bluuebunny/crossref_metadata_2025 huggingface dataset:
Consumer Health Educators in Health Care Institutions in West Virginia
Authors: Baranowski Tom , Doria James
Published: February 2007

A two-phase survey was conducted of administrators of health care institutions (hospitals, rural primary care clinics, and com munity mental health centers) and, in turn, people conducting consumer health education (patient and community) in these settings. The purposes of the surveys were to identify the people who were conducting health education activities, their training, the tasks they were performing, and how they practiced health education. A broad variety of professionals was identified who perform consumer health education in these health care institutions. Only two professionally trained health educators were iden tified out of 232 respondents. The type of health education practice varied by type of institution, with hospitals being patient education oriented, mental health centers being community education oriented, and rural clinics requiring both patient and community education activities from their health educators. Most respondents reported the distribution of printed materials and individual counseling as their most frequently employed health education techniques. A need was documented for train ing in health education techniques. A broad variety of approaches to meeting this need are discussed.
Integration of Theory, Practitioner Standards, Literature Findings, and Baseline Data: A Case Study in Planning Breast Self-Examination Education
Authors: Zapka Jane G. , Mamon Joyce A.
Published: February 2007

Delineation of the planning process necessary for design ing sound education programs aimed at changes in health behavior con tinues to be a primary concern of health educators. Careful planning will ultimately maximize the application of existing evidence and identify areas in need of further research and evaluation. This paper discusses the preliminary and refinement planning phases involved in the design of an educational program for a three-year breast self-examination demonstra tion/evaluation project. The initial phase involved review of empirical data of previous studies, and application of behavioral science theory and standards of professional practice. The refinement phase involved the ap plication of results from a community diagnostic baseline survey of the target population. Factors found to correlate with BSE practice were inte grated into the educational strategies: group sessions in classes and informal workshops, a breast exam clinic, and mass media activities.
Who Volunteers for a Breast Self-Examination Program? Evaluating the Bases for Self-Selection
Authors: Grady Kathleen E. , Kegeles S. Stephen , Lund Adrian K. , Wolk Claudia H. , Farber Neil J.
Published: February 2007

Interest in a free breast self-examination (BSE) teaching program offered to a patient population (n=1590) was assessed, and a follow-up survey of refusers undertaken to determine difference between participants and refusers. Fifty-one percent of the known, eligible women patients expressed interest in the program and 24% ultimately had the teaching. Participants differed from refusers most notably in terms of less previous experience with BSE, more family history of cancer, a longer relationship with their physicians, and different health beliefs. They state more confidence in the effectiveness of breast cancer detection and treatment, less fear and embarrassment, and more personal and physician responsibility for health outcomes, as measured by the Health Locus of Control Scales. Self-selection thus seems rationally based on the kind of program and the needs of the women. Such self-selection can be cost- effective in delivering health education to the people most in need of it and most likely to benefit from it.
The Implications of Developing a Profession-Wide Code of Ethics
Authors: Clark Kim Robert
Published: February 2007

Current efforts by two professional health education associations to draft a code of ethics could lead to the establishment of a profession-wide code serving as the basis for awareness, inspiration, train ing, and professional conduct. Such a code would also serve the social functions of professional protection and control. A coordinated attempt to formulate a profession-wide code could more closely unite all existing national health education organizations through a process of cooperative effort and value clarification, with implications for centralization, enforcement, and licensure.

Members of the Society for Public Health Education, Inc. (SOPHE) and the Association for the Advancement of Health Education (AAHE) are currently engaged in an attempt to formulate a health education code of ethics. This article explores the history and purposes of such codes. In addition, it compares current health education professional concerns with those of the American Medical Association during the last century. Finally, it discusses the implications of a profession-wide code for cen tralization, enforcement, and licensure.
Multi-Matrix Sampling: An Approach to Evaluation of Health Education Programs
Authors: Gold Robert S. , Basch P.H. Charles E.
Published: February 2007

Sampling is often used in evaluation as an economical and efficient means of estimating population parameters. Among the approaches to sampling traditionally used, few provide the apparent flexibility of multi-matrix sampling. The current paper proposes multi- matrix sampling as an alternative to traditional sampling approaches for evaluation of health education programs. A comparison is made be tween examinee sampling and multi-matrix sampling. No significant differences were found between the estimates of mean test perform ance provided by the two sampling plans following completion of the fifth grade unit of the School Health Curriculum Project. The advantages and disadvantages of multi-matrix sampling are examined, and potential applications of this technique are illustrated.
Preschool Health Education Program (PHEP): Analysis of Educational and Behavioral Outcome
Authors: Parcel Guy S. , Bruhn John G. , Murray James Lester
Published: February 2007

