ann , de la Sota Ann , Rachelefsky Gary , Lewis Charles E. , Quinones Hernan , Richards Warren
Published: February 2007

A randomized clinical trial is in progress to evaluate an asthma educational program for Latino children and their parents. The intervention, "ACT—Asma Control y Trata miento Para Ninos," was adapted from ACT for Kids, an asthma self-management pro gram for English-speaking families. Results of a pilot study indicated that socioeco nomic status was a critical variable to be considered in the design of such programs. Latino children and parents encounter significant barriers to access and continuity of medical care. Therefore, the intervention was redesigned to include "linkages" using a nurse to reduce barriers and to coordinate care. The lesson plans emphasize concrete, experimental learning experiences, with repetition of key points in each session.
The Effect of a Structured Education Program on Knowledge and Psychomotor Skills of Patients Using Beclomethasone Dipropionate Aerosol for Steroid Dependent Asthma
Authors: Heringa Pat , Lawson Lauren , Reda Domenic
Published: February 2007

The purpose of the study was to evaluate the efficacy of a structured education program on knowledge and psychomotor skills of subjects using inhaled beclometh asone dipropionate. The sample was comprised of 26 male outpatients with a mean age of sixty years (range 49 - 69 yrs) and mean educational level of 11 years (range 7 - 18 yrs). Subjects were tested to assess knowledge of drug action, self-administration, and side effects. Skill in self-administration was assessed by two independent raters who were blind to group assignment. Then, patients were randomly assigned to an experimental group (n=13), who received a structured educational program, or a con trol group (n=13), who received no structured educational interventions. Patients were retested four weeks after randomization.

Subjects in the experimental and control groups did not differ significantly with re spect to their initial mean knowledge and performance scores. The post-test mean knowledge score was significantly higher when compared to initial score for each group. Mean knowledge score at post-test did not differ significantly between groups. However, when comparing post-test performance scores to initial scores the experi mental group had a significantly greater increase in mean score than the control group. It is concluded that a structured patient education program is an effective method for improving the psychomotor skills necessary for proper use of beclomethasone dipro pionate aerosol.
Living with Asthma: Replications and Extensions
Authors: Creer Thomas L.
Published: February 2007

This article reviews replications and extensions of Living with Asthma, a self-man agement system developed and tested at the National Asthma Center in Denver be tween 1977 and 1980. Research on the system since the latter date has been con ducted within the conceptual framework provided by the social or cognitive learning model. This approach has switched experimenter effort away from developing and evaluating the acquisition of self-management skills toward assessing their performance by patients. Efforts to insure these skills are used effectively by patients to control their asthma, focusing particularly on the assessment of performance variables, are described.
Making Childhood Asthma Management Education Happen in the Community: Translating Health Behavioral Research into Local Programs
Authors: Krutzsch Christine B. , Bellicha Terry C. , Parker Sydney R.
Published: February 2007

The public health benefits of research can be realized only if proven new techniques are translated into readily usable processes and materials and widely adopted by professionals and patients alike. To accomplish this, a systematic technology transfer process is needed.

One recent outcome of health behavior research has been identification of the skills needed by children and parents to effectively manage childhood asthma. Methods for teaching these skills were tested on hundreds of families in a variety of health care settings. They were then packaged in program manuals that guide health professionals through the teaching process and provide all necessary materials for conducting sessions. The resulting four programs teach attack prevention and control skills. They also emphasize coping skills and help families come to terms with the behavioral factors that impinge on asthma management and affect compliance with medical advice.

A technology transfer project for getting initial community adoption of these programs is described. The evolution of the project, including the development of the programs themselves, packaging considerations, establishment of a unique partnership for dissemination, development of a model workshop for stimulating health professionals, implementation of programs, and follow up and evaluation, is described. Successful elements are identified at each step.
Inventorying Community Health Promotion and Risk Reduction Services: Virginia's Approach
Authors: Smith Nancy H. , Howze Elizabeth Harper
Published: February 2007

Early in this decade the U.S. Centers for Disease Control gave a mandate to states receiving Health Education/Risk Reduction Funds (HERR) to inventory health pro motion and risk reduction services. This article reports on the findings of the Northern Virginia Inventorying Project, in which an existing service classification system in use in a health planning district serving over one million people was modified to permit the annual inventorying of community health promotion and risk reduction services. The approach has utility for community health education needs assessments, ongoing evaluation of community services and progress vis-á-vis health status indicators, and for the diffusion of health promotion service information to service providers and the public.
Focus Group Interview: An Underutilized Research Technique for Improving Theory and Practice in Health Education
Authors: Basch Charles E.
Published: February 2007

