bluuebunny/crossref_metadata_2025 huggingface dataset:
Provider—client models of individual outreach and collective behavioural change: the delivery of sexual health promotion among sex workers
Authors: Kirkpatrick Kyla
Published: March 2007

This paper explores outreach as a method of service delivery among sex workers and critically considers theoretical models of outreach presented by Tim Rhodes. Data are drawn from the experience of outreach delivery by Dorset Working Women's Project and from research among 23 service users via anonymous questionnaire. These data are used to challenge several of Rhodes' arguments. Firstly, the notion that provider-client models of indi vidual outreach fail to identify and respond to consumer need is disputed. Secondly, a range of factors that hinder the implementation of community- oriented models of outreach is examined. This raises the question of how effectively theory can be translated into practice. Thirdly, research findings begin to indicate questions about the notion that provider-client models of individual outreach cannot encourage collective behavioural change. Finally, it is argued that Rhodes' theoretical model leads to a rigid categorisation of type, which is in conflict with the inherently dynamic nature of outreach.
The attitudes of non-smoking bar staff to exposure to environmental tobacco smoke at work
Authors: Francis Nicola , Blevin Andrew , Aveyard Paul
Published: March 2007

British pub workers are heavily exposed to environmental tobacco smoke. We interviewed 32 non-smoking pub workers in Birmingham to examine their views on smoke exposure and protection. They had little knowledge about the risks of environmental tobacco smoke. Most felt that something should be done to protect them, but few felt that effective measures were likely, and that exposure to smoke was part of pub work. Campaigners working to protect these workers need to know that pub workers expect to work in a smoky environment, do not feel able to change this themselves, and nor do they expect others to change it for them.
Emergency contraception: a survey of knowledge and attitudes among PSHE co-ordinators in Avon secondary schools
Authors: Graham Anna , Dawson Nona , Moore Laurence
Published: March 2007

Emergency contraception can be used as a back up if unprotected intercourse occurs or contraception fails. Personal, social and health education (PSHE) co-ordinators may be in a position to provide information about emergency contraception in school in a health promotion context, and for individual pupils. Little is known about what these teachers know about emergency contraception, and whether they see their role as providing pupils with infor mation about it. This paper reports on a survey of PSHE co-ordinators in Avon, South West England. Respondents did believe that it is their responsi bility to teach about contraception (80 per cent), including emergency con traception (69 per cent). The results suggest that there are gaps in respondents' knowledge: 85 respondents (98 per cent) knew of hormonal emergency con traception but knowledge of the correct time limits (72 hours) were known to only 65 per cent of respondents, There is a wide range of intended practices in the giving of confidential information to individual pupils.
Diversity within ethnic groups: alcohol and tobacco consumption by young people in the East Midlands
Authors: Denscombe Martyn , Drucquer Nicky
Published: March 2007

Findings from two surveys of alcohol and tobacco consumption by 15- and 16-year-olds in the East Midlands of England are reported. The fist survey took place in 1990 ( n = 1009), and the second in 1997 (n = 1648). The frequency of alcohol consumption and levels of tobacco use were found to have increased over the period 1990-97 and, in line with findings elsewhere, alcohol and tobacco consumption among South Asians was found to be much lower than among the white population. However, there was evidence that, within the broader ethnic group 'South Asian', there were differing levels of alcohol and tobacco use by Hindus, Muslims and Sikhs. Findings for alcohol and tobacco use by religious subgroup are compared with overall findings for the broader ethnic group, and the implications of these are explored. It is concluded that culturally sensitive sub-categories are needed in order to reflect divergences in alcohol and tobacco consumption within the broader 'South Asian' ethnic group.
A qualitative study of parents' experiences of providing sex education for their children: The implications for health education
Authors: Walker Joy L
Published: March 2007

0bjective To explore how parents talk to their children and identify the factors that influence parents talking to their children about sex. In addition, to uncover ways by which this sex education could be enhanced.

Design A qualitative study of parents' experiences of providing sex education to their children.

Setting Interviews were carried out in the field within parents' homes or workplace.

Method Fifty semi-structured interviews were conducted with parents across Leeds. One or both parents were interviewed to gather qualitative data.

Results Factors that were found to enhance or limit parent-child communication were dynamically inter-related. These include parents' perceptions of the child, their role as a parent and their perception of sex education from school and health agencies. Gender of the parent and their own experience of sex education clearly influenced provision. Mothers tended to be the main educators although a few fathers shared the role. Uncertainties were experienced, especially about giving sons sex education. Parents also possessed many skills as educators taking opportunities, establishing open communication or responding to ideas progressively and appropriately during their child's development. Participants welcomed access to sources of information, support and good communication within the school and health care settings.

