bluuebunny/crossref_metadata_2025 huggingface dataset:
'Resistance' and health promotion
Authors: Crossley Michele L.
Published: March 2007

The main aim of this paper is to present some theoretical ideas which derive from the author's empirical research on health promotion, specifically amongst gay men, and health promotion relating to safer sexual practices. This research has been ongoing over the last five years and has involved sustained analysis of gay men's narratives relating to sexual practices, derived from ethnographic work, interviews, focus groups, questionnaire data and a detailed analysis of published autobiographical and fictional works. The paper suggests that reported increases in unprotected anal intercourse amongst gay men may be partially explained by a 'transgressive' and 'resistance' stance towards repeated health promotion efforts. It is also hypothesised that this 'resistant' response to health promotion may not be specific to gay men and may become increasingly common amongst the general population. Accordingly, the paper ends by sounding a cautionary note for health education and promotion, and emphasises the need for sustained empirical research in this area.
Pupil snacks: The extent to which food and drink policies in Wirral schools promote health
Authors: Cheater Sylvia
Published: March 2007

Objective To examine evidence of policies that underpin the consumption of food and drink (excluding lunch) in Wirral, Merseyside schools. Design A cross-sectional descriptive survey was used.

Setting Nursery, primary, secondary and special needs schools in Wirral, Merseyside.

Method The questionnaire survey was distributed to headteachers in Wirral's 137 schools, using the Local Education Authority's internal mailing system.

Results The response rate was 109 schools (80 per cent). The results suggest that whilst there was some evidence of policies that regulated snack foods and drinks in Wirral schools, these were confined mainly to primary schools. There was very little evidence of consultation in the policy-making process beyond headteachers and school teaching staff. Headteachers were given the opportunity to request help in developing health promoting snack policies and 62 schools (57 per cent) indicated that they would like help.

Conclusion The key findings of this research are: there is very little evidence of health promoting snack policies in Wirral schools, apart from those that regulate foods and drinks brought into primary schools, and there is almost no evidence of wide ranging consultation and part icipation in the policy making process. A positive outcome is that a majority of the participating schools stated that they would welcome help in developing nutrition policy. On the basis of these results, it is suggested that schools require constructive information, motivation through examples of good practice and support to encourage the development of health promoting nutrition policy.
Student perceptions of exercise role modelling by secondary health educators
Authors: Drummond Jan L. , McGuire James G. , Bennett Gregg
Published: March 2007

Objective To examine secondary student perceptions, as well as health educator perceptions, as they relate to health educator role modelling of exercise. Additionally, self-reported exercise behaviours of health educators and their students were reported. For the purposes of this study, role modelling is defined as the influence health educators have regarding the exercise behaviours of their students.

Design A teacher questionnaire and similar student questionnaire were developed and designed to self-report current exercise behaviours and role modelling perceptions of secondary health educators and their students. Questions included items regarding exercise participation, frequency, duration, type of exercise, self-perceived level of physical fitness, importance of being physically fit, and health educator role modelling information.

Setting Questionnaires were administered to health educators and their ninth grade students during health education classes.

Method Teacher questionnaires, administered to secondary health educators ( n=20),and student questionnaires,administered to secondary health education students ( n=656), were used as a means of gathering data. All questionnaires were administered by the investigators.

Results Secondary health educators appeared, through reported behaviour, to exhibit positive exercise role modelling. Eighteen health educators (90 per cent) perceived themselves to be exercise role models

for their students, while 77.8 per cent of the students perceived their teacher to be an exercise role model. Students indicated the curriculum regarding the health benefits of exercise presented in class by the health educator as the primary reason for the teacher serving as a positive role model.

Conclusion It was concluded that health educators may, indeed, be a powerful influence for promoting exercise to their students, but students appear to be less perceptive of the health educator's participation in exercise and more perceptive of the exercise curriculum presented in health class.
Exercising for a healthy heart: A qualitative study of women's beliefs
Authors: Clayton Julie , Ruston Annmarie
Published: March 2007

Objective The aim of this study was to explore women's beliefs about exercise in relation to key messages about physical inactivity and coronary heart disease.

Design This was a qualitative study using semi-structured interviews. Setting Cardiac and gynaecological units of three hospitals in different locations.

Method Open-ended, semi-structured interviews were conducted with 50 women admitted with a cardiac related event or suspected cardiac event, and 33 women without manifest coronary heart disease who had been admitted to the same hospitals for routine elective surgery/procedures. Results Women related to exercise primarily in terms of losing weight, looking good, staying mobile and keeping fit generally. Moderate physical activity was considered best and there was a perception that activity inherent in women's domestic lives provided this. Women believed overexercise could be potentially harmful.