The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of- the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, litera ture describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this tech nique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; appli cability of marketing research to understanding and influencing consumer behav ior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualita tive research methods.
The Potential Contribution of Computerized School-Based Record Systems to the Monitoring of the Disease Prevention and Health Promotion Objectives for the Nation
Authors: Basch Charles E. , Gold Robert S. , Shea Steven
Published: February 2007

This article discusses the potential contribution of computerized school-based record systems to help monitor the 1990 and future health objectives for the nation, to provide a continuing health data base on nearly 50 million Americans, and to improve current school health record-keeping practices. Limitations of paper-based health record systems and the state-of-the-art and future potential of computerized record systems are described. Several key obstacles to computerization of school health records are considered, including technological problems, difficulties in appre ciating and evaluating the benefits of computerization, costs, acceptability to individ uals and organizational users, standardization problems, and concerns about confiden tiality. Implementation steps involving research and surveillance measures for attaining the 1990 objectives that may be facilitated by improved school health records and information systems are specified. As school health education and school health serv ices increasingly become vehicles for achieving national public health objectives, including those set for 1990, it will be desirable to establish data systems that link information collected in individual schools with research and surveillance activities at the state and national level. Moreover, it will be desirable for school's health records and information systems to contain data describing students' health-related knowl edge, attitudes, behaviors, and physiological risk factors, in addition to the data tradi tionally maintained in such records.
Exemplary School Health Education: A New Charge from HOT Districts
Authors: Stevens Nancy H. , Davis Lorraine G.
Published: February 2007

School health education is generally regarded as instructional programs for stu dents. Such programs have limited impact, especially when the social environment is inconsistent with instructional messages. A study of Oregon school districts reveals that some school personnel have gone beyond curricula in their school education programs. Exemplary districts addressed noninstructional issues, most notably staff de velopment programs and food service offerings. In doing so, they have changed not only the social context of the schools, but their ability to directly influence a greater number of Health Objectives for the Nation.
School-Based Clinics: Their Role in Helping Students Meet the 1990 Objectives
Authors: Dryfoos Joy G. , Klerman Lorraine V.
Published: February 2007

Service statistics and observations from site visits across the country indicate that school-based clinics (SBCs) may be having an impact on several of the problems tar geted in the 1990 health objectives, including unplanned pregnancy and substance abuse. At least 120 junior and senior high schools in 61 communities are currently operating or developing clinics. Growth is attributed to increasing concern about high- risk youth, especially among educators in their roles of "surrogate parents"; to dis illusion with categorical interventions and a movement toward more comprehensive services; and to student, parent, school, and community approval of the new programs. This article describes the comprehensive school-based clinic model, including its history, organizational strategies, school/community partnerships, and services.
Effectiveness of Four School Health Education Projects Upon Substance Use, Self-Esteem, and Adolescent Stress
Authors: Bonaguro John A. , Rhonehouse Michael , Bonaguro Ellen W.
Published: February 2007

The purpose of this investigation was to evaluate the effectiveness of school health education projects on substance use, self-esteem, and stress. The subjects were 161 adolescents in fifth through eighth grades in four school health education projects funded through the Ohio Department of Health. Data collection included pretest/post test questionnaires on self-report use of tobacco products, alcohol, marijuana, and other drugs. In addition, the Hare Self-Esteem and the Adolescent Stress Sympto mology Scales were utilized. There was a six-week interval between pretest and post test administration. MANCOVA, with age as a covariate, was used to compare pretest/ posttest scores for self-esteem and stress symptomology. Furthermore, interviews were conducted with project staff about the educational methodology of their inter vention. The results revealed that the predominate educational method used by the projects was lecture/discussion. There were no significant differences between pretest/ posttest questionnaires for frequency of substance use, self-esteem, or stress sympto mology. Effective school health education programs need sufficient quantity and quality in order to have an impact on health behaviors and the intermediate health- enhancing variable of self-esteem.
Evaluation of a Tobacco and Alcohol Abuse Prevention Curriculum for Adolescents
Authors: Hansen William B. , Malotte C. Kevin , Fielding Jonathan E.
Published: February 2007