Conclusion Parents were found to possess skills as educators, but also experience uncertainty and embarrassment about aspects of their role. The realities of provision were intricate. However, parents' natural role in sex education was evident. Agencies should consider fully integrating parents into their health education strategies.
Introduction to the Symposium 'Health Resistance': The limits of contemporary health promotion
Authors: Crossley Michele L.
Published: March 2007

This paper presents a brief introduction to the Symposium 'Health Resistance': The Limits of Contemporary Health Promotion. In particular, the concept of 'health resistance' is defined and its affinity with psychological reactance theory articulated. The relevance of the 'health resistance' concept is highlighted, particularly in a social context in which the general public appear to be becoming increasingly sceptical and distrustful towards science, medicine and health professionals. This introductory paper also seeks to further clarify the nature of 'health resistance'. Is it a product of individual psychological differences, or is it related more to the social and political context of particular subcultures or societies? Or is it a mixture of both? This Symposium addresses this question in relation to a variety of different health related domains and behaviours including mental health, unsafe sex, recreational drug use, smoking and MMR (measles, mumps and rubella) vaccination. Finally, a number of moral and ethical questions are raised. How can and should health promoters respond to 'health resistance'?
The meaning of'health improvement'
Authors: Abbott Stephen , Florin Dominique , Fulop Naomi , Gillam Stephen
Published: March 2007

Objective To explore how those working in and with primary care organisations understand the term 'health improvement'.

Design Six qualitative case studies.

Setting Primary Care Groups and Trusts and partner organisations. Method Semi-structured interviews with senior personnel from participating organisations.

Results Informants offered a wide range of definitions which generally combined more than one meaning. Replies ranged from, on the one hand, an emphasis on National Health Service (NHS) service provision to, on the other, an emphasis on the socioeconomic determinants of population health, or the quality of life of individuals. Some explained the term primarily as a government strategy; some, as a set of activities for the NHS; some, in terms of the overarching purpose of health improvement. Conclusion Our informants offered more detailed definitions of 'health improvement' than are articulated in Department of Health documents. However, they did not include health inequalities in their definition. Recent government announcements about health inequalities targets may help to ensure that all primary care organisations consider the inequalities in the health of their population.
Antipyretic prehospital therapy for febrile convulsions: Does the treatment fit? A literature review
Authors: Woollard Malcolm , Pitt Karen
Published: March 2007

Objective The objective of this literature search was to find evidence to support (or refute) the prehospital emergency use of antipyretic therapies, such as tepid sponging and paracetamol, to prevent the recurrence of febrile convulsions.

Methods An on-line literature search was made of Medline. The key text words utilised were febrile convulsion(s); febrile seizure(s); infantile convulsion(s); paracetamol; acetaminophen; rectal administration; treatment; prevention; pathophysiology, (a)etiology; recurrence; tepid; sponging; bathing; antipyretic; temperature reduction; fever. References from retrieved papers were also sought and reviewed where available. Each paper was critically appraised for relevance and content.

Results Forty-eight papers were identified. Twenty-nine were irrelevant. Conclusions The available evidence suggests that neither antipyretic medication (including paracetamol) nor tepid sponging prevent the recurrence of febrile convulsions following a simple initial fit, and both are associated with risk to the patient. We recommend that neither intervention be used in the prehospital phase of treatment.
Methodological issues in piloting a physical activity diary with young people
Authors: Wormald Helen , Sleap Mike , Brunton Julie , Hayes Louise , Warburton Peter , Waring Mike , White Martin
Published: March 2007

Objective This study aimed to explore methodological issues in piloting a recently developed physical activity diary for young people.

Design Fifty-five participants aged 9-14 years completed the diary four times a day for seven consecutive days, recording the duration and intensity level of all activities in which they engaged.

Setting Participants were randomly selected from two primary and two secondary schools in Hull and East Yorkshire.

Method Following diary completion, focus group discussions were conducted to ascertain participants' perceptions of the diary. In addition, analysis of diary entries was carried out to investigate the quality of data collected.

Results Administration of the diary was a relatively quick and easy process, although meetings with teachers and pupils were occasionally problematic and required thorough organisation as well as constant verbal and written reminders. Meetings with participants were held during break times and were not intrusive to the school timetable. Ninety- one per cent of the diaries were returned, eleven per cent of which were invalid. The quality of data derived from the diaries was very good and extremely detailed. Participants reported that completion of the diary

had been relatively straightforward, although it was inconvenient to carry around and difficult to remember to fill in.