A health education curriculum structured around age- appropriate types of behavior that enable children to assume more responsibility for their own health was developed, taught, and evalu ated in an early childhood learning center. The curriculum was then field-tested and evaluated in several additional preschools utilizing a design which included comparable nonintervention preschools. The findings indicate that the curriculum contributed to learning and sug gest that it has some potential in influencing health related behavior. It is not possible to determine from the findings the precise contribution of the curriculum to the observed changes in children's learning out comes and health behavior. It is likely that the curriculum and the children's general maturation and development all contributed to the changes observed. The studies demonstrated that the curriculum was effectively structured to be appropriate for the targeted age group, acceptable for use by preschool staff and easily implemented into a variety of preschool settings.
An Adaptation of Bigge's Classification of Learning Theories to Health Education and an Analysis of Theory Underlying Recent Health Education Programs
Authors: Vojtecky Michael A.
Published: February 2007

This paper attempts to examine the practice of health education from the perspective of learning theory. Examples of recent health education programs are discussed in this context. It is suggested that, in general, health education and program rationales are firmly rooted in learning theory, but that goals, educational interventions, and evaluation methods are not always consistent with the learning theory apparently underlyng the program. Furthermore, it is suggested that such inconsistencies are relevant to many controversial issues in health education and may have considerable impact on policy devel opment.
The Health Belief Model: A Decade Later
Authors: Janz Nancy K. , Becker Marshall H.
Published: February 2007

Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health be haviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically- significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived sus ceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.
Effects of a Health Education Curriculum on the Smoking Intentions of Preschool Children
Authors: Parcel Guy S. , Bruhn John G. , Murray James Lester
Published: February 2007

A smoking questionnaire that was designed to assess children's views about the identity, availability, and use of tobacco products, as well as their intentions to use such products in the future, was given to 150 four-year-old preschool children, 99 of whom had been taught the Preschool Health Education (PHEP) curriculum. Results indicated that significantly fewer of the children who received the PHEP curriculum intended to smoke in the future. Most of the children who intended to smoke were influenced by adult models.
Health Promotion in Long-Term Care: A Contradiction in Terms?
Authors: Minkler Meredith
Published: February 2007

While health promotion potentially could play a significant role in improving the health and quality of life of nursing home residents, several major changes must take place if this concept is to hold relevance for the elderly in the long-term care environment. First, interpretations of the concept of health promotion must be broadened to include a focus on macro- as well as micro-level change and on a diversity of target groups including, importantly, policy makers and providers. Second, the "youth bias" inherent in many conventionl health promotion efforts must be overcome, so that goals such as decreasing functional dependence in the frail elderly are seen as legitimate and appropriate health promotion foci. Third, viable alternatives to nursing home placements must be developed and adequately funded for the many frail elders who would be better served in less intense care environments. And fourth, the dependency producing nature of institutional long-term care must undergo major changes compatible with the goals of pro moting individual autonomy and enhancing quality of life. Nutrition, drug use and misuse, mental health, and staff training and retention are four areas examined in a closer look at specific changes needed to create nursing homes amenable to health promotion. Such changes on the institutional level, coupled with a strong national commitment to nursing home reform, are in keeping with Green et al.'s broad definition of health promotion as encompassing a variety of interventions on multiple levels designed to facilitate behavioral changes conducive to health. It is within this larger context that health promotion is seen as holding considerable promise for improving the health and quality of life of the institutionalized elderly.
Life Events, Social Network, Life-Style, and Health: An Analysis of the 1979 National Survey of Personal Health Practices and Consequences
Authors: Gottlieb Nell H. , Green Lawrence W.
Published: February 2007