This study examined the effectiveness of a tobacco and alcohol prevention program that was delivered to sixth and seventh grade students by minimally trained classroom teachers. The program focused on (a) teaching students to identify and resist peer in fluences, (b) information about short- and long-term consequences of tobacco and alcohol use, (c) the correction of normative expectations, and (d) the establishment of conservative intentions regarding tobacco and alcohol use. Two cohorts of students were pretested, and subsequent to delivery of the program, they were tracked longi tudinally. The first cohort was followed for four years, the second was followed for three years. Results indicate that the program reduced the onset and prevalence of tobacco use but not alcohol use. The effects for tobacco were differentially related to the school district in which the program was delivered, the sex of student, and eth nicity, suggesting that prevention program content is only one variable that may affect the effectiveness of prevention interventions.
Implementing Organizational Changes to Promote Healthful Diet and Physical Activity at School
Authors: Simons-Morton Bruce G. , Parcel Guy S. , O'Hara Nancy M.
Published: February 2007

Diet and physical activity patterns appear to be learned at early ages, suggesting the need for school-based intervention. The potential of schools to improve children's diet and physical activity has been offset by countervailing school environments. In the first year of the "Go For Health" health promotion project, organizational change innovations were implemented to facilitate changes in school lunch, physical educa tion, and classroom health education in support of healthful student diet and physical activity. At first follow-up after one year of intervention, the amount of sodium in selected foods served in school lunch was reduced from baseline (1985) to year one (1986) in the experimental schools by 29 and 33%, respectively, and fat was reduced by 28 and 42%, respectively. At first follow-up, students in the experimental schools participated in fitness activities 44.1 and 38.0% of the time, compared with 19.5 and 22.7% in the control schools.
Evaluation of Continuing Education in Health Education: The Society for Public Health Education's 1983, 1984 and 1985 Mid-Year Scientific Symposia
Authors: Daltroy Lawren H. , Roccella Edward
Published: February 2007

The Society for Public Health Education's (SOPHE) first three mid-year scientific symposia were evaluated three months after each meeting with questionnaires mailed to all national SOPHE members who attended and a 10% sample of members who did not attend. 3% of SOPHE members attended the first meeting, rising to 7% and 12% in subsequent years. Persons spending their time in direct education and program plan ning/development and persons less active in health education professional organiza tions were under-represented at the meetings. About 90% of those who attended the meetings learned something that they had applied to their health education work. A third to a half had made contact with another health educator on health education business, and about one fifth had increased their participation in SOPHE affairs due to the meeting. Those who attended the mid-year meetings were significantly more likely to plan attendance at the next annual meeting than those who did not attend. Over half of those polled felt that SOPHE should continue to hold mid-year meetings; most of the rest were not sure. Strengths and weaknesses of the individual meetings are dis cussed, as well as suggestions for improvement, topics and forums for future meetings.
Personal Health Training and the Severely Handicapped: A Curriculum Based Research Investigation
Authors: McCubbin Jeffrey , Combs C. Sue , Jansma Paul , Decker James T. , Ersing Walter
Published: February 2007

Project TRANSITION studied, as part of a three year field initiated research proj ect, the effect of training selected personal health skills and their relationship to adaptive behavior. The subjects were moderately, severely, and profoundly retarded individuals residing in a state-operated developemental center. Eighty-eight subjects were selected and then randomly assigned to one of four experimental groups and participated in a 14-week training program. To test the effects of the training, valid and reliable curriculum-embedded tests were developed and used. A curriculum-em bedded test uses the material to be learned as the basis for assessing the degree to which the material has been learned. 1 These tests were designed to measure and monitor subjects' independent ability to perform each task analyzed skill. The Adap tive Behavior Scale2 was used to measure changes in adaptive behavior. Results of the personal health skill testing yielded significant group differences on the independent indices developed for the Project. No meaningful significant differences were found in adaptive behavior. The data indicated that the developed curriculum and scoring sys tem was effectively used to train and monitor selected independent personal health skills of the severely mentally retarded adults in this study.
Aptitude x Treatment Interactions: Implications for Patient Education Research
Authors: Holloway Richard L. , Spivey Richard N. , Zismer Daniel K. , Withington Amelia M.
Published: February 2007