Conclusion It was concluded that the diary had the potential to assess young people's physical activity habits, and that participants were willing to commit time and effort to complete the diary. The accuracy of data is reliant upon effective strategies for instructing young people how to complete the diary, and might be improved with parental and teacher support.
Hepatitis C and injecting drug use: The realities of stigmatisation and discrimination
Authors: Habib Shah E. , Adorjany Lester V.
Published: March 2007

Objective To examine the extent of discrimination and stigmatisation related to hepatitis C virus (HCV) infection, as experienced by injecting drug users in Sydney, Australia.

Design Data were collected through a self-administered questionnaire from injecting drug users (IDUs). Questions included basic demo- graphics, injecting and sexual history, HCV knowledge, risk practices, self-reported HCV diagnosis, and experiences of discrimination and o stigmatisation, as well as harm reduction services provided by needle and syringe programmes (NSPs). Both qualitative and quantitative data were collected from IDUs.

Setting Questionnaires were distributed to clients of NSPs in the Sydney metropolitan area.

Method Ten NSPs and one methadone clinic were selected. Questionnaires were distributed to all of these outlets and a total of 274 persons were recruited. The staff at the selected sites asked clients to fill out the questionnaire while distributing injecting equipment.

Results Most HCV related discrimination against drug users was reported in health care settings. Fifty-two per cent of the participants experienced this as a result of being HCV positive. In addition, more than half of the sample (65 per cent) reported that such discrimination was actually as a result of being a drug user. Females were more likely than males to experience discrimination because of their HCV status.

Conclusion The level of discrimination and stigmatisation was widespread in health care settings, resulting from the stereotyping of IDUs. The barriers to IDUs accessing health services need to be identified and removed. Implementation of an awareness campaign among health professionals would be a feasible way to address this issue.
Towards a new model for health promotion? An analysis of complementary and alternative medicine and models of health promotion
Authors: Hill Faith J.
Published: March 2007

Objective This paper examines the professional interface between health promotion and complementary and alternative medicine from the perspective of five different health promotion models. The objective of this paper is to move forward the current debate concerning collaboration between health promotion and complementary medicine.

Design The paper offers a conceptual analysis of the issues involves in health promotion/complementary medicine collaboration. The views of professionals from either side of the interface are reported under three broad headings: medical and behavioural change models; education and empowerment models; and social change models.

Setting The discussion is grounded in research conducted primarily in the UK, but also in the USA and Eastern Europe.

Methods The study was based on the principles and practices of contemporary ethnography and involved in-depth interviews with over fifty key professional from either side of the interface.

Results Health promoters and complementary therapists mostly reject 'medical model' approaches to health promotion and health care. They come closest when employing educational and empowerment models of practice. Health promoters committed to social action are the least likely to work with complementary medicine.

Conclusion The paper concludes that the level of future collaboration between health promotion and complementary medicine will depend partly on which health promotion models dominate the 21st century. Depending on the response of health promotion to recent policy initiatives, future collaboration between the two areas may offer a new model of practice.
'Breakfast, lunch and dinner': Attitudes to infant feeding amongst children in a Scottish primary school. A qualitative focus group study
Authors: Russell Bridie , Richards Helen , Jones Anni , Hoddinott Pat
Published: March 2007

Objective To describe the knowledge, attitudes and beliefs about infant feeding in one primary school in Scotland.

Design Qualitative focus group study.

Setting A single primary school which serves a mixed socioeconomic area in the north of Scotland.

Method Parents gave demographic details about their family and information about whether their children had been breastfed. Twenty- three children, aged 6, took part in three focus groups which were conducted by two facilitators, according to a predetermined topic guide. Focus group data were supplemented with analyses of children's drawings and with fieldnotes.

Results Children generally spoke of and drew pictures of bottle-feeding. Their lack of everyday language for breastfeeding suggested that breastfeeding was not a'taken-for-granted' activity. The repeated reference to adult meal patterns and to equipment suggested that the children have a mechanistic and confused idea of what breastfeeding involves. Their difficulties conceptualising night feeds and feeding in public places suggested that the children viewed breastfeeding as a private activity, permissible only in certain contexts. Children had vivid recall of TV images of infant feeding.

Conclusions Despite the observation that breastfeeding was not generally perceived as a natural activity, our findings suggest that primary school children are interested in infant feeding and that they can be engaged in and educated about it as young as six years old. Larger studies are needed to further explore attitudes to infant feeding.
A multidisciplinary osteoporosis service-based action research study
Authors: Whitehead Dean , Keast John , Montgomery Val , Hayman Sue
Published: March 2007

Objective To investigate an existing Trust-based osteoporosis service's preventative activity, determine any issues and problems and use this data to reorganise the service, as part of a National Health Service Executive/Regional Office-commissioned and funded study.