The relationships among social structure, stress, social support, life-style health behavior, and health status are explored in this multivariate analysis of data from the National Survey of Personal Health Practices and Consequences. Path analyses showed social structural factors to influence life-style practices both directly and indirectly through social network and negative life events. For women, social network and life events had direct relationships to health related life-style practices, while age and income acted both directly and indirectly through social network and, for income, through life events. Education was also directly related to life-style. For men, social network and education had the only direct effects on health practices, and age and income had indirect effects through social network. We then examined the relative contri butions of the social network index elements, life events, and demographic variables to each of the life-style practices. These analyses confirmed the importance of gender, education, age, and income to predicting life-style behaviors. Negative life events were associated with smoking for both men and women, sleep for women only, and physical activity and alcohol use for men, which suggests sex-specific norms for coping with stress. For both sexes, church attendance and marriage were associated with favorable smoking and alcohol use, implicating cognitive social support or social control as a mediator of health promotion. Finally, analyses for each gender using health status as the outcome variable indicated that age, income, education, and life events affected health directly, while the effects of church attendance and marriage were likely mediated through smoking and alcohol behaviors.
Reducing Motor Vehicle Trauma Through Health Promotion Programming
Authors: Sleet David A.
Published: February 2007

Health Promotion approaches found effective in reducing morbidity and mortality from chronic diseases are being applied to reducing death and disability from motor vehicle trauma. The use of safety belts and child safety seats are of recognized benefit in reducing the public health problem associated with traffic crashes. Because traffic crashes are one of the leading causes of productive years of life lost and the leading cause of death among age groups 5-34, safety belt and child safety seat programs that use effective community health promotion strategies are needed. This article suggests programs and educational approaches in which safety belt and child restraint use are promoted as preventive health practices. Health educators are encouraged to view these protective behaviors as part of a healthy life-style and promote occupant protection as a life-style behavior.
Occupant Protection as a Priority in National Efforts to Promote Health
Authors: McGinnis J. Michael
Published: February 2007

Motor vehicle accidents are the leading cause of death for Americans ages 1 to 34 and cost our nation almost 57 billion dollars a year. Fortunately, many of the fatalities and serious injuries in motor vehicle accidents are preventable through proper and consistent safety belt and child safety seat use. Surprisingly, 80% to 90% of Americans rarely use safety belts, clearly making this one of the most significant public health problems. Increasing awareness of the importance of, and potential solution for this problem has led to integrating issues about motor vehicle trauma prevention into today's public health agenda. Efforts by federal health agencies are beginning to impact motor vehicle trauma reduction, but the involvement of public health workers at all levels is necessary for success.
Developing Motor Vehicle Occupant Protection Programs in Local Health Departments
Authors: Reynolds John A. , Nyberg Judith M.
Published: February 2007

Motor vehicle crashes are the leading cause of death for young people in America and a major national health threat. Unfortunately most crash victims do not use safety belts or child safety seats which could reduce or eliminate their injuries. This article describes how motor vehicle occupant protection issues have been introduced into local health departments in Michigan and how several of these health departments have developed programs to increase the proper use of child safety seats and safety belts in their communities.
Safety Belt Use and Related Health Variables in a Worksite Health Promotion Program
Authors: Merrill Barbara E. , Sleet David A.
Published: February 2007

Few corporate-based health promotion programs address a major preventable killer that strikes American workers—motor vehicle crashes. The use of vehicle safety belts is a known and effective prevention measure yet few workers use them. Very little research has been done on safety belt use as a health behavior, particularly as it relates to a corporate health promotion program. Data from an Employee Health Survey on 3,947 employees at Control Data Corporation were examined in 1982-83 to determine the relationship between safety belt use and other health habits. Comparisons between participants in the StayWell Program (a health promotion program) and nonparticipant and control groups were analyzed. Users of safety belts reported more moderate use of alcohol, better exercise habits, less smoking and were less likely to be overweight than nonusers. Among StayWell employees completing a Health Risk Profile, higher levels of safety belt use were reported. Recommendations are made which have implications for the design of safety belt motivation programs within the context of worksite health promotion.
A Statewide Hospital-Based Program to Improve Child Passenger Safety
Authors: Colletti Richard B.
Published: February 2007

A statewide network of hospital-based low-cost car seat rental and educational programs, operated by volunteers, was begun in Vermont in 1979. In four years the rate of correct car seat usage by newborns at hospital discharge increased from less than 16% to 71%. High usage rates appear to continue in the first two years of life. It is hypothesized that availability of car seats, direct educational intervention in the hospitals, high visibility, and indirect educational processes in the community contributed to these changes. It is concluded that hospital-based programs should be included in comprehensive strategies to improve child passenger safety.
The National High Blood Pressure Education Program: A Description of Its Utility as a Generic Program Model
Authors: Roccelia Edward J. , Ward Graham W.
Published: February 2007