Aptitude x treatment interaction (ATI) has been used only rarely in patient educa tion research. This research paradigm incorporates individual differences (aptitudes) into experimental studies exploring differences in information strategies (treatments). ATI has great potential for applications to patient education research. It identifies patient characteristics and optimal instructional treatments, it is compatible with psychological theories and clinical approaches alike, and it offers a specific method ology for approaching existing problems in a new way. This article presents studies in which ATI has illuminated specific patient needs and treatments, and suggested further applications. Three studies (in addition to those reviewed) are examined in depth. One study determined general guidelines for designing instructional literature to accom pany medication (drug package inserts), that would satisfy the requirements of a group of patients with varied reading ability. Another study examined the effect of patients' "prior knowledge" on their participation in a health education program. A third study explored the interaction between patients' view of self-control over their health and the use of different media for health-care instruction. Guidelines and considerations for conducting further ATI-based research are presented and discussed.
Do Only the Healthy Intend to Participate in Worksite Health Promotion?
Authors: Zavela Kathleen J. , Davis Lorraine G. , Cottrell Randall R. , Smith Warren E.
Published: February 2007

Few companies or organizations involved in health promotion have addressed the major question of whether they are reaching the employees with the greatest health needs or those who could benefit most from these efforts. The popular view that only individuals who are already physically fit and healthy participate in worksite wellness programs was critically examined. Data from 523 survey respondents at the University of Oregon were analyzed to determine whether employees differed on health-related characteristics and their interest in attending a worksite health promotion program. Comparisons between program participant "intenders" and "nonintenders" revealed that both groups had similar lifestyle habits, preventive health practices, and health status profiles. Significant differences were more related to age and perceptions about their physical and emotional health status. Implications for health risk reduction pro gram planning in the work setting are discussed.
Social Marketing and Public Health Intervention
Authors: Craig Lefebvre R. , Flora June A.
Published: February 2007

The rapid proliferation of community-based health education programs has out- paced the knowledge base of behavior change strategies that are appropriate and effec tive for public health interventions. However, experiences from a variety of large-scale studies suggest that principles and techniques of social marketing may help bridge this gap. This article discusses eight essential aspects of the social marketing process: the use of a consumer orientation to develop and market intervention techniques, ex change theory as a model from which to conceptualize service delivery and program participation, audience analysis and segmentation strategies, the use of formative research in program design and pretesting of intervention materials, channel analysis for devising distribution systems and promotional campaigns, employment of the "marketing mix" concept in intervention planning and implementation, development of a process tracking system, and a management process of problem analysis, planning, implementation, feedback and control functions. Attention to such variables could result in more cost-effective programs that reach larger numbers of the target audience.
Seeking Information: Where Do Pregnant Women Go?
Authors: Aaronson Lauren S. , Mural Carol Macnee , Pfoutz Susan K.
Published: February 2007

As part of a larger investigation of health behaviors and beliefs during pregnancy, a sample of 529 women were asked to identify their major sources of information about what they should and should not do during their pregnancies. Health care providers and books were cited as first or second most important by the largest number of respondents. When associations between respondent characteristics and preferred in formation sources were explored, it was found that women of higher socioeconomic status (SES) relied more on books and less on family than did women of lower SES. In addition, having had a previous pregnancy was associated with greater use of one's self as an information source. Although provider characteristics were not associated with choice of information source, women who perceived more support from their pro viders viewed them as more important sources of information. A similar effect for family was found. Health locus of control beliefs also were related to the relative importance of selected sources of information, while general social support was not.
An Ecological Perspective on Health Promotion Programs
Authors: McLeroy Kenneth R. , Bibeau Daniel , Steckler Allan , Glanz Karen
Published: February 2007

During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health pro motion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease.

This article proposes an ecological model for health promotion which focuses atten tion on both individual and social environmental factors as targets for health promo tion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individ uals in the population is essential for implementing environmental changes.
Issues of Control and Responsibility in Workers' Health
Authors: Green Kathryn L.
Published: February 2007

The issues of responsibility for health and control of factors influencing health are discussed with regard to workplace health programs. The role of each of the parties involved—workers, unions, management, and the government-can best be understood in relation to the interests they hold in workers' health. A matrix is presented which divides influences on workers' health according to the degree to which they are con trolled by employers and workers. This matrix is used to suggest that workplace health promotion and employee assistance programs may represent employer involvement in areas over which they lack legitimate control. These programs are also criticized for their emphasis on behavior and their neglect of work-related causes of ill health and unhealthy behavior. They should be considered supplemental to a work environment which is conducive to both physical and psychosocial health; they will be most effec tive and appropriate with a high degree of worker involvement and control. Evidence regarding the effects of occupation and class on health and health-related behavior is presented to support the need for a comprehensive, ecological approach to workers' health. Such an approach should take into account the full range of influences and recognize the limits of legitimate control.
A Hospital-Based Infant Safety Seat Program for Low-Income Families: Assessment of Population Needs and Provider Practices
Authors: Brink Susan G. , Simons-Morton Bruce G. , Zane David
Published: February 2007