Setting A UK Hospital Trust's Osteoporosis Service.

Design & Method A Participatory Action Research (PAR) methodology was adopted, using PAR group sessions and reflective journals to collect and analyse qualitative data.

Results The service was investigated and found to be lacking in preventative osteoporosis-related activity. Subsequently, the research participants identified and implemented a range of preventative activities.

Conclusion Osteoporosis is a preventable disease that is known to place both a huge economic and social burden on societies worldwide. Despite this, evidence suggests that preventative osteoporosis activity is afforded a low priority within health services. This was the case with the osteoporosis service at the beginning of this study, but demonstrates how a service can be reorientated to accommodate a programme of preventative activity.
Widening participation for black and ethnic minority women: A pilot educational intervention using action research
Authors: Gregory Pat , Lester Carolyn , O'Neill Martin , Gray Louise
Published: March 2007

Objective The project's objective was to provide a course in community and career development to enable women with a diversity of educational and ethnic backgrounds to move into appropriate employment or to enter mainstream education or training.

Design The course was developed using action research with continuous feedback from participants.

Setting The course took place in an ethnically mixed and disadvantaged inner city area.

Method Women were recruited by the course leaders via existing community networks. Both leaders had wide experience of working with women in the area where learning took place. The course was developed collaboratively with participants and course leaders.

Results Action research provided an appropriate framework for developing the course to meet the needs of participants. Half the participants achieved accreditation and half had gained related paid employment by the end of the course.

Conclusion Collaborative development resulted in a course that was more appropriate to participants' expressed needs and provided the foundation for future work with 'widening participation' students. The movement of women from ethnic minority communities into appropriate work is likely to have positive health impacts on the wider community.
The snacking habits of adolescents: Is snack food necessary to meet dietary recommendations?
Authors: Howard Susan , Reeves Sue
Published: March 2007

Objective To investigate the role of snack foods in the diets of adolescents in relation to recommendations.

Design A quantitative study whereby the food intakes of 28 adolescents aged 11-14 years were recorded for three consecutive days.

Setting A secondary school in South West London.

Methods Food intake was recorded using food diaries and the computer package CompEat-5.ANOVA and T-tests were used to identify significant differences.

Results Snack foods made significant ( p<0.001) contributions to all nutrients. However increased saturated fat intakes were beyond acceptable levels. Boys had higher intakes of all nutrients, with the exception of calcium, and significantly ( p<0.01) greater intakes of iron and zinc. Conclusion Without compromising the benefits of snack foods, health promotion strategies need to be designed to reduce adolescent intakes of fat and sugar.
Policies for improving oral health in Europe
Authors: Blinkhorn Anthony S. , Downer Martin C. , Drugan Caroline S.
Published: March 2007

Background and Objective The main purpose of this review was to rehearse the available evidence of good practice in dental public health in order to define policies that could improve oral health in the enlarged European Union and associated countries. Secondary objectives were to describe the basic principles of health service organisation and management, to examine available data on current oral health in Europe and some of its likely determinants - together with a brief overview of the organisation of dental services in the constituent countries - and to discuss aspects of policy related to the task of delivering oral health care, including organisational frameworks and resources, strategies and operations, management and the workforce, and monetary and other motivating incentives.

Methods Relevant literature was reviewed selectively and synthesised. Data were abstracted from appropriate papers and reports, and collated and analysed.

Results The information gained was used to suggest a series of strategies to help inform decision makers and those formulating oral health service policy in Europe.

Conclusions The review concludes with a list of suggestions and recommendations that are not intended to be prescriptive but which should point the way toward future progress.
Complementary therapy services for mental health service users: Results of a consultation project
Authors: Walton Patricia , Latham Nicola
Published: March 2007

Objective The aim of this paper is to report on the findings of a consultation project exploring demand for mental health related complementary therapy services in the local area. The project and findings are reported with reference to historical context and the literature from service user, healthcare policy and complementary therapy fields. Design The consultation was commissioned by a voluntary sector mental health organisation to establish whether a case could be made for the development of a mental health related complementary therapy service, and what form such a service might take. The researchers sought breadth and balance by seeking views from four standpoints: mental health service users, informal carers, health and social care professionals, and complementary therapy providers.

Setting The consultation activities took place in statutory and voluntary sector settings in Liverpool and surrounding areas. The Merseyside region is an area of long term social disadvantage and environmental neglect, currently subject to extensive regeneration activity with significant UK and EU funding.

Method Service user views were captured through a combination of focus groups, in mental health centres, and questionnaires, completed at these events or distributed through mental health groups. Health and social care professionals' views were elicited through group meetings, questionnaires or interviews based on the questionnaire structure. Complementary therapy providers completed questionnaires or were interviewed using the questionnaire structure.

Results The consultations discovered a high level of interest and confidence in holistic forms of therapy amongst service users, carers and professionals, together with interest and expertise in helping with mental health related problems amongst the therapists.

Conclusion This main contribution to knowledge is in the wealth of detail about potential therapeutic applications and suggested organisational principles for complementary therapy services in the mental health field. The findings are inconclusive on the macro question of service design.
Health education in North Yorkshire Junior Schools
Authors: Langmaid W.O.
Published: March 2007

THE SURVEY was designed to assess the extent to which health education is practised in junior schools in North Yorkshire, and to enquire into ways in which the North Yorkshire Area Health Authority may best help teachers in their health education activities. Question naires were therefore sent to a 50 per cent randomized sample of all junior schools in the new county of North Yorkshire.
Housing and Health Education
Authors: Brown Celia Latham
Published: March 2007

THERE is a clear correlation between poor housing and poor health. What is not clear is how far poor housing conditions might be a direct cause of poor health and how far health education might improve levels of health where housing conditions appear to be a cause of ill-health.
Health education and the school curriculum
Authors: Finch Janet , Clayton Susan , Clements John
Published: March 2007

THIS article considers the kind of issues which are raised by the possibility of including one par ticular topic, that of infant feed ing, set within the general context of parenthood educa tion. The intention is to draw out some more general issues about the inclusion of this kind of health education 'topic' within the school curriculum: issues about what can be in cluded, how it can be included, and the implications for other aspects of the school's work.

The argument is: firstly, that there is a case for including education for infant feeding in the school curriculum; secondly, that the case for its inclusion implies the adoption of certain models of health education, and the rejection of others; thirdly, that these models have implica tions for how the topic is taught, when and by whom; and fourthly, that there are further implications for consistency of teaching methods and for the general ethos of the school.
A community approach to the problems of solvent abuse
Authors: Peers I.S.
Published: March 2007

THIS paper is a précis of current thinking relating to solvent abuse, more erroneously known as glue-sniffing. Reference is made to the practice of solvent abuse and early clinical effects are detailed. A strategy is outlined in which schools and the community at large can tailor a programme to fit their own particular needs. Examples of educational objectives are included and some practical questions for educators are discussed. Solvent abuse is defined as the intentional inhalation of volatile substances for non-medical purposes.
Effectiveness of a mailed reminder on the immunisation uptake of pre-school children
Authors: Chung Sylvia
Published: March 2007

A BIRTHDAY card was sent to all four year-olds within a given sector of a district, reminding them to have a booster immun isation before starting school. A follow-up after six months, showed a statistically significant increase in uptake, although no immediate motivational effect of the card was demonstrated. Health education of parents of young children is an on-going process. Moreover the effective ness of any one method, taken in isolation, may be difficult to de monstrate but, when reinforced by other strategies, may well produce the desired outcome.
Relapse: Why can't we kick the habit?
Authors: Hallett R.
Published: March 2007

DEPENDENT behaviours and addictions are damaging both personally and socially. Despite a range of treatments, people continue to fail in their attempts to break harmful habits. A recent model of dependence suggests that behaviour therapy offers a way forward. The model and therapy are discussed, and it is argued that a blueprint is now available for the development of effective treatments.
Health Education in the National Health Service: the differing perceptions of community physicians and health education officers
Authors: Nutbeam Don
Published: March 2007

COMMUNITY physicians and health education offi cers (HEOs) are the two key health professionals with a particular responsibility for the delivery of health education services to the community. For this reason it is important that they achieve some measure of consensus in terms of the aims, objec tives and methods employed by such a service. The results of a study based on a questionnaire and detailed interviews with both groups, indicate that this consensus is rarely achieved. It shows that community physicians and HEOs have important differences of opinion in a number of key areas, including both the level of intervention and methods employed in health education
Development of a primary school health education programme with special emphasis on the prevention of cigarette smoking
Authors: Calman A L H , Carmichael S. , Deans H.G. , Calman K.C.
Published: March 2007

'JIMMY on the road to super health' is a health education programme designed for use in the upper primary school. The programme, which is particular ly concerned with the prevention of smoking, was developed with the assistance of teachers in Strathclyde region, Scotland. Evaluation conducted during the development of the programme has demonstrated that it is eminently acceptable to teachers and pupils alike. Short-term studies also indicate that the programme increases childrens' health knowledge and deters some from smoking.
Marketing and health education units
Authors: Ashton Loraine
Published: March 2007

A wide range of non- profit organisations are now coming to see marketing as a useful tool. How does this apply in health education and health promotion?
Aids — a health education approach in West Glamorgan
Authors: Griffiths Colin , Cruse Elizabeth , Harries Joan , Williams Toni , Littlepage B N C
Published: March 2007

AN education programme on Aids has been estab lished in West Glamorgan. It was designed to provide an information network amongst health authority staff which would reach as wide an audience as possible. The programme has been organised on a direct contact approach because of the limitations of other methods of disseminating information to large groups of people. The initial success of the programme has led to its extension among other interested groups in West Glamorgan such as the prison population, drug groups, and members of the gay community. The programme is to continue and be updated on a regular basis.
Community health action
Authors: Boot Neil
Published: March 2007

Health education has traditionally been concerned mainly with health issues seen from a personal perspective-brushing our teeth, smoking, and choosing and eating our foods. Involvement in community action can bring rewards, and some problems
Can school health education be more effective?
Authors: Reid Donald , Massey Doreen E.
Published: March 2007

THIS paper reviews the evidence for the effects of health education on health-related behaviour, with special reference to NHS support for schools. It is concluded that effectiveness in these terms has considerably increased, especially in relation to smoking, dental health, rubella immunisation, sex education, and even family health as a whole. Schools may also have a significant role to play in education concerning nutrition and exercise, but positive results from alcohol and drug abuse pro grammes remain hard to find.

Further improvements are possible if greater attention is paid to in-service training; support from peers; co-operation with available services; parental involvement; timing of appropriate lessons; school policies; and teacher attitudes to health education. Of these seven factors, particular importance is attached to co-operation between schools and local services, and to timing, especially in relation to bet ter provision for the 11-14 age group. Finally, health programmes for teachers themselves might prove a particularly valuable investment of scarce resources.
Health education perspectives in continuing education programmes for pharmacists
Authors: Morrow Norman C , Speedy Patti , Totten Christopher
Published: March 2007

THIS paper describes the design and evaluation of a continuing education programme for pharmacists related to health education and traces the subse quent development of the programme. While the majority of participants agreed that the provision of health education should form part of the community pharmacist's commitment, appropriate education and training was identified as a primary requirement in preparing pharmacists to fulfil this role. The wider implications of this finding are discussed.
The use of leaflets in a comprehensive food policy
Authors: Amos Amanda , Ineson Antonia
Published: March 2007

THREE-QUARTERS of health authorities are cur rently developing or implementing district food and health policies. It is widely assumed that, for the policies to be successful, it is necessary to provide clear advice, usually in leaflet form, to the public about food and health and healthy eating. This paper reports on a survey and observations carried out dur ing the piloting of such a leaflet for hospital patients in the Royal Free Hospital, Hampstead. The leaflet was intended to be part of the general development of a policy on food and health. The results of the study highlight the importance of considering the wider context surrounding the implementation of such policies.
Searching health education literature
Authors: Sharp David
Published: March 2007

The first two articles in this series looked in different ways at relationships between libraries and health education units. We now look at a selection of bibliographic and indexing tools that can be used to identify journal articles, books and other materials of interest to health educators. Audio-visual items are not covered.
Alcohol - the national context
Authors: Linthwaite Peter
Published: March 2007

THE Health Education Council's South-West alcohol programme, Understanding Alcohol, is being evaluated by a team of researchers (also funded by the HEC) at the School for Advanced Urban Studies at Bristol University As part of this work, Randall Smith - the joint head of the team - has prepared a report which examines the national context of alcohol policy and alcohol edu cation within which the South-West programme finds itself, docu menting particularly the development of the Health Education Council, its alcohol programme and the relationships between the various agencies involved in this area, including the DHSS. The report, The National Politics of Alcohol Education: a review, has been published by SA US as a Working Paper, and is summarised below.
Media professionals' views of the Government's 1987 Aids Campaign
Authors: Brewin Chris R. , Gunter Barrie
Published: March 2007

ONE hundred and twenty six journalists and pro gramme-makers were interviewed to ascertain their views about the effectiveness of the Government's campaign in early 1987 to inform the public about the risks from Aids. The majority view was that it was a good all-round campaign focused on the public at large and on several at-risk groups. It was also thought to have been acceptable to the public. But a sizeable minority of media professionals felt that more selective targeting would have been desirable, and that the information was not specific enough. Another criticism concerned the lack of an adequate follow-up. There was general agreement that before the campaign the public knew little about Aids, and that afterwards they were better informed, in par ticular about the prevalence of Aids and the exist ence of high-risk groups. Overall, however, respondents underestimated the campaign's achievements in increasing knowledge, while over estimating changes in attitudes and behaviour. Rec ommendations were made about the format and content of TV programmes for future public infor mation campaigns concerning AIDS.
It's a woman's world - fathers' participation in smoking and drinking reduction in pregnancy
Authors: Waterson E.J. , Evans C. , Murray-Lyon I.M.
Published: March 2007

THIS paper uses an interview survey of twelve pro spective fathers to describe some of the current issues involved in encouraging fathers to help their partners to reduce smoking and drinking during pregnancy. Paternal knowledge about adverse influ ences on the fetus was vague and varied. Although half of the fathers reduced their drinking during the pregnancy, only three did so out of support for their partners. The other six fathers increased their intake. Reactions to women who did not reduce their smok ing and alcohol intake in pregnancy and general per ceptions of health education suggest a need for clear information on this topic set within a health pro motion framework.
Exploring young people's attitudes to and knowledge of Aids — the value of focused group discussions
Authors: Boyle M.E. , Pitts M.K. , Phillips K.C. , White D.G. , Clifford B. , Woollett E.A.
Published: March 2007

THIS paper explores the use of focused group dis cussions to explore undergraduates' knowledge of HIV/Aids and their attitudes towards it. It argues that such open-ended settings allow the free expres sion of doubts and concerns which might be obscured or not investigated by the more structured and quantified techniques commonly used to investi gate knowledge, beliefs and attitudes towards health issues.
The family atmosphere - growing up in smoke
Authors: Michell Lynn , Stenning Keith
Published: March 2007

THIS is a first descriptive account of UK children's reports of their experiences as passive smokers in their own homes. The subjects were 658 children aged 10 to 14 years from three contrasting school catchment areas. The children completed a multiple- choice questionnaire exploring the smoking behaviour of their families, their own smoking behaviour, and their attitudes to other people smok ing in their homes and in public places. It included an open question "How do you feel about other people smoking?". Results revealed that the majority of chil dren were exposed to at least one person smoking in their homes, that exposure to passive smoking varied enormously with school catchement area, and that in general children objected strongly to other people smoking. The presence of a family member who smoked proved a powerful indicator of the children's own smoking behaviour and their attitudes to other people smoking, but further correlations and log- linear modelling revealed differential effects of mother's and father's smoking behaviour. Impli cations for intervention programmes are discussed.
The forgotten exemplars - smoking among female community-care students
Authors: Charlton Anne
Published: March 2007

WHEN discussion of the exemplar role of health pro fessionals arises, attention is immediately focused on nurses and doctors. But many other professions and occupations are seen by the public as being health-related and provide examples for health behaviour. The small pilot study described in this paper indicates a high prevalence of smoking among students training for various community-care pro fessions. It also shows their dissatisfaction with smoking and with being smokers; their wish to stop smoking; their general lack of success in quitting and their need for help.
Women smoking and coping: an analysis of women's experience of stress
Authors: Wells Julie , Batten Liz
Published: March 2007

MOST research examining the relationship between women's smoking and stress has focused on women living on a low income. The present study looked in detail at comparative groups of women in terms of smoking status (that is, smokers, non-smokers and ex-smokers) and social class, and investigated simi larities and differences in terms of coping strategies. Results suggest that not all women who smoke do so to relieve stress, though women across all social classes suffer from stress. Health promotion should therefore address itself to promoting positive coping mechanisms for all women. Women who do empha sise smoking as a vital coping strategy are likely to live on a low income, in poor housing and often live in isolated conditions with pre-school children. Health promotion must therefore seek to work with welfare agencies in combating the structural factors which cause women to depend on health-damaging coping strategies.
Planning an achievable strategy for 'Health For All' in the inner city: the development of local targets
Authors: Jacobson Bobbie
Published: March 2007