The National High Blood Pressure Education Program recently celebrated its tenth anniversary. It is timely and appropriate to assess progress toward the realization of its mission and to examine the critical elements of this large-scale, community-based intervention program. This article describes the origin of the National Program, the planning process and models used in undertaking this national health education effort, the application of theoretical models, and approaches used to evaluate the effort. The lessons learned and the application of the National Program as a model for health education interventions are offered.
Getting Messages on the Air: Findings from the 1982 Alcohol Abuse Prevention Campaign
Authors: Maloney Susan K. , Hersey James C.
Published: February 2007

A necessary step in an effective public education campaign is obtaining sufficient broadcast time to reach substantial numbers of a target audience. By this criterion, the 1982 Alcohol Abuse Prevention Campaign was very successful. Between February and December 1982, 17,409 alcohol-related public service announcements (PSAs) were broadcast in 75 major media markets around the country. Campaign messages reached target audiences with sufficient frequency to have had likely effects on attitudes and behavior. Key elements in the success of the effort were (1) producing high quality broadcast materials, (2) providing technical assistance to aid state and local groups in the message dissemination process, and (3) providing for state and local control over the timing and release of materials.
Promoting Social Support: The Impact of California's "Friends Can be Good Medicine" Campaign
Authors: Hersey James C. , Klibanoff Leonard S. , Lam David J. , Taylor Robert L.
Published: February 2007

Increasing recognition of the importance of social support for health has not been accompanied by commensurate increases in knowledge about how to strengthen natural support networks on a large scale. This study evaluated the impact of California's innovative "Friends Can Be Good Medicine" public education campaign in promoting social support. Campaign impact was as sessed with pre-, post-, and long-term follow-up interviews with a panel sample of 340 adults in the six county Fresno media market area. Comparisons of exposed and unexposed individuals found that the campaign appeared to have measurable impact on knowledge, attitudes, behavioral intentions, and support enhancing behavior. Follow-up interviews indicated that these gains maintained themselves over the course of a year. The campaign was most effective when it utilized multiple channels of communication. In Fresno City, where there was the most intensive combination of community activities and media exposure, respondents indicating substantial likelihood of engaging in support enhancing behavior increased from 42% to 59% compared to smaller gains in areas which relied primarily on community implementation, and no gains in areas where exposure to the campaign was limited to mass media. The campaign appeared particularly effective with people who had experienced the death of someone close to them during the past year, and within that group, gains were largest among respondents below average in initial levels of social support.
An Application of the Health Belief Model Toward Educational Diagnosis for VD Education
Authors: Simon Kenneth J. , Das Anima
Published: February 2007

A protocol is developed which allows the translation of the Health Belief Model (HBM) to practice in supplying empirical needs assessment data on which to build responsive and effective VD education. The HBM is recognized as among the most important theoretical formulations to explain health behavior available in the health education literature, although there has to date been no information as to how to bridge the gap between theory and practice for actual, specific, and detailed programmatic input. The present study describes a procedure for using the HBM as a tool enabling practitioners to isolate those beliefs that need to be addressed for a given population.

Prior attempts at belief identification have been limited to the four major dimensions of the HBM (perceptions of susceptibility, seriousness, barriers, and benefits), often with a single item to address each gross dimension. Such efforts are incapable of determining discrete areas of beliefs subject to change through direct educational intervention. The conceptualization and development of an extended view of these dimensions to include numerous individual entities enables the practitioner to create a data base which overcomes this limitation.

The development of the VD Health Belief Scale is detailed. Subscales were operationalized by developing standardized attitude scales comprised of Likert-type items requiring a response on a five-point scale of agreements instrument refinement occurred at several stages; and selected items were screened through internal consistency item analysis. Resultant scales had acceptable reliability with alphas of .89, .66, .91, .86, and .84.

A straightforward procedure is described to explain how the measure is used to develop appropriate needs assessment data using the HBM framework. Studies performed by the authors utilizing the procedure are presented to illustrate the application of the research protocol.
Social Networks and Social Support: An Overview of Research, Practice, and Policy Implications
Authors: Gottlieb Benjamin H.
Published: February 2007