Evaluation of a hospital-based car safety seat education and loan program for low- income families included hospital interviews with new mothers ( N=94), a survey of pediatricians (N=28), and a task analysis of the program coordinator's time. Mothers who entered the hospital with safety seats were more likely than those without safety seats to (1) be White or Mexican-American than Black; (2) not be dependent on public transportation; (3) have an older child who always rides in a car seat; and (4) wear seat belts themselves. Mothers with seats did not differ from mothers without seats in knowledge or beliefs about the importance of, or intent to use, car seats. Of mothers without seats, 86.3% were aware of the hospital's car seat rental program, but only 12 of 51 rented a seat from the program. 61% of pediatricians surveyed believed that mothers' lack knowledge and skills to acquire and use car seats regularly, but only 31% always included education about the importance of using car seats and only 21% always referred mothers without seats to the rental program. Car seat loan programs addressing low-income populations should place greater emphasis on education of medical providers to provide education and referrals, encourage organizational policy that requires a safe first ride home and address issues of social support and perceived norms and ease of acquisition.
Health Promotion in Context: The Effects of Significant Others on Health Behavior Change
Authors: Zimmerman Rick S. , Connor Catherine
Published: February 2007

Maintenance of health behavior change over the long-term has been routinely diffi cult. One of the reasons for this difficulty is that only individuals' attitudes or behav ior are changed, without concomitant support from the social environment. The purpose of this study was to explore several of the ways in which significant others- family members, friends, and coworkers-may affect changes in health behavior. Eighty-four participants in a work site health promotion program were the subjects of the study. Self-reports of health behaviors were gathered at baseline and at the end of the 7-week program; in addition, subjects reported the extent to which significant others generally supported health behavior changes, encouraged them to maintain changes they had made, and made changes in their own health behaviors. Results provide support for the general hypothesis that one individual attempting to change health behavior may be positively influenced by significant others during the course of the change process. Family members were particularly helpful, and overall supportive ness was more helpful than others' change in health habits or encouragement. Behav iors most influenced by others were exercise and fat consumption. Suggestions for future theoretical development, research, and intervention are discussed.
Measuring and Tracking Education Program Implementation: The Minnesota Heart Health Program Experience
Authors: Finnegan John R. , Murray David M. , Kurth Candace , McCarthy Pamela
Published: February 2007

In an overall framework uniting program planning and evaluation, process evalua tion can assist community-based health promotion programs in establishing participa tion objectives, monitoring their achievement and the quality of interventions used, and translating these into useful information for managing and developing programs. This research reports on efforts by the Minnesota Heart Health Program to develop a system that permitted tracking educational program contacts, its implementation, and its use to make management decisions about program activities. The system was devel oped as part of a planning and evaluation framework with specific criteria for develop ing and tracking educational programs drawn from the social-learning literature. Over all, the system helped to make participation objectives more concrete, aided decision making about allocation of personnel and material resources, and encouraged the development of innovative programs.
Development of a New Self-Help Guide — Freedom From Smoking® For You And Your Family
Authors: Strecher Victor J. , Rimer Barbara K. , Monaco Karen D.
Published: February 2007

This article describes the development of a new smoking cessation and maintenance guide aimed at a broad spectrum of cigarette smokers. To accomplish this task the authors reviewed the research literature and conducted a series of iterative pretests with representatives of the target populations using qualitative and quantitative meth ods. A process is described for developing health education materials which includes the selection of the target audience, organization and presentation of content, and pretesting of the material. The utility of this user-oriented strategy and step-by-step pretesting is discussed.
Pretest and Treatment Effects in an Elementary School-Based Alcohol Misuse Prevention Program
Authors: Campanelli Pamela C. , Dielman T.E. , Shope Jean T. , Butchart Amy T. , Renner Deborah S.
Published: February 2007