THE development of a realistic, action-orientated strategy for 'Health For All' in the City and Hackney Health Authority is described. The need to set achievable interim objectives that relate to the pro cess as well as the long-term outcomes is stressed. The advantages and disadvantages of using the World Health Organisation's European strategy and the approach adopted in the United Kingdom by the authors of 'The Nation's Health - A Strategy for the 1990's as a basis for local planning are discussed. The value of using the annual public health report and its epidemiologically determined priorities is empha sised, together with the need to agree a common agenda between participating health agencies. The global WHO approach has been translated into six local priorities, with agreed targets to be achieved for the first four. Progress towards achieving these short- term targets is assessed, and the limitations of local target-setting discussed.
Reducing coronary heart disease in England: targets and implications
Authors: Mohan John , Killoran Amanda , Johnson Ken , McKenzie Jeanie
Published: March 2007

IN a previous paper we reported on the extent of district health authority (DHA) variability in mortal ity from coronary heart disease in England. In this paper we discuss two issues: possible methods for setting target levels of mortality for individual DHAs, and the implications of the variations for action by those involved in health education and health pro motion. We are not suggesting that targets should be 'top down', but that districts should be able to assess an appropriate contribution to a national target, tak ing account of local circumstances. In addition, local targets should not be an excuse for inaction at national level. A commitment is required, not least from central government, in pursuing progressive public health measures, including issues of food pol icy and strict price and advertising control of smok ing.
Women undergoing colposcopy: their satisfaction with communication, health knowledge and level of anxiety
Authors: Kincey John , Statham Sara , McFarlane Tom
Published: March 2007

A SURVEY of women undergoing colposcopy investi gated their levels of anxiety, knowledge and satis faction with communication about the procedure. The mean level of state anxiety immediately before the procedure was at least as high as previously reported for women or men undergoing surgery which requires general anaesthetic. Objective levels of understanding about the procedure were signifi cantly less than complete and were subjectively rec ognised as such. The procedure was, without exception, considered important. Fewer than half of the sample were satisfied with the information received about the procedure.
The way forward for school nursing
Authors: Bagnall Pippa
Published: March 2007

Much thought has gone into redefining the role of the school health service over the past year, and in particular, considering how it might become part of a 'health promoting school'. Here Pippa Bagnal reports on the recommendations stemming from the Health Visitors' Association's review of school nursing, and in the following article J A. Reid proposes a new public health function for the service.
Survey research and HIV-related behaviours: a case for caution
Authors: Bagnall Gellise
Published: March 2007

THIS paper discusses some of the findings from a recent survey of HIV and Aids-related issues amongst a random household sample of 16-30 year- olds. The focus of the discussion is on the method ological problem of respondent refusal, particularly internal non-response when significant numbers of respondents refused to answer the more sensitive questions asked by the interviewer. Differences be tween respondents who refused to answer such questions, and those who were willing to answer, are presented. Refusers were younger than those who responded, and less likely to be in a stable partner ship. It is argued that this loss of information has important implications, and a general need for cau tion in interpreting the results of such surveys is emphasised.
Parents' views of child health surveillance
Authors: Boyle Gillian , Gillam Stephen
Published: March 2007

THE creation of internal markets and the develop ment of audit have intensified interest in parental perceptions of community child health services. This paper describes the views of 236 parents on develop mental checks administered in both general practice and community clinic settings in Barnet in Septem ber to November 1991. Generally high levels of satis faction with the service were recorded, but many parents did not recall being asked about specific top ics judged to be important by local community pae diatricians and clinical medical officers. For example, only 37 per cent of mothers attending six- week or eight-month checks recalled being asked about sleep difficulties. Forty per cent of mothers (all checks) did not recall being asked about their anxie ties. Many parents were disappointed by the mech anistic nature of the encounter. Other issues raised included the inconvenience of clinic times for over one quarter of parents and the lack of play or chang ing facilities. Ease of access was the factor most commonly influencing parental choice of where to attend. Doctors and health visitors may benefit from scrutinising more closely the content of these en counters and balancing their own screening require ments with the needs of mothers for information and an opportunity to share concerns.
Reviews of interventions to reduce social inequalities in health: research and policy implications
Authors: Gunning-Schepers Louise J. , Gepkens Annemiek
Published: March 2007

The Netherlands government commissioned a review of the literature on evaluated interventions to reduce socio-economic health differences. This was to serve as the basis for a second research programme that would focus on evaluating interventions. The review purposely included as many local-level interventions as possible, even though these were often not formally published, and were reported only in the so-called 'grey' literature. More than two-thirds of the interventions identified used health education methods in some way. The most successful ones always combined providing information with either structural measures or per sonal support. Many of the local community interventions were a very diverse mixture of activities, most of which could be classified as health promotion. The review offers a good starting point for a policy to reduce socio-economic health differences, but also shows how little we have invested in the past to gain experience systematically with interventions that can be transferred to other settings. Research and policy implications are drawn out in the final sections.