Conclusion Key messages about physical activity and its importance in preventing coronary heart disease need to take into account women's ideas about the benefits and hazards of exercise.
Students' and teachers' experiences of a problem-based learning method in health promotion in a Finnish polytechnic
Authors: Poskiparta Marita , Liimatainen Leena , Sjögren Auli
Published: March 2007

Objective This study explored students' and their teachers' experiences of a problem-based learning method (PBL) and its manifestation in health promotion education.

Design The study was based on a more extensive follow-up research project that investigated the teaching and learning of health promotion in two polytechnics of health care from 1997 to 2000.

Settings A Finnish polytechnic of health care and nursing within a larger multidisciplinary educational institution.

Method The data consisted of interviews with nine student nurses and ten teachers, conducted in 1999 and 2000. The data were analysed using inductive content analysis.

Results During the first year when the polytechnic started to teach by using the PBL method, both the students and the teachers thought that there was insufficient time to work on problems and learning materials. They also experienced frustration regarding the lack of solutions to their problems and were disappointed with the role of facilitators. Both groups were concerned about controlling the students' learning and the quality of education. During the second year, the students and the teachers had learnt to use the PBL method and apply it to health promotion issues. Both groups thought that the PBL method made it easier for individuals to work together, to overcome barriers and to create solutions that were more flexible or unconventional.

Conclusions The results represent a major challenge concerning the practical circumstances of learning and teaching by using the PBL method. The learning cases emphasise the interdependence of the content and the teaching method of health promotion in curricula.
Improving public understanding of healthcare ethics
Authors: Terry Louise M.
Published: March 2007

Healthcare delivery in the UK faces many problems which often raise questions of an ethical nature. In general, the only access to any ethics 'education' available to the public is through media commentary, television soaps and dramas. These commentaries may range from high quality to sensationalist; rather than educate they merely worry and confuse the layperson. This article proposes that the extensive ethical expertise found within the NHS (National Health Service) and the universities that educate its staff should be harnessed in the form of a National Healthcare Ethics Week based on the existing, very successful British National Science Weeks, and the Bioethics Weeks run in Alberta, Canada, to enhance public understanding of ethical issues related to health and wellbeing. The benefits of increased public understanding of healthcare ethics issues could range from improving public responsibility towards the NHS, its staff and resources, encouraging people to think about careers in healthcare, improving partnerships in care between patient, family and healthcare providers and developing greater recognition of the impact of religious and cultural beliefs upon healthcare. Participating in a National Healthcare Ethics Week could help staff 'make a difference' and can be envisaged as the type of personal and professional development that helps attract and retain staff within an organisation. At the moment, the media has appointed itself both public educator and watchdog. A National Healthcare Ethics Week would allow the NHS to take the lead in public healthcare ethics education.
An exploratory study of perceptions and practices related to physical activity in women college teachers and students in Bangalore, South India
Authors: Vaz Mario , Bhorathi A.V.
Published: March 2007

Objective To assess perceptions of the benefits of physical activity, actual physical activity practices and perceived barriers to the adoption of a more physically active lifestyle, in women college lecturers and students. Setting The city of Bangalore in South India, with a population of approximately 5.5 million.

Method A self-administered questionnaire in a convenience sample of 130 women college lecturers and 129 students.

Results 43.4 per cent of students and 53.1 per cent of college lecturers did not perform any discretionary exercise-related activity during the previous month. The overall physical'activity status in the lecturers as indicated by the physical activity level (PAL) was higher than in the students ( p<0.05); lecturers spent more than three times the duration in household chores as compared to the students ( p< 0.05) and at marginally higher intensities ( p< 0.05). In both these educated urban groups, knowledge regarding the health benefits of physical activity was virtually nonexistent for some diseases like osteoporosis. Lecturers were better informed about the benefits of physical activity with regard to hypertension, diabetes and arthritis than the students ( p<0.01) , but the level of awareness was similar for 'heart disease'. A lack of time and of motivation were at the top of the list of perceived barriers to the adoption of a more optimal exercise programme in both groups. Except for 'lack of facilities', which was listed more frequently by the students than the faculty ( p< 0.05), all other perceived barriers were reported to a comparable extent in both groups.

Conclusions This exploratory study indicates that there is a need to improve both knowledge and practices with regard to physical activity in educated urban women. While using lecturers in colleges as vehicles for public health messages may be intuitive and desirable, it will be necessary to ensure that they are better informed and convinced about the utility of lifestyle changes themselves.
Immunising Children in Primary Care in the UK - What are the Concerns of Principal Immunisers?
Authors: Maconachie Moira , Lewendon Gill
Published: March 2007

Objective To determine the levels of concern about risks associated with childhood immunisations among principal immunisers in general practice.