Forty-nine schools (N = 5,680 fifth and sixth grade students) were assigned to pre test/treatment, pretest/no treatment, no pretest/treatment, and no pretest/no treat ment conditions in the context of an alcohol misuse prevention study. At the first posttest, five months after the pretest and two months after the intervention, the effects of the pretest and of the intervention were examined. The analyses showed that failure to correct for the design effect due to clustering within schools resulted in the overestimation of the significance of treatment and pretest effects. After correction for the design effect, a significant treatment effect in the hypothesized direction was found with respect to students' awareness of the content of the curriculum. As hypo thesized, significant treatment effects on the alcohol use and misuse measures had not yet developed but are expected to occur at subsequent posttest occasions. Significant pretest effects were found for indices measuring trouble with peers resulting from students' alcohol use, students' internal health locus of control, and their perceptions of adults as a locus of control for their health. Two of the three pretest effects were in the direction that would be hypothesized if the pretest were providing the same impe tus as the intervention. Implications of these findings for school-based substance abuse prevention programs are discussed.
Introduction: Drinking, Driving, and Health Promotion
Authors: Sleet David A. , Wagenaar Alexander C. , Waller Patricia F.
Published: February 2007

Alcohol-impaired driving* continues to be one of the nation's most serious public health problems. There is now little question that consumption of alcoholic beverages, even in amounts much lower than the legal limit, is a major contributor to motor vehicle crashes and the casualties and injuries that result.1,2 One study estimates that eliminating alcohol would reduce traffic fatalities by 47 percent (± 4%), equivalent to a reduction of between 20,000 and 24,000 fatalities annually.3 There is no doubt that a reduction in alcohol-impaired driving would result in a substantial savings of human lives and resources, worldwide.4
The Nature of the Alcohol Problem in U. S. Fatal Crashes
Authors: Fell James C. , Nash Carl E.
Published: February 2007

Alcohol is involved in more than half of all U.S. traffic fatalities. In 1987, an esti mated 23,630 people were killed in alcohol-related crashes. Alcohol-related traffic fatalities continue to be the leading cause of death for young people. Alcohol is involved in almost 80% of the fatal crashes that occur between 8 p.m. and 4 a.m. on any night of the week. During the 1980s, alcohol involvement in fatal crashes declined. The proportion of drivers involved in fatal crashes who were intoxicated at the time of the crash decreased 17% from 1982 to 1987. The reduction was especially signifi cant for teenaged drivers, females, surviving drivers, teenaged pedestrians, older drivers, and drivers in daytime crashes. On the other hand, there was little or no change for drivers aged 25-34, motorcycle drivers, pedestrians aged 20 to 64, and drivers in late- night crashes. Reasons for the reduction in alcohol appear to be: (1) increased public awareness of the problem during that time period; (2) tougher laws and better enforce ment of existing laws by state and local governments; (3) the raising of the drinking age to 21 in most states; (4) other public and private programs to reduce drinking and driving, and (5) socioeconomic and demographic factors.
An Attribution Theory Perspective on Alcohol-Impaired Driving
Authors: DeJoy David M.
Published: February 2007

Attribution theory is offered as a theoretical framework for generating and testing hypotheses about how people perceive and respond to the behavior of impaired driv ing. Recent work on the attribution of responsibility for alcohol-impaired driving indi cates that the perceived seriousness of this behavior varies with the consequences and circumstances associated with it. In some instances, impaired driving is not considered to be particularly blameworthy, while in other instances, relatively minor variations in the event sequence have pronounced effects on the assignment of responsibility and punishment. In general, the seriousness of impaired driving is related to the conse quences produced. Impaired driving is not perceived as being particularly negligent as long as it does not result in harm to others. Other findings suggest that people are likely to deny the personal relevancy of situations involving impaired driving. The final section of the article discusses the program implications of this research. Specific attention is given to sources of attributional "error" and to how these inaccuracies might be identified and corrected within a prevention/intervention program context.
Drinking and Driving among Youth: A Study of Situational Risk Factors
Authors: Vegega Maria E. , Klitzner Michael D.
Published: February 2007

The situational factors associated with youthful driving while intoxicated (DWI) and riding with an impaired driver (RWID) are examined. Data were collected from separate samples of youth who had driven while impaired by alcohol and who had ridden with an alcohol-impaired driver. The purpose of the study was to determine whether there are consistent situational factors associated with DWI and RWID among youth, and to ascertain whether the situational factors vary as a function of demo graphic variables. The results indicate that DWI and RWID are largely a function of the role alcohol plays in the youth culture. When situationally determined, DWI and RWID appear to be controlled by a perceived need to get home or to get a passenger home. The implications of these results for future prevention program planning are discussed.
Research Needs and Opportunities in Server Intervention Programs
Authors: Saltz Robert F.
Published: February 2007

Prevention specialists have recently focused on ways to shape the drinking context and environment to reduce the risks of drinking and driving. Server intervention refers to a set of strategies to control drinking in service establishments through changes in management policies, serving practices, and by training servers and other employees to monitor and control patrons' alcohol consumption.