Following a brief overview of the stressful life events-illness model and its implications for intervention, this article highlights the role of social support as a resource for resisting stress- induced illness and disability. It identifies three different connotative meanings that have been assigned to the social support construct, and describes their empirical operationalizations in several recent studies. Specifically, the social integration/participation formulation, the social network approach, and the social intimacy measurement strategy are described and contrasted. Within the latter approach, one study that illuminated types of informal helping behaviors is discussed in greater detail. A review of possible mechanisms whereby social support accom plishes its health-protective impact is also offered, and two types of planned interventions involving the mobilization or optimization of social support are spotlighted. The article concludes with ideas about ways that professionals can safeguard the natural helping skills of citizens and achieve an appropriate balance between formal and informal systems of service delivery in the health and human services fields.
Social Networks and Social Support: Implications for Natural Helper and Community Level Interventions
Authors: Israel Barbara A.
Published: February 2007

The convincing evidence of the relationship between social support, social networks, and health status has influenced the development of program strategies which are relevant to health education. This article focuses on the linkage between social support and social networks and health education programs which involve interventions at the network and community level. Two broad strategies are addressed: programs enhancing entire networks through natural helpers; and programs strengthening overlapping networks/communities through key opinion and infor mal leaders who are engaged in the process of community wide problem-solving. Following a brief overview of definitions, this article highlights several network characteristics which are often found to be related to physical and mental health status. Suggestions are made for how these network characteristics can be applied to the two program strategies. Principles of practice for the health educator, and some of the limitations of a social network approach are delineated. The article concludes with a recommendation for engaging in action research—a perspective highly consistent with both the strategies discussed and the concepts of social networks and social support. This approach not only recognizes, but also acts to strengthen indigenous skills and resources.
Institutionalizing Social Support Through the Church and into the Community
Authors: Eng Eugenia , Hatch John , Callan Anne
Published: February 2007

The positive influence of social support on such health related outcomes as patient adherence to medical regimens and stress reduction at the worksite has captured the attention of public health researchers and practitioners alike. Yet, the broader social outcome of building community competency to undertake and sustain health related solutions without constant intervention from professionals still remains elusive. The difficulty may lie with the need to uncover on each occasion the various roles and functions of social support structures that may or may not exist in a given community. The intent would then be to graft an intervention onto these existing roles and functions in order to mirror the naturally occurring social support structures. A conceptual framework that has been used to institutionalize health related activities through the role and function of the black Church, as a social unit of identity and solution for rural black communities in North Carolina, is put forth for consideration.
Supportive Ties: A Political Ecomony Perspective
Authors: Pilisuk Marc , Minkler Meredith
Published: February 2007

The growing body of evidence linking social support and health has important implications for health promotion, disease prevention and treatment. But serious unsolved problems remain in the areas of research, practice and policy. Key among these are the ethical issues which arise when the reality of the importance of social support is translated simplistically into a policy emphasis stressing individual and interpersonal responsibility for health and justifying major cutbacks in health and social programs. This article examines the interdependencies between supportive ties on the individual and community levels and the larger social and political environments within which social networks operate. The effectiveness of families and other micro level support systems is seen as heavily dependent upon the adequacy of programs and policies on the local state and national levels which provide help with income maintenance, housing, transportation and other basic necessities. The cutting back of these more basic programs and services will be seen to disrupt the delicate web of natural relationships. Professionals concerned with the application of social support and health findings need to look beyond the individual and interpersonal levels toward policy and institutional level interventions. They thus may make an important contribution in advocating on behalf of those policies and programs which are critical to the effective functioning of natural helping networks, and which are at the same time faced with cutbacks. By helping alert colleagues, policy makers and the public both to the promise of the social support and health findings, and to the interdependence of support on local, state and national levels, health educators and others in the health professions may help to facilitate the effective application of these findings in policy and practice.
Reactions to Life-Style Warnings: Coffee and Cancer
Authors: Weinstein Neil D.
Published: February 2007

A well-publicized report linking coffee to cancer of the pancreas provided an opportunity to examine how people react to life-style warnings. According to the concepts of cognitive dis sonance and defensive avoidance, coffee drinkers might be expected to avoid this report or dispute its validity. Within the sample of 89 secretarial and clerical workers, coffee drinkers were found to be somewhat more likely than nondrinkers to be aware of and to recall the contents of the report. The more they drank, the more likely they were to have changed their coffee consumption in response to the new information. Coffee drinking had no effect on interest in receiving a copy of the original report nor were coffee drinkers more likely than nondrinkers to doubt the future confirmation of the reported coffee-cancer link. It was suggested that life- style warnings, particularly warnings about risks that are newly recognized, do not produce strong avoidance motivations. Several reasons for this lack of avoidance are discussed.
Psychological Aspects of Patient Education for Stressful Medical Procedures
Authors: Williams Carolyn L. , Kendall Philip C.
Published: February 2007