Design Self-administered postal questionnaire survey.

Setting South & West Devon Health Authority.

Participants Eighty-eight/102 general practices: 78 practice nurses, 7 general practitioners, 3 health visitors. Of these, 73 (83 per cent) were the principal immuniser for the general practice and comprise the study sample.

Results A third of the principal immunisers (34.2 per cent) were concerned about at least one of the immunisations given to children. Most of the concern reported focused on the measles, mumps and rubella vaccinations. Issues mentioned in the reasons given for concern included concerns about safety (risks, reactions and side effects), about parents, about adverse media and publicity, about research evidence, doubts about the need for the second MMR and personal experiences.

Conclusion The role of principal immunisers is crucial especially when many parents are undecided about immunisation when they attend a clinic. Addressing their concerns may contribute to improving overall confidence in the immunisation programme.
Concepts for telephone-based health education
Authors: Brouse Corey H , Basch Charles E
Published: March 2007

A key challenge facing cancer educators is the extent to which effective programmes can be widely disseminated and implemented. Differences between target populations with respect to social, psychological, and educational characteristics, as well as the social and economic context make it difficult to replicate 'cookbook' approaches. Tailoring of communications has mitigated this problem to some degree, but the heterogeneity of target populations is still an impediment. In this paper the authors, therefore, propose guidelines that may be useful in implementing cancer education for a variety of populations and settings.
Can health visitor intervention change sun safety policies and practice in preschool establishments? A randomised controlled study
Authors: Syson-Nibbs Linda , Peters Jean , Saul Carol
Published: March 2007

Objective In the UK there have been no initiatives identified to increase the use of sun safety policies in preschool establishments. This study tests the hypothesis that health visitors with appropriate sun safety training can successfully facilitate the development and implementation of sun safety policies and practices in preschool education and care establishments.

Design A two-stage randomised controlled study.

Setting All providers of preschool care or education situated within the boundaries of North Derbyshire Health Authority ( n=198).

Method In stage one an initial postal screening survey of all preschool providers was conducted to determine the extent to which their policies and practices were consistent with ideal practice for sun safety. Providers who did not have a written sun safety policy were invited to participate in stage two of the study in which they were randomly assigned to either intervention group or control group. The intervention establishments received visits over a four-month period from a health visitor who had attended a one-day sun safety training event.

Results The overall response rate to the initial screening survey was 67 per cent ( n=133) of which 90 per cent did not have a written sun safety policy ( n=96). In the intervention group ( n=33) 88 per cent ( n= 29) of playgroups and nurseries had changed their sun safety practice by

developing and implementing a sun safety policy, following visits from a health visitor. For example, the percentage of children wearing sun hats was associated with policy development ( r=0.4, p<0.05). In the control group ( n=41) no changes had been made to sun safety policy or practice.

Conclusion This is an important finding for Primary Care Trusts who are charged with the development of the public health capacity of health visitors.
Men and health promotion in the UK: Ten years further on?
Authors: Robertson Steve , Williamson Peter
Published: March 2007

Within the UK, health promotion work with men is well established with examples now dating back for over twenty years. Ten years ago, Robertson1 wrote a review of the state of health promotion services for men in the UK. However, much has changed in policy and practice since this time. This brief paper therefore provides a periodic review of how such services have developed and progressed in the last ten years. The reasons for these developments are explored before consideration is given to what current challenges remain in health promotion work with men. The paper suggests that, despite innovative changes in practice, and a policy agenda that facilitates more holistic approaches, there is little change in men's health related practices and subsequent health outcomes. The reasons for this are considered, as are the opportunities that currently exist to help improve future health promotion services for men.
Helping NHS staff to stub it out: a study of the smoking habits of staff working for a mental handicap unit
Authors: Munchow Jane D. , Hayton Paul , Britton Peter G.
Published: March 2007

IN 1984, the health promotion group of West Cumbria via its smoking interest group initiated a pilot study to determine the number of smokers in a discrete sample of the district NHS staff. It was anticipated that the detailed information obtained would facili tate the planning of future health education on smoking and influence local NHS smoking policies. Results indicated that while the problem is not as great as had been anticipated, particular groups of staff appear to be at risk. There was a difference in the number of nursing versus non-nursing staff who smoke; the former are more likely to be smokers. In particular, the proportion of night staff who smoke is comparatively high. It is recommended that future health education policy must be geared to answering the specific needs of different staff populations.
Health education from Council to classroom
Authors: Leighton Jessie
Published: March 2007

Curriculum development is a slow process, but after years spent laying the groundwork, the tide for school health education is now in. Health as a topic, though, has implications beyond the classroom- for the school itself, the families of its pupils, and the wider community.
Youth in distress
Authors: McFadyean Melanie
Published: March 2007

The letters sent in to the advice column of one of Britain's most widely- read youth magazines- Just Seventeen - reveal a disturbing level of distress, fear and ignorance among British teenagers. Many of the problems raised are health-related.
Smoking in hospital — a survey of staff attitudes at Westminster Hospital
Authors: Burns C. , Jones S.A.M. , Pearson R.
Published: March 2007

A SURVEY of staff attitudes to smoking and facilities for smokers and non-smokers at Westminster Hospi tal and associated buildings revealed widespread support for firmer measures to limit and control smoking on health service premises. The survey was eventually undertaken with the agreement of staff side union representatives who had initially resisted the health authority's wish to implement a policy on smoking. In the event, the results provided support to the TUC's 1981 Resolution calling for increased smok ing restrictions in workplaces as part of an overall policy to reduce smoking prevalence among working people, which has been followed up in local initiat ives by unions throughout the country.
Promoting the new public health in Mersey
Authors: Ashton John , Seymour Howard , Ingledew David , Ireland Robin , Hopley Eric , Parry Alan , Ryan Mike , Holbourn Alison
Published: March 2007

WHEN Liverpool Town Council appointed William Henry Duncan as the first Medical Officer of Health in 1847, the appointment was not made out of any particular sense of vision. Rather, housing and environmental conditions were so bad that urgent action appeared to be necessary. Duncan had been the one physician locally with the necessary insight into the living conditions of his patients, and the necessary motivation to bring the situation to public attention1.2. The liberal reforms that were under way in response to the harsh effects of the industrial revolution meant that he was in the right place at the right time with pertinent things to say, and as a result he was listened to. As with Duncan, so with present-day health promoters, if only they are prepared to take their opportunities and involve themselves with what is now becoming well established — the new public health.
Teaching about Aids in schools
Authors: Massey Doreen E.
Published: March 2007

Effective strategies and methodologies exist for teaching about Aids, says Doreen Massey, a parent and school governor. Aids teaching should form part of a comprehensive approach to personal, social and health education, and should be carried out in full consultation with parents and governors.
Aids education in black America
Authors: Gayle Jacob A.
Published: March 2007

As Aids continues to hit American black communities at alarmingly dispropor tionate rates, both black Americans themselves, and the American mass media must begin to confront the realities of the problem, and devise a plan of action to educate blacks about health risks and prevention, argues Dr Gayle.
Health attitudes and behaviour among the 'healthy' and the 'sick' — some implications for practice
Authors: McGill Pauline C.L.
Published: March 2007

THREE groups completed detailed questionnaires on their personal health attitudes; habit behaviours such as smoking, drinking and eating; and illness behaviour. One group contained subjects who were attending classes with a specific health aim (eg stop smoking); one was composed of subjects who were engaged in a general health activity (eg yoga); the control group were attending adult education classes unrelated to health topics.

The 'health problem' group were more likely to smoke, drink and consult their doctors and esti mated their health as 'below average'. However, they did not differ from the controls in being overweight, failing to take regular exercise and in their attitudes to health. The 'health activity' group had, in general, the healthiest attitudes and behaviour.

Conclusions are drawn about the appropriate tar get populations for health messages, and rec ommendations are made for holistic approaches to clinical work.
Alcohol education in the workplace
Authors: Cyster Richard , McEwen James
Published: March 2007

THIS paper summarises the findings of a two-year research and development project to design, imple ment and evaluate materials for use in alcohol edu cation at the workplace. Conducted in association with a major national employer, the Post Office, the project demonstrated that education and training initiatives can make a significant contribution to employees' knowledge of alcohol, and also aid man agement in the implementation of a problem drink ing policy. The authors make recommendations concerning the planning of future initiatives in this area.
Does health knowledge affect eating habits?
Authors: Charny M. , Lewis P.A.
Published: March 2007

A SURVEY of 4266 people in Cardiff set out to discover their behaviour, knowledge and attitudes in relation to food. Higher levels of knowledge were always associated with healthy changes in food consump tion over the past year. The survey identified areas in which further educational effort is needed.
Women and alcohol
Authors: Soutter Kate
Published: March 2007

Women face particular difficulties in the 1980s, as mass media images of glamour, coping and confidence clash with economic realities which force them to work, and tradition which expects them to run a family or a home, and perhaps care for a child or dependent relative as well.
Public awareness of healthy life-style factors and sources of advice
Authors: Philipp Robin , Hughes Anthony , Mackley Fiona , Fletcher Gillian
Published: March 2007

IN an attempt to ascertain patients' understanding of health risks associated with different life-styles, and where information about them can be obtained, a questionnaire study among 865 patients was under taken in 58 general practices. Many of the respond ents failed to mention life-style factors such as smoking behaviour, alcohol intake and weight con trol that can be modified to improve health. The find ings suggested poor knowledge about available sources of advice, and there was widespread interest in obtaining information about the magnitude of risks attributed to different life-styles and how risk levels could be influenced by changes in personal behaviour. Seventy two per cent of respondents would welcome a booklet with this information. Such a booklet could be jointly developed by epidemiolo gists, health educators and general practitioners.
Making changes — women, food and families
Authors: Pill Roisin , Parry Odette
Published: March 2007

GIVEN the recognised importance of diet and health, much health education on nutrition has been directed at women who are assumed to control fam ily eating patterns since they generally carry out the bulk of shopping and food preparation. However, recent research on the sociological significance of food and eating, and family decision-making, suggests that mothers, particularly working class mothers, may face considerable constraints in ini tiating changes in dietary behaviour. Empirical data from a survey of Welsh mothers, classified as Social Class IV and V, are used to illustrate these issues, and it is argued that health educators need to be more aware of the context in which behavioural change is attempted and direct their efforts at other family members, particularly husbands, whose attitudes may be crucial.
Why do more girls than boys smoke cigarettes?
Authors: Swan A.V. , Melia R.J.W. , Fitzsimons B. , Breeze E. , Murray M.
Published: March 2007

A COMPREHENSIVE review of the scientific litera ture on adolescent smoking published in English since 1970 shows a remarkable worldwide pattern of development in adolescent smoking. One developed country after another has reported figures showing that girls now have a higher prevalence than boys. No single factor known to be associated with the uptake of smoking in this age range would have had a large enough effect or changed enough to account for this phenomenon. Advertising and the introduction of low-tar cigarettes may have partly contributed to this development, but a new hypothesis is proposed. The fact that girls mature earlier has combined with a steady change in social attitudes, helped by the commercial pressures, so that girls now exhibit smoking behaviour similar to boys one or more years older. Advertising aimed at young women must be discouraged, and anti-smoking education pro grammes in schools should be revised with particu lar reference to their relevance for adolescent girls.
Toothbrushing frequency and physical recreation in 14-year-old schoolchildren
Authors: Macgregor I.D.M. , Balding J.W.
Published: March 2007

A SURVEY of 4075 14-year-old children from second ary schools throughout England was made to obtain information about toothbrushing frequency and par ticipation in physical recreation. Subjects completed a questionnaire, anonymously, in class. In both sexes, toothbrushing frequency was found to rise sig nificantly as participation in vigorous and sedentary sports outside of school hours increased. There was a similar association between toothbrushing fre quency and vigorous team games in school in males, but not in females. These results support previous findings that toothbrushing behaviour is associated with personal and social behaviours, and emphasises the need to consider dental health behaviour in relation to the whole function of the individual.
Aids survey in Croydon — attitudes, knowledge and opinions
Authors: Williams E.S. , Kennedy Jane
Published: March 2007

A MARKET research survey in Croydon produced 510 completed questionnaires. Fifty three per cent of respondents were female. Just over a third of respondents wanted more information on Aids, although 85 per cent claimed to know enough to protect themselves against the disease. Only six per cent of the sample answered the knowledge question incorrectly, and 60 per cent spontaneously identified homosexuals as a risk group. The sample was div ided in half by the statement "It's a person's own fault if they get Aids", with more men and more old people agreeing with the statement. There was fairly general agreement that society is prejudiced against people with Aids (82%), with young people and women tending to perceive more prejudice. Of the 15 per cent who do not know enough to protect them selves against Aids, half say they do not want more information, suggesting a small group that is resistant to health education. The main conclusions were that although respondents were very knowl edgable on Aids, there is still a great deal of preju dice. The main issue facing health education is changing attitudes, not increasing knowledge.
General practitioners' attitudes to prevention
Authors: Williams Angie , Bucks Romola , Whitfield Michael
Published: March 2007

SIX questions about general practitioners' views on prevention were incorporated into a questionnaire that was completed by 424 (81%) of Avon's general practitioners. The great majority of the doctors agreed that they had a role in health promotion, but there was evidence of some apprehension about patients' possible negative reactions to preventive advice. This concern about patient rejection may be behind the large number of opportunities for health promotion that are apparently being missed by gen eral practitioners. Older doctors generally appear less enthusiastic about health promotion, which may again indicate their unwillingness to disturb long- established doctor-patient relationships or may, more likely, be simply an indication of less evangeli cal beliefs and changes in both knowledge and medi cal teaching.
The self in relation to mass media representations of HIV and Aids — match or mismatch?
Authors: Stockdale J.E. , Dockrell J.E. , Wells A.J.
Published: March 2007

THIS study examines images of HIV/Aids portrayed in exemplars of campaign posters and advertise ments. The aims and potential efficacy of these cam paigns are examined in relation to self-perceptions of group membership, subjective assessments of risk, and likelihood of taking action to prevent con tracting HIV. The results indicate that material in general maps onto its target groups. Both our homo sexual and heterosexual groups recognised the tar get at which the material was aimed. However, only the homosexual subjects showed any match between the way they perceived their own behaviours and life-style and groups identified as 'at risk'. The implications of these results for the design and efficacy of future campaigns are discussed.
Crack — the story so far
Authors: Shapiro Harry
Published: March 2007

In a bid to separate fact from myth, the Institute for the Study of Drug Dependence is asking a range of publications to publish this background paper Breaking its usual practice of exclusive publication, the Journal is pleased to co-operate.
Geographical variations in deaths from injury and poisoning in England and Yorkshire — implications for health promotion
Authors: Renvoize E.B. , Clayden A.D.
Published: March 2007

AN epidemiological study of injury and poisoning deaths has revealed differing patterns of mortality in the regional health authorities of England and the district health authorities of Yorkshire. The implica tions of these findings for health promotion are explored, and it is concluded that the identification and monitoring of local patterns of mortality are essential in any campaign to reduce deaths from injury and poisoning, if limited resources are to be used efficiently and effectively.
Networking: A strategy for the professional development and support of health educators
Authors: Heathcote Gaye
Published: March 2007

THIS paper explores the potential of networking for the professional development and support of health educators, particularly holders of the Certificate in Health Education. The analysis is based on a study of six networks which have contrasting structures, pur poses and organisation, and highlight network mem bers' perceptions and experiences. Finally, it offers some evaluation of the role of networks in terms of their functions, membership patterns, role allocation and organisational forms.
Health knowledge and behaviour change: a comparison of Edinburgh and north Glasgow
Authors: Shewry M.C. , Smith W.C.S. , Tunstall-Pedoe Hugh
Published: March 2007

DATA from surveys relating to coronary heart disease have been used to investigate differences between Edinburgh and north Glasgow in levels of health knowledge and changing behaviour, and the links between them. Little difference was found between the conurbations when people were asked about par ticular ways of reducing their risk of a heart attack, but further analysis suggests that people in Edin burgh are more likely to have changed their behav iour in accordance with their knowledge of the health benefits. Attitudes to healthy behaviour, rather than health knowledge, appear to be associ ated with risk factor levels. Responses varied consid erably according to socio-economic status and the social differences between the conurbation were found partly to explain the differences in levels of health knowledge and behaviour change.
Healthy eating policies in schools: an evaluation of effects on pupils' knowledge, attitudes and behaviour
Authors: Young Ian
Published: March 2007

THE effect of a healthy eating health promotion in itiative on the knowledge, actitudes and behaviour of secondary-school pupils was investigated in this study in Lothian Region in 1992. This was under taken by comparing pupils in a case study school, which had introduced a healthy eating policy, with pupils in two control schools. The investigation dem onstrated that the levels of knowledge of healthy eating were similar in the three schools, but there were significant differences in eating behaviour be tween the schools. Pupils in the case study school demonstrated healthier snack selection at school and a greater uptake of school meals. There was evidence that wider factors, not within the domain of the school, counteracted the case study school's achievement and the policy implications of this are discussed.
Travel to work and its effects on commuters' health: a methodology
Authors: Cuninghame CJ
Published: March 2007

THIS study developed a methodology to investigate the possible adverse health effects of commuting, in terms of stress, physical or other reactions, and whether more difficult commuting journeys cause worse effects. Two postal questionnaires (bench mark and diary-type) comparing different transport methods were developed; 127 employees of the Royal Free Hampstead NHS Trust were randomly selected (response rate of 63 per cent) and 28 of these were randomly re-selected to complete the daily questionnaire (response rate of 74 per cent). Achieve ment of the study's main aim, the testing of methods, was demonstrated by high response rates and the co-operation generated. Questionnaire adminis tration was successful and the blinding procedure ensured anonymity. The most significant adverse ef fects appeared to be tiredness, followed by irritation and bad temper: however, for the majority of jour neys, no ill-effects were reported.
Sex education: the effect of a peer programme on pupils (aged 13-14 years) and their peer leaders
Authors: Phelps F.A. , Mellanby A.R. , Crichton N.J. , Tripp J.H.
Published: March 2007

In 1992 and 1993, 66 selected, trained peer leaders (aged 16-17 years) worked with 38 secondary school classes in the Southwest of England. Questionnaires elicited the views of the class teachers (N = 12), peer leaders (N = 54) and pupils (N = 884; 98 per cent). The majority of the pupils (aged 13-14 years), including those with low self-esteem or special needs, participated in discussion (90 per cent) and role plays (83 per cent), and talked about the programme (with friends: 66 per cent; parents: 24 per cent). Responses indicate that the programme positively affected the pupils' knowledge, skills, and beliefs relating to social norms; peer leaders gained knowledge, skills and self-confidence. Peer education in school could be extended, benefiting both peer leaders and the recipients.
Development and evaluation of the Changing what you eat resources for primary care
Authors: Hunt Paula
Published: March 2007

The Changing what you eat booklets were developed for use in one-to-one nutrition counselling in the primary health care setting. This paper describes a study to pre-test draft versions of the booklets with patients and practice nurses. Overall the response to both the patient booklet and the guide for professionals was positive. The assessment tool, 'What do you eat?' and the food groups model, 'The healthy food selection guide' were especially liked. There were concerns about the notion of a 'Contract for change'. The need for appropriate training for health professionals was highlighted.
Exercise on prescription: does it work?
Authors: Lord J.C. , Green F.
Published: March 2007

This report concentrates on two aspects of an evaluation of the Stockport Exercise on Prescription Scheme: patterns of compliance, and changes in physical and mental health. Data were collected using a series of questionnaires at the first consultation, after ten weeks and again after six months of the scheme. Qualitative methods were also used to explore particular aspects of the project. A 60 per cent initial uptake rate was achieved, although compliance rates at ten and six months were disap pointingly low at 18 per cent and 14 per cent respectively. There were, however, very positive results in terms of improvements in mental and physical health for participants. The experiences in Stockport and the implications for similar schemes are discussed.
A video to inform and reassure autonomous cystic fibrosis carriers identified by a community screening programme
Authors: Boulton Mary , Cummings Carole , Mayall Ed , Watson Eila , Williamson Robert
Published: March 2007

Carrier screening programmes for cystic fibrosis have found that many of those identified as carriers are initially anxious about their result, although this generally declines after genetic counselling. This paper describes a project to try to reduce initial anxiety and the need for extensive post-test counselling through the production of a video to be sent in addition to the usual leaflet to individuals receiving a positive test result through the post. Fifty-five individuals were identified as cystic fibrosis carriers through a community screening programme and were sent the leaflet and video; 53 agreed to be interviewed and 52 also completed a follow-up questionnaire. The video was found to be an acceptable and effective way of providing information and support as part of an overall package including printed information and personal counselling.
Women and 'safer sex' promotion: perceptions of risk and provision of effective interventions in different health care settings
Authors: Ruston Annmarie
Published: March 2007

A survey of female clients and nursing staff in a variety of health care settings was conducted during 1995. The purpose of the study was to determine the barriers to effective sexual health interventions in these settings. Despite reasonably high levels of concern in women about becoming infected with HIV and other sexually transmitted diseases, the number of women who knew how to protect themselves was barely influenced by frequency of visits to the clinics. The main reason for this appeared to be the assumptions made by professionals, rather than determination of the risk status of clients, and the consequent inappropri ate targeting and use of unsuitable health education approaches. In order to take advantage of the enormous potential for health education interventions in these settings, there is a need for training and support to enable nursing staff to deal effectively with sexual health issues.
Disseminating research findings on women's smoking to health practitioners: findings from an evaluation study
Authors: Blackburn Clare , Graham Hilary , Scullion Philip
Published: March 2007

This paper evaluates the dissemination methods developed as part of a researeh project on women's smoking. An information pack and dissemi nation strategy were developed to disseminate key research findings and practice implications to health practitioners. The information pack was designed to be user-friendly, distilling key research findings in ways that were relevant to practice. The dissemination strategy utilised existing organisational and professional networks. The evaluation of the strategy and the information pack suggests that they provided an effective mechanism for reaching practitioners at the front-line of care, and for improving their knowledge of women's smoking and smoking cessation strategies, and their reported professional practice.
An assessment of the feasibility of health authorities generating unpaid mass media publicity in the long term
Authors: Mindell Jennifer
Published: March 2007

Generating unpaid mass media coverage has been shown to be the most cost-effective method of reducing smoking prevalence. This study looks at the feasibility of generating such unpaid coverage over a prolonged period. Press releases, letters for publication and articles on tobacco-related items Were sent to the local media by an initiative co-ordinated by a health authority cancer-prevention project. Between April 1990 and March 1992, this generated at least 1120 column-inches in the local and national press (81 per cent of the press coverage of tobacco by the three main Oxford papers). More coverage, was generated for policy matters (635 column- inches) than for items relating to knowledge or individual behaviour (485 column-inches). Half the press releases were used by the radio stations and all were published. This assessment concluded that it is feasible to initiate good coverage of health issues and to sustain this over a two-year period.
Exploring children's perceptions of health: does drawing really break down barriers?
Authors: Pridmore PJ , Lansdown RG
Published: March 2007

A study was conducted in primary schools in London to explore the idea that involving children in drawing as well as writing provided greater insights into their health perceptions than writing alone. Three approaches were used: write only, draw-and-write and label-and-write. All methods provided roughly the same number of categories of response but write-only identified categories more quickly while draw-and-write revealed more on how ideas were interlsnked. Label-and-write provided more information on physical signs of health or ill health and the appearance and use of drugs and foodstuffs. Drawings helped to decipher poor hahdwriting. These findings imply that no single method is best in all contexts and that an imaginative combination of drawing and writing can balance the strengths and limitations of each method. However, the choice of methods must be determined primarily by the questions to be answered and the situational constraints.
Drug education in primary schools: putting what we know into practice
Authors: Paxton Roger , Finnigan Sue , Haddow Mel , Allott Rory , Leonard Rob
Published: March 2007

Innovative methods and evidence of effectiveness, together with school-by- school assessment of the needs of teachers, pupils and parents formed the basis of a new programme of drug education in Northumberland. The project team was drawn from local health and education services, and funded by the NHS. After needs assessment the project provided programme design, and teacher training and support. All stages were evaluated. The programme was directed at children aged 9-10, and a total of 1428 pupils in 18 middle schools, 185 teachers and 1442 parents were involved. Educational methods included a "draw-and-write' technique and theatre in health education. Needs assessment findings from teachers, parents and pupils concerned knowledge, confidence and realism, and both teachers and parents regarded drug education as impor tant for this age group. After a half-day of training teachers provided four teaching sessions on drug issues, and a parent session was arranged in the same week. After these interventions the teacher training was regarded as applicable to everyday practice and teachers reported improved knowledge and confi dence. Pupils showed more realism in statements about coping with drug issues. Parents showed improved confidence and support for educationally sound methods of drug education. At one year follow-up most participating schools were continuing to use the methods.
Promoting health against inequality: using research to identify targets for intervention — a case study of women and smoking
Authors: Graham Hilary
Published: March 2007

With inequality back on the agenda of health promotion in the UK, researchers are being called upon to unravel the chain of risks which runs between socio economic disadvantage and poor health and to identify links in the chain where interventions should be targeted. This article is one response to the call. It is written as a contribution to a wider debate between the research and policy communities about how to understand and how to tackle health inequalities. It addresses one area of the debate, examining, and drawing policy messages from, the socio-economic patterning of women's smoking. Firstly, it describes the socio-economic differentials in women's smoking status, setting these in the context of widening income inequalities and the emergence of new forms of poverty. It notes how female smokers are concentrated among those who have lost out in the process of social polarisation. Secondly, the paper describes how women's smoking careers take shape within the socio-economic pathways which they follow through adolescence and across adulthood. Thirdly, the paper identifies a policy framework for health promotion which targets income inequalities, breaks into disadvantaged pathways and provides respite for those unable to escape their disadvantaged circumstances.
Women, low income and smoking: developing community-based initiatives
Authors: Gaunt-Richardson Paula , Amos Amanda , Moore Maureen
Published: March 2007

Smoking is a major cause of inequalities in women's health in Scotland. However, few initiatives have been designed to meet the needs of women living on low incomes. This paper describes a three-year project which is attempting to address this issue. The project has provided funding, and evaluation support, to 20 community-based initiatives concerned with women and smoking. This paper highlights the methods used to develop community contacts, the range of initiatives that have been funded and their approach, and some of the key issues that have emerged so far.
Development and evaluation of a brochure on sun protection and sun exposure for tourists
Authors: Segan Catherine J. , Borland Ron , Hill David J.
Published: March 2007

Holidays in the sun have been identified as a risk factor for the development of melanoma. This paper describes the development and evaluation of a brochure designed to reduce sun exposure in tourists travelling to high-risk destinations. The tourists came from an area where there are strong social norms for sun protection, so the focus of the brochure was to highlight the extra risks associated with their destination, ie the higher ambient levels of ultraviolet radiation (UVR) closer to the equator. The effectiveness of the brochure was tested using a randomised controlled trial ( n=373). Results suggest that the brochure was appreciated, and that those who received the brochure may have spent more of the four-hour peak UVR period out of the sun. However, receiving the brochure does not appear to have resulted in lowered sunburn rates. Brochures about sun protection and sun exposure on holi days distributed at the point of embarkation may be a useful priming strategy as part of more comprehensive programmes which should include structural interventions at the holiday destinations.