Research on server intervention is mixed, but seems to indicate that some server intervention practices can reduce levels of alcohol intoxication by patrons. Further work is needed to determine how such effects can be enhanced. Topics for future research include optimal components of specific training curriculum, policies needed to support and extend server training, importance of "booster" sessions, and the rela tionship of server intervention to broader social and legal environments that discourage drinking and driving.
Training of Persons for the Delivery of the Staying Healthy After Fifty Program
Authors: Kane-Williams Edna , Travis Salisbury Zora , Benson Lisa
Published: February 2007

The process by which volunteers were selected and trained to conduct a national health promotion program for older Americans, Staying Healthy After Fifty (SHAF), is described in this article. Feedback was elicited from participants ( N=210) concern ing the training they received in educational team workshops using pre and postwork shop questionnaires. The areas of focus during training were: medical issues, lifestyle and consumer issues, and class management and process skills. Information regarding the quality of the training procedures was also collected. In addition, 50 educational teams supplied data for a field evaluation which covered the content of the SHAF program and the educational materials and methods used. The results of the evaluation of the training of persons to deliver SHAF indicated that the team approach used was successful in delivering the program effectively to consumers and in establishing a net work of high quality instructors.
Evaluation of the Staying Healthy After Fifty Educational Program: Impact on Course Participants
Authors: Benson Lisa , Nelson Eugene C. , Napps Shirley E. , Roberts Ellen , Kane-Williams Edna , Salisbury Zora Travis
Published: February 2007

A study to evaluate the impact of a medical self-care program on older adults was conducted. The test group ( n=161) participated in an 11-session educational interven tion with training in clinical skills, lifestyle, and the use of health services. The compar ison group (n=164) received no intervention. The test group was assessed pre-interven tion, post-intervention, and six months post-intervention and the comparison group was assessed at corresponding intervals. The results indicated that medical self-care instruction produces substantial improvements in health-related knowledge, health skills performance, and health actions. This study produced no evidence, however, that medical self-care instruction has any effect on health status, the utilization of medical care, or other aspects of life quality.
Hawaii Asian-American Response to the Staying Healthy After Fifty Program
Authors: Roberts Ellen , Takenaka June I. , Ross Carswell J. , Chong Evelyn Hu , Tulang Juliette I. , Napps Shirley E.
Published: February 2007

A nationwide project conducted by the American Association of Retired Persons, the American Red Cross, and the Dartmouth Institute for Better Health to disseminate a health promotion program for older adults included a study to test its ability to serve different ethnic minorities. This article reports how the Staying Healthy After Fifty Program, designed for the general United States population, was introduced into the State of Hawaii, how it was adapted for use with two Asian-American groups, the Japanese and Filipinos, and on the benefits reported by participants. To determine the appropriateness and effectiveness of the adapted SHAF program, a quasi-experimental design, involving a test group and a comparison group whose members completed ques tionnaires at three points in time, was used. The results of the data collected from the Hawaiian population were consistent with the results of the general U.S. population study. Improvements were made by both groups at a similar rate in the health skills, health activities, and health care cost skills areas. Participants were very pleased with the course and its quality, as noted in the high ratings of course satisfaction.
Interorganizational Collaboration and Dissemination of Health Promotion for Older Americans
Authors: Simmons Jeannette J. , Salisbury Zora Travis , Kane-Williams Edna , Kauffman Carole K. , Quaintance Barbara
Published: February 2007

This article describes how a successful health promotion program for older adults was adapted and disseminated through collaboration of the American Association of Retired Persons, the American Red Cross, and the Dartmouth Institute for Better Health. The details of this effort are presented in three sections: the conceptual frame work used to build the collaborative relationship, the outcomes, and an analysis of these experiences as they relate to the diffusion of innovations in organizations. The problems encountered are discussed as well as the need for more time to elapse before judging the ultimate success of the diffusion of the program.
Characteristics of Volunteers Who Deliver Health Education and Promotion: A Comparison with Organization Members and Program Participants
Authors: Wells Barbara L. , DePue Judy D. , Buehler Charles J. , Lasater Thomas M. , Carleton Richard A.
Published: February 2007

The use of volunteers in this culture for community health endeavors is an understudied area. Yet, there may be many potential benefits for utilizing volunteers in the delivery of community health education and promotion. Volunteers may have more immediate access to their peers, credibility, and familiarity with the cultural environment and or ganization elements. An assumption of volunteer use is that persons drawn from a targeted organization (or community subgroup) will be like other members. Such an assumption, however, should be confirmed or disproved. This article compares a sample of volunteers to a sample of members from organizations from which the volunteers were recruited. The paper also compares the volunteers to a sample of program participants. The par ticipants were persons to whom the volunteers delivered CVD prevention programming and, in most cases, were also organization members. Collectively using the variables under investigation, multivariate analyses of variance found that the volunteers were different from the organization members, and different from program participants. To assess differences between the samples on each individual variable, univariate tests were conducted stratifying the samples by age. Statistically significant differences were found regarding organization activity, formal education level, success with past health habit change, health self-assessment, occupation, gender, and marital status.
Towards an Understanding of Risk Behavior: An AIDS Risk Reduction Model (ARRM)
Authors: Catania Joseph A. , Kegeles Susan M. , Coates Thomas J.
Published: February 2007

This report presents a three-stage model (ARRM) that characterize people's efforts to change sexual behaviors related to HIV transmission. ARRM focuses on social and psychological factors hypothesized to influence (1) labeling of high risk behaviors as problematic, (2) making a commitment to changing high risk behaviors, and (3) seeking and enacting solutions directed at reducing high risk activities. The proposed model integrates important concepts from prior behavioral medicine and human sexuality stud ies, specifies their differential import to achieving the goals associated with each stage of the model, and denotes factors hypothesized to influence people's motivation to con tinue the change process over time. Current findings are discussed within this three-stage model and directions for further research are suggested. Recent findings from our ongoing studies of gays and heterosexuals in San Francisco are presented.
Development of the Children's Health Ratings Scale
Authors: Maylath Nancy Schmalzried
Published: February 2007

Following pilot testing, the 17-item Children's Health Ratings Scale was group ad ministered to approximately 1,200 fourth- through sixth-grade students. The internal consistency reliability, concurrent validity, and construct validity of the scale were ex amined utilizing various statistical methods, including calculation of the alpha coefficient, factor analysis, and other correlational techniques. The scale was found to be reliable with an alpha coefficient of .83. Concurrent validity was supported by the finding that higher scale scores, were associated with higher ratings on a single, general health item and with lower ratings on single items concerning pain, health worry, and the presence of sickness. Correlations between scores on the Children's Health Ratings Scale and sex, grade level, and a measure of response bias were of low magnitude and presented no serious threat to instrument validity. Five factors were identified for interpretation during factor analysis. A post hoc validity study compared the mean scale scores of a group of asthmatic children and a subsample from the scale development study. Suggestions for further study are presented.
A Systematic Effort to Reduce Smoking at the Worksite
Authors: Gottlieb Nell H. , Nelson Alicia
Published: February 2007

Smoking control is a key element of worksite health promotion. This three-stage study in a large state human services agency included a baseline survey, an assessment of the effects of competition on recruitment to a self-help cessation program, and examination of the outcome of the cessation program. In stage 1, scales for measuring smoking-related attitudes and the social environment were developed and used to study norms for smoking. Regression analysis was used to ascertain correlates of smokers' intentions to quit and to join a self-help program and non-smoker assertiveness. In stage 2, an evaluation using a quasi-experimental design indicated that competition was moderately effective in in creasing the recruitment of all employees to the Great American Smoke-Out (70 vs. 17%) and of smokers to a self-help cessation program (28 vs. 6%). In stage 3, the self- reported quit rate at the end of the program was 28% and the biochemically-verified six months' cessation rate was 7%. Efforts are needed to strengthen, using ethical means, the norms for not smoking at the worksite and to increase both the recruitment to and the effectiveness of smoking cessation programs.
Health Education in Medical Group Practices: Promoting Health or Business?
Authors: Havlicek Penny L. , Olson Lorayn
Published: February 2007

This article attempts to explain differences in the health education activities of medical group practices. Potential explanatory factors examined include: providing prepaid care, group ownership, group size, and specialty composition and mechanism for making group policy. The data used in this analysis were collected by the American Medical Association through the 1986 National Survey of Medical Groups. Results indicate that the conduct of a variety of health education activities was determined primarily by the group's policy mechanism. That groups with more formal policy mechanisms are more likely to conduct health education activities suggests that the provision of health education is a business decision rather than a medical one. Some implications for health educators of the use of health education to promote a practice are discussed.