Psychological preparation for stressful medical procedures is becoming more and more com mon, and health educators frequently design and implement many of these programs. This article summarizes many of the issues relevant to these patient education programs. Individual differ ences among patients and their differential responses to types of interventions are emphasized, and descriptions of information provision, skills training, relaxation training/desensitization, modeling, self-statement modification interventions are provided.
The Concept of Health Promotion and the Prevention of Adolescent Drug Abuse
Authors: Perry Cheryl L. , Jessor Richard
Published: February 2007

A three-dimensional conceptual model for health promotion interventions to prevent adolescent drug abuse is elaborated. The model is based on an analysis of the concept of health into four domains—physical, psychological, social, and personal; an analysis of intervention approaches to change behavior into two major strategies—introducing/strengthening health-enhancing be havior, and weakening/eliminating health-compromising behavior; and an analysis of the foci of interventions into three levels—environmental, personality, and behavior. Components of a specific health promotion program, the Minnesota Heart Health Program, that are designed to prevent adolescent drug abuse are described. These include health behavior campaigns, edu cational interventions, and community organization. The theoretical content of the components is shown to be linked logically to the health promotion model.
A Health Belief Model Approach to Adolescents' Fertility Control: Some Pilot Program Findings
Authors: Eisen Marvin , Zellman Gail L. , McAlister Alfred L.
Published: February 2007

We report initial findings from a community-based intervention intended to strengthen un married teenagers' fertility control behaviors (i.e., abstinence or consistent contraceptive usage). The Health Belief Model (HBM) was used as a conceptual framework for developing curriculum materials and for evaluating a 15-hour educational program targeted at 13- to 17-year-olds of both genders. Interview data pertaining to sexual and contraceptive perceptions, knowledge, and behaviors were collected three times in a no-control, short-term, longitudinal study design: (1) just before; (2) immediately after; and (3) three to six months following the intervention. Dependent variables of major interest were changes in perceptions, knowledge, and self-reported fertility control behaviors. Based on data from the 120 teenagers who completed the followup (80% of those completing the intervention), we found: (1) consistent contraceptive usage in creased significantly; (2) changes in HBM-based contraceptive perceptions and sexual knowledge at immediate post-testing were predictive of increases in contraceptive usage at longer followup; and (3) the majority (62%) remained abstinent from pre-intervention to followup. These findings, study limitations, and suggestions for a future controlled study are then discussed.
Some Notions About Assumptions Underlying Health Education
Authors: Lorig Kate , Laurin Janette
Published: February 2007

By definition, the objective of health education is to change health behavior. One assumption underlying this objective is that changed health behaviors will result in improved health status. Both the objective and its assumption are based largely on experience with acute health problems. However, health education is now changing its focus towards chronic diseases.

This paper cxamines a number of chronic disease health education studies. Investigation reveals that although there is often an improvement in health status, the associations between changed health behaviors and improved health status are not clear and at times do not appear to exist. In light of this evidence, the authors suggest that there is, in some cases, a need to reevaluate the assumptions that underlie health education and a need in health education programs to study factors other than, or in addition to, behavior change as mediators of health status.
Comparison of Three Methods of Teaching Women How to Perform Breast Self-Examination
Authors: Assaf Annlouise R. , Cummings K. Michael , Graham Saxon , Mettlin Curtis , Marshall James R.
Published: February 2007

This paper presents results from an experimental study designed to evaluate the relative effectiveness of three methods of teaching women how to do breast self-examination (BSE). Frequency of BSE, confidence in examination performance, proficiency of BSE technique, and lump detection performance were the main outcome variables assessed. The three training methods compared in this study were provision of a pamphlet describing how to do BSE, having women view a videotape depicting proper performance of BSE, and having women practice doing BSE on a life-like breast model. Results showed that passive methods of BSE instruction such as the use of pamphlets or films were of little value in helping women develop the tactile skills necessary for proficient BSE. Three months after training, it was found that lump detection performance, as measured on silicone breast models, was significantly higher among those women who had been given an opportunity to practice doing the breast examination on a breast model with corrective feedback given by a BSE instructor. The opportunity to practice doing the examination with corrective feedback on performance appears to be a critical variable in the acquisition of BSE skill.
What is the Society for Public Health Education if Not an Open Society? SOPHE Presidential Address 1984
Authors: Green Lawrence W.
Published: February 2007

When I began worrying about this presentation several months ago, I coined a title that I was embarrassed seeing in print later, "The Paradox of Increasing Responsibility and Declining Influence: What is SOPHE Besides Small?" I was concerned then with the de cline in our membership, a 20% drop in 1978 and a 10% net loss each year after that. What happened in 1978 to cause that abrupt, precipitous change in our strength?
Avoiding Type III Errors in Health Education Program Evaluations: A Case Study
Authors: Basch Charles E. , Sliepcevich Elena M. , Gold Robert S. , Duncan David F. , Kolbe Lloyd J.
Published: February 2007

Monitoring the implementation of a program being evaluated can improve the interpretability of data collected and help evaluators to avoid committing a Type III error: evaluating a program that has not been adquately implemented. This article describes an evaluation that analyzed the implementation of a school health education curriculum, assessed cognitive learning outcomes attributable to the curriculum, and examined the relationship between classroom implementation and changes in students' knowledge. Five fifth-grade classes (n = 101) participated in the curriculum, and five classes ( n = 84) served as a comparison group. Data collection procedures involved a pretest and posttest of all students' health-related knowledge, daily monitoring of classroom implementation by the five teachers participating, and questionnaires completed by principals and teachers. Analysis methods included descriptive statistics, parametric and non- parametric tests of significance, and qualitative assessment procedures. Results indicated that the curriculum had a positive effect on learning in students; curriculum implementation varied considerably among the five classes participating; teaching/learning activities that were most and least likely to be implemented could be identified and described; both teachers and principals perceived the program favorably: some health instruction was occurring in the comparison classes, so it was not appropriate to consider them as pure controls; and no statistically significant relationship between curriculum implementation and cognitive outcomes was observed. This study provides evidence of the need for and value of measuring implementation of programs being evaluated. Implications for developing implementation measures and the role of formative evaluation in health education practice are considered.
A Study of a Self-Care Rehabilitation Program in Pediatric Asthma
Authors: Whitman Neal , West Dee , Brough Franklin K. , Welch Molly
Published: February 2007

The Self-Care Rehabilitation in Pediatric Asthma (SCRPA) project was designed to ascertain (1) the level to which children with asthma are able to acquire the asthma knowledge and skills presented in a self-management training program conducted by the American Lung Association of Utah and (2) the effect of such training on the asthma experience.

The preschool SCRPA Curriculum (ages 2-5) consisted of six 1-hour classes scheduled twice a week for 3 weeks. The first and last classes were for one or both parents only, and the middle four sessions were for the child and parent(s). The school-age SCRPA curriculum (ages 6-14) consisted of eight 90-minute classes for both child and parent(s) scheduled twice a week for 4 weeks.

Private physicians referred 21 preschool children and 38 school-age children into the program. The school-age children were randomly assigned to a study or control group, and the preschool children served as their own controls.

A comparison of asthma episodes during the 3 months before and after training showed a statistically significant decrease in the number of episodes but no change in severity in the preschool, school study, and school control groups. The decrease in episodes for the control groups suggest that the family record keeping required of all subjects may have a beneficial effect, a phenomenon worth further investigation. Also, the school-age group, in pre- and posttesting, demonstrated that the SCRPA curriculum increased knowledge and skills in the study group, changes not found in the control group.
The Mouse That Roared: A Case History of Community Organization for Health Practice
Authors: Winder Alvin E.
Published: February 2007

This article presents a case study of a health education process, community organization, that deals with an issue of health protection. The issue concerns herbicide spraying along rights-of- way in Leverett, Massachusetts. The intervention team consisted of the author and a graduate class in community organization. The case study provides a description of the community and history of the problem, the nature of the intervention team, the theoretical and conceptual model held by the intervention team, a description of the intervention, assessment of outcomes, and implications for theory and practice. The intervention extended over a period of 6 months. The intervention represented, for the intervention team, an opportunity to learn community organ ization and community education skills through active participation in the community. Both the nature and the effects of the intervention are described and discussed.
Cable Television and Health Promotion: A Feasibility Study with Arthritis Patients
Authors: Katz David
Published: February 2007

Community access cable television channels can be used to provide low-cost health pro gramming in many communities. This article describes a study undertaken to ascertain the extent to which arthritis patients could be targeted by arthritis-related programming over a local cable system. A number of publicity sources were used to advertise the programs to a preidentified group and the public at large. Telephone and written surveys revealed that the programming garnered a moderate viewing audience composed preponderantly of arthritis patients. Some conceptual and practical issues involved in targeting chronic patient groups for health program ming are discussed.
Computerized Health Education: A Comparison with Traditional Formats
Authors: Deardorff William W.
Published: February 2007

The present study compared a computerized health education format to face-to-face and written methods. The effects of delivery method on the retention of health information and on participant evaluation of the condition were assessed. College student participants ( N = 200) were ran domly assigned to one of four conditions (computerized, face-to-face, written, or control) such that each condition contained 25 males and 25 females. The experimental groups reviewed a lengthy text on sexually transmitted diseases (STD) whereas the control group received no information. Participants were then assessed for self-report anxiety, appraisement of the ex perience, and recall of the text. Results showed participants in the computer and written con ditions freely recalled at an equivalent rate which was superior to the face-to-face format. No differences emerged between high and low computer experience subgroups of the computer condition. The face-to-face and computer conditions were assessed in positive terms with the written format being assessed more negatively. Although, detailed analysis revealed there was the potential for more negative perception of the computer method in association with increased anxiety. Results are discussed in terms of their demonstrating support for a computerized approach to health education.
The Role of Self-Efficacy in Achieving Health Behavior Change
Authors: Strecher Victor J. , McEvoy DeVellis Brenda , Becker Marshall H. , Rosenstock Irwin M.
Published: February 2007

The concept of self-efficacy is receiving increasing recognition as a predictor of health behavior change and maintenance. The purpose of this article is to facilitate a clearer understanding of both the concept and its relevance for health education research and practice. Self-efficacy is first defined and distinguished from other related concepts. Next, studies of the self-efficacy concept as it relates to health practices are examined. This review focuses on cigarette smoking, weight control, contraception, alcohol abuse and exercise behaviors. The studies reviewed suggest strong relationships between self-efficacy and health behavior change and maintenance. Experimental manipulations of self-efficacy suggest that efficacy can be enhanced and that this enhancement is related to subsequent health behavior change. The findings from these studies also suggest methods for modifying health practices. These methods diverge from many of the current, traditional methods for changing health practices. Recommendations for incorporating the enhancement of self-efficacy into health behavior change programs are made in light of the reviewed findings.
A Sociodemographic Analysis of Preventive Dental Behavior among White American Families
Authors: Chen Meei-shia
Published: February 2007

Data collected from a national family dental survey were used to study the relationships between the sociodemographic characteristics and the preventive dental behavior of wives, husbands, and children. A canonical correlational analysis showed that preventive dental be havior of family members including toothbrushing, flossing, and preventive dental visits, sig nificantly correlated with sociodemographic characteristics (level of education, income, occu pation, population density, age, family size, and presence of children). The relationships studied accounted for 11-15% of the variance in the preventive dental behavior of family members. However, the patterns of correlation for different family members varied. The extent of the effects of various sociodemographic variables on preventive dental behavior were not uniform and the degrees of responsiveness of toothbrushing, flossing, and dental visits to the influence of sociodemographic characteristics were also different. The results of the study are compared with those of previous studies. The implications of the findings are discussed.
Community Intervention to Lower Blood Cholesterol: The "Know Your Cholesterol" Campaign in Pawtucket, Rhode Island
Authors: Lefebvre R. Craig , Peterson Gussie S. , McGraw Sarah A. , Lasater Thomas M. , Sennett Leslie , Kendall Leigh , Carleton Richard A.
Published: February 2007

Sufficient data exist to support approaches to lowering cardiovascular disease risk which target populationwide reductions in elevated blood cholesterol levels. Within the context of a multi- factorial cardiovascular disease prevention program, a 2-month cholesterol education campaign was launched to encourage citizens to "Know Your Cholesterol" by attending screening, coun seling, and referral events (SCOREs) held throughout the community. These events featured assessment of dietary fat and cholesterol, rapid blood cholesterol analyses with a fingerstick procedure and the Kodak Ektachem DT60, and immediate dietary counseling by trained vol unteers. A total of 1439 persons attended 39 SCOREs: nearly 60% were found to have blood cholesterol levels that exceeded recommended goal levels. At a 2-month follow-up of 1040 of these same individuals, 600 had lowered their blood cholesterol level by an average of 29.1 mg/dl. This experience suggests that similarly modeled campaigns may have a significant impact on the distribution of blood cholesterol levels in the entire U.S. population.