bluuebunny/crossref_metadata_2025 huggingface dataset:
Hazard Communication in a Large U.S. Manufacturing Firm: The Ecology of Health Education in the Workplace
Authors: Robins Thomas G. , Klitzman Susan
Published: February 2007

This article describes the design, implementation, and evaluation of a workplace health and safety education program intended to bring a large U.S. manufacturing firm into compliance with a Federal regulation, the Hazard Communication Standard. The methods of program delivery and levels of resources allocated were decided by local plant management and union representatives resulting in marked variations among the five plants studied. These differences in program delivery were associated with differ ences in employee assessment of the training's usefulness, changes in employee work practices, working conditions, and organizational handling of health and safety prob lems. In all five plants, the program evidenced indirect beneficial effects on the use of hazard control measures and organizational approaches to health and safety issues which went beyond the requirements of the federal Standard. The results appear well- explained by an ecological model which views health and disease as outcomes of a complex system of interactions between the individual worker and multiple levels of environmental influences. Implications of these findings for health educators are discussed.
Health Education, Health Promotion and the Open Society: An Historical Perspective
Authors: Minkler Meredith
Published: February 2007

This article provides an historical perspective within which two recent, alternative directions for health education are examined. Each direction is seen as reflecting a unique vision of health promotion, with the first focusing primarily on personal be havior change and the latter on a broad empowerment/environmental model of health promotion. Key historical developments in the evolution of these two perspectives are examined, as are some of the assumptions and ideological values underlying these alter native approaches. The World Health Organization's "Healthy Cities Project" then is used to illustrate the broader vision of health promotion in practice. While recognizing that the health educator has contributions to make on both the micro and macro change levels, a case is made for moving the field of health education further in the direction of this broader model of health promotion, and roles for the health educator within such a paradigm are outlined.
Promoting Nutrition at the Point of Choice: A Review
Authors: Mayer Joni A. , Dubbert Patricia M. , Elder John P.
Published: February 2007

The modification of dietary behaviors on a community-wide basis requires broad- based, multilevel approaches. Dietary interventions at the point of choice have the potential, as one approach, of reaching a large number of individuals at minimal cost. This article presents the potential advantages and limitations of point-of-choice inter ventions, and describes the controlled evaluations of their efficacy in restaurants/ cafeterias and supermarkets. Discussion addresses the refinement and extension of successful restaurant-based strategies and the challenge of developing more powerful strategies for influencing supermarket purchases.
Correlates of Adolescents' Use of Smokeless Tobacco
Authors: Colborn James W. , Cummings K. Michael , Michalek Arthur M.
Published: February 2007

Data are presented on the prevalence and correlates of smokeless tobacco use among a group of 568 adolescents from five public schools located in western New York State. Two of the five schools were located in rural communities, two were loca ted in suburbs of Buffalo, and one school was located in the city of Buffalo. Nineteen percent of males reported current use of smokeless tobacco. There was very little regular use among girls, although 18% reported having tried it. Sharp regional differ ences in the use of smokeless tobacco were observed with the highest percentage of users among students from rural communities. Experimentation with cigarette smok ing was associated with use of smokeless tobacco, however, few regular users of smoke less tobacco were current smokers. As is the case with cigarette smoking, social influ ences, especially those of peers and family members, were important factors associated with use of smokeless tobacco. Study findings suggest that programs that attempt to prepare students to cope with social pressures for using and stress the immediate negative consequences of use (i.e., stained teeth, bad breath) are more likely to be successful in discouraging adolescents from using smokeless tobacco than programs that only educate about the detrimental health effects of chewing and/or dipping tobacco.
The Epidemiology of Drinking and Driving: Results from the Behavioral Risk Factor Surveillance System, 1986
Authors: Smith Perry F. , Remington Patrick L. , Behavioral Risk Factor Surveillance Group
Published: February 2007

Alcohol-related motor vehicle crashes result in thousands of deaths and serious injuries each year. For effective intervention in this problem, it is important to under stand the epidemiology of "drinking and driving." To study this behavior, we analyzed the self-reports of 34,395 respondents in the 26 states conducting behavioral risk factor surveillance during 1986. An estimated 4.1% of the survey population and 7.2% of drinkers reported drinking and driving at least once in the month before the survey. In general, the prevalence of drinking and driving was highest among men, young adults, and divorced or separated persons. States with the highest prevalence of drink ing and driving tended to cluster in the north-central region of the United States. In 15 states conducting surveillance from 1984 to 1986, the overall prevalence of drinking and driving changed little during this period. However, among persons less than 25- years old, the prevalence decreased. Efforts to deter drinking and driving are likely to reduce the number of motor vehicle crashes and should include both legal sanctions and greater public education about the dangers of this behavior.
A Focus Group Study on Decision Processes of Young Drivers: Reasons That May Support a Decision to Drink and Drive
Authors: Basch Charles E. , DeCicco Ingrid M. , Malfetti James L.
Published: February 2007

This article explores reasons that may support a decision by young drivers to drink and drive. Forty focus group discussions on driving and traffic safety were conducted with 316 volunteers 18 to 22 years of age in 10 cities in the United States and two cities in Canada. The audiotaped discussions identified some factors that may influ ence young peoples' decisions to drink and drive, such as inappropriate knowledge about alcohol and driving, lack of decision making skills, and the tendency to ignore the increased risk of drinking and driving. While some respondents drove intoxicated because they were unaware of the dangers, others rationalized their drinking and driv ing behavior. Improved understanding about the nature and extent of the factors influ encing young drivers' decisions to drink and drive is essential to planning effective health education programs.
An Ecological Approach to the Prevention of Injuries Due to Drinking and Driving
Authors: Simons-Morton Bruce G. , Brink Susan G. , Simons-Morton Denise G. , McIntyre RoseMarie , Chapman Michelle , Longoria Janice , Parcel Guy S.
Published: February 2007

Among the many alcohol-related public health concerns, motor vehicle crashes account for nearly one-third of all deaths attributable to alcohol. Adolescents and young adults, particularly males, are important target populations for intervention efforts. Taking an ecological perspective of individuals within their social and physical environments, a diagnostic framework is employed in reviewing the literature on factors associated with drinking and driving injuries and on interventions to prevent injuries due to drinking and driving. Intervention planning is conceptualized according to a multilevel intervention framework, which consists of four phases: (1) health goals selection, (2) intervention planning, (3) intervention, and (4) evaluation. Possible intervention objectives, targets of the intervention actions, intervention approaches, and evaluation criteria are identified and discussed for three societal levels and four practice settings.
Policy Alternatives for Alcohol-Impaired Driving
Authors: Farrell Susan
Published: February 2007

This article summarizes current scientific evidence about the impact of public policy measures on alcohol-related motor vehicle crashes. The public policy measures considered are ( 1) minimum drinking age laws, (2) taxation of alcoholic beverages, (3) drinking and driving laws, (4) laws and regulations governing the physical availability of alcoholic beverages, and (5) server intervention programs. It is concluded that certain public policy measures reduce alcohol-related crashes. These measures include higher taxes on alcoholic beverages and at least some laws and regulations governing the physical availability of alcohol (as well as the minimum drinking age). The article suggests that strengthening drinking and driving laws without also adopting these other measures may have less than optimum (and possibly disappointing) effects.
A Health Promotion Program: Staying Healthy After Fifty
Authors: Simmons Jeannette J. , Nelson Eugene C. , Roberts Ellen , Salisbury Zora Travis , Kane-Williams Edna , Benson Lisa
Published: February 2007

In this article, a description of how a comprehensive health promotion program for older adults was developed, tested with a quasi-experimental study design, and then revised to become a nationwide AARP and Red Cross program is presented. Teaching and learning methods used in the course are described with supporting education and behavioral theory. The course content for instructors, facilitators, and course partici pants is outlined. The key elements in the preparation of instructors and facilitators are identified. Results of the implementation of the program are given.
Community Health Advocacy for Racial and Ethnic Minorities in the United States: Issues and Challenges for Health Education
Authors: Thomas Stephen B.
Published: February 2007

The 1985 Heckler report on Black and minority health clearly demonstrated that minority groups suffer excess morbidity and mortality directly related to social inequal ities. Subsequently, improving the health status of minorities must go beyond personal health care delivery and address the broad issues of health policy. There is increasing evidence that wide public support is mounting to address many of the major health problems facing minority groups. In order to modify health behavior of minorities, health educators must recognize that traditional health promotion activities, focused on vol untary personal behavior change, may not be effective in reducing morbidity and mortality rates. Efforts to improve the health status of minorities must include an aggressive health policy dimension. Personal behavior change efforts without an equal or greater emphasis on policy change is tantamount to blaming the victim. As health educators become increasingly aware of the political nature of health issues, it will be necessary to examine the health status of ethnic and racial minority populations from the perspective of com munity health advocacy.
An Outcome Evaluation of Project Model Health: A Middle School Health Promotion Program
Authors: Moberg D. Paul , Piper Douglas L.
Published: February 2007

This article reports findings from the outcome evaluation of Project Model Health (PMH), an intensive in-school health promotion program for middle school students. Promising prevention strategies identified in past research based on social influences theory were combined in PMH, targeting multiple health behaviors in the areas of nu trition, marijuana use, tobacco use, drinking and driving, and sexuality. Results reported in this paper are based on an experimental group of 115 eighth graders who were exposed to the 32 hour program, taught by college-age "role models." The evaluation included both an extensive qualitative process evaluation and a quasi-experimental outcome evaluation. The outcome evaluation used both a prior year's cohort and students from a similar untreated school for comparison purposes. While an immediate post-test showed only inconsistent results, a 20-month follow-up resulted in clear positive out comes for experimental students on measures of cigarette smoking and improved food choices, and ambiguous but positive results on rates of intercourse. Limitations of the methodology (nonexperimental assignment to conditions, reliance only on self-report data) are such that further more rigorous testing of this program model is called for. However, PMH shows significant promise as an effective adolescent health promotion approach.
Maintaining Employee Participation in Workplace Health Promotion Programs
Authors: Lovato Chris Y. , Green Lawrence W.
Published: February 2007

This article examines the issue of maintaining participation in workplace health pro motion programs. The term "maintaining participation" is defined here as both continued program attendance and maintenance of recommended behaviors. The factors associated with participation and approaches to maintaining participation are reviewed. Evidence suggests that combinations of environmental and individual approaches are necessary to address the problem of maintenance. An approach to maintaining participation is sug gested that utilizes a preprogram diagnostic interview model to identify and address environmental and individual factors that may cause an employee to drop out of a program or relapse into prior behavioral patterns.
Health Beliefs in a Population: The Michigan Blood Pressure Survey
Authors: Weissfeld Joel L. , Kirscht John P. , Brock Bruce M.
Published: February 2007

In a general population sample, we examined relationships between sociodemographic characteristics and health beliefs. Individual questionnaire measures for components of the health belief model were combined to form six scales. In analyses which adjusted for perceived levels of health, sociodemographic markers of social disadvantage (e.g., black race, or low socioeconomic status) appeared to associate with favorable health beliefs, that is, with health beliefs often associated with health promoting behaviors. Specifically, we found that blacks expressed greater concern about health. Women believed they tended to get sick more often and to suffer more severely from illness. Female and older respondents placed greater value on the kinds of services provided by members of the health professions. Female, black, older, and lower socioeconomic status respondents placed greater value on such healthful personal habits as exercise, alcohol avoidance, and proper diet. These results suggested that the poor health suffered by relatively disadvantaged members of society are not, in some manner, a consequence of funda mental beliefs about health.
Psychological Immunization: Theory, Research, and Current Health Behavior Applications
Authors: Duryea Elias J. , Ransom Mary V. , English Gary
Published: February 2007

A critical review of McGuire's Inoculation Theory, its research base and current health behavior applications in health education research is presented. Foci include research efforts in the areas of smoking, alcohol, and diabetes management. The theory and its utilization in future resistance-to-persuasion interventions in health education is exam ined.
Health Risk Factors among the Amish: Results of a Survey
Authors: Fuchs Janet A. , Levinson Richard M. , Stoddard Ronald R. , Mullet Maurice E. , Jones Diane H.
Published: February 2007

The Amish are a unique societal subgroup deliberately setting themselves apart from the modern world through religious beliefs and practices. Few reports and no systematic studies have been conducted on Amish health behaviors. A representative sample of 400 Amish adults residing in Holmes County, Ohio, were interviewed using the Behavioral Risk Factor Survey (BRFS). For comparison, a representative sample of 773 non-Amish adults responded to the same survey through telephone interviews. Prevalence of self- reported hypertension was lower among Amish than non-Amish, obesity was greater among Amish than non-Amish women but similar among men, and stress responses were more prevalent among Amish than non-Amish. While some differences between groups could be influenced by response biases, many are supported by less systematic obser vations of Old Order Amish societies. Patterns of health behavior reflect characteristics of Amish culture and may be responsible for certain favorable mortality rates among the Amish population. Need for cultural sensitivity is evident in health promotion program design and implementation.
Evaluating Understanding of Popular Press Reports of Health Research
Authors: Yeaton William H. , Smith Dawn , Rogers Karen
Published: February 2007

This research assessed the ability of a sample of persons on a college campus to understand media reports of health research. Three or four articles on each of five contemporary health topics (dietary cholesterol and heart disease, treatment for breast cancer, starch blockers, drug treatment for heart disease, test tube skin) were selected from widely circulated newspapers (e.g., New York Times ) and magazines (e.g., News- week). A sample of 144 college students responded to content-based and application- based questions derived from photocopies of these popular press articles. The overall rate of reader misunderstanding approached 40% and generally fell beween one third and one half for each of 16 articles representing five health topics. Several strengths and weaknesses of the research are considered as they relate to the accuracy of estimated error rates and to the generality of study findings. The implications of these findings for other areas of health (e.g., AIDS risk factor research) are also discussed.
Planning and Implementing Health Promotion in the Workplace: A Case Study of the Du Pont Company Experience
Authors: Bertera Robert L.
Published: February 2007

This case study describes the needs assessment, design, implementation, and prelim inary evaluation of a comprehensive workplace health promotion program. The company had 110,000 U.S. employees at more than 100 locations engaged in a variety of manu facturing, research, sales, and support occupations in 1980. The PRECEDE framework was used to focus program planning and evaluation on key areas of health knowledge, attitudes, and behavior. The needs assessment included use of company morbidity and mortality data, a survey of medical and human resources staff, and a survey of employees, spouses, and pensioners. An in-house network of lay committees, site medical personnel, and corporate health education, nutrition and fitness specialists was used to staff critical program functions. Interventions included: public health approaches to program kick- off and health risk assessment; group and self-directed lifestyle change activities; rec ognition and awards; and workplace climate changes such as smoking policies that favor nonsmokers. One pilot location experienced a 47.5% decline in hourly employee absen teeism over six years versus a 12.5% decline in the total Du Pont hourly workforce. A number of lessons are discussed on how to improve the planning, implementation, in stitutionalization, and evaluation of health promotion programs in large industrial com panies. Four areas where future research and practice should be focused include: reaching spouses, sales personnel, shiftworkers, and employees at small sites; balancing what is popular with what reduces risks over the long-term; documenting program impacts when research resources are scarce; and integrating health promotion programs with workplace medical, safety, employee assistance and benefits programs.
A Simple Guide for Design, Use, and Evaluation of Educational Materials
Authors: Rice Marilyn , Valdivia Leonel
Published: February 2007

Few health workers in Latin America are trained in how to produce effective and appropriate health education materials. In order to provide an instrument and a strategy to help overcome this problem, the Pan American Health Organization developed an effective methodology to orient the design, use, and evaluation of health education materials. This article describes the development of this methodology and summarizes the basic operating principles and criteria for evaluation. These operating principles include developing educational materials from the community perspective, ensuring that they are an integral part of a health education program, relating them to health services delivery, pretesting the materials, and distributing instructions for use along with these materials. An evaluation scale helps health personnel assess materials that have been designed elsewhere and decide if they would be appropriate for their own target audiences. The scale also promotes self-evaluation by the community in the development of its own materials. This simple and straightforward methodology has been successfully applied in courses and seminars as well as in the design, use, and evaluation of health education materials throughout Latin America.
Oral Health Promotion in the Schools: A Historical Analysis and Case Study
Authors: Wright F.A.C.
Published: February 2007

This article discusses the historical shifts between the treatment-oriented, instructional and primary preventive approaches to oral health promotion, especially in school-based programs in New Zealand and Australia. While in the past much effort has been put into treatment-oriented and instructional programs, their impact has been limited. Among those primary preventive activities that have demonstrated clear benefits are various types of fluoridation and adhesive sealants for the occlusal surfaces of teeth. Further emphasis on primary prevention over treatment is needed to better insure the success of school-based oral health promotion programs. In addition, more effort needs to be put into policy direction, linkages within the educational system, planning, and evaluation.
Patient Counseling by General Practitioners: Republic of San Marino's Experience
Authors: Mamon Joyce , Paccagnella Bruno
Published: February 2007

General practitioners (GPs) can play a unique role in improving individual health behaviors. To maximize this role, it is important to know what health education activities GPs are performing and where improvements can be made. This article presents data covering a one-year period regarding the health education/counseling activities of GPs in the Republic of San Marino, which has a National Health Service. The overall rate of health education interventions is 8.8 per 100 GP contacts. The diagnosis having the highest rate of health education counseling is lipid metabolism disorders (50/100). Other diagnoses having high rates are: anxiety, depression, irritable bowel syndrome, and disorders of stomach dysfunctions/gastritis (42, 40, 36, and 33/100 respectively). The lowest rate within the top 17 diagnoses receiving health education is uncomplicated hypertension (11.4/100). The range of provider variation in performing health education interventions ranges from 1.2 to 24.1 per 100 patients contacts. Such analyses permit identification of the specific areas where GPs may need assistance for increasing the appropriate use of effective health education interventions so that further progress can be made in meeting the health needs of communities.
Normative Beliefs about Factors That Affect Health and Longevity
Authors: Love Mary Beth , Thurman Quint
Published: February 2007

Since the release of the Surgeon General's report, Healthy People,1 the general public has been barraged with health information and advice by the popular media. Accordingly, this article introduces a method for examining the public's beliefs about the importance of behavioral risk factors associated with health and longevity. The factorial survey approach—a technique appropriate for studying normative beliefs—seems uniquely suited to measuring the degree of public consensus regarding complex social phenomena. Data collected using this experimental vignette methodology suggest that there is much public agreement about the sources of good health. Information described in hypothetical vignettes about smoking, body weight and alcohol consumption are judged most important in promoting health and longevity even when controlling for other behavioral factors such as exercise activity, diet, amount of rest, stress, personality type, and coping strategies. The implications of these findings are briefly discussed.
Health Lifestyles: Audience Segmentation Analysis for Public Health Interventions
Authors: Slater Michael D. , Flora June A.
Published: February 2007

This article is concerned with the application of market segmentation techniques in order to improve the planning and implementation of public health education programs. Seven distinctive patterns of health attitudes, social influences, and behaviors are identified using cluster analytic techniques in a sample drawn from four central California cities, and are subjected to construct and predictive validation: The lifestyle clusters predict behaviors including seatbelt use, vitamin C use, and attention to health information. The clusters also predict self-reported improvements in health behavior as measured in a two-year follow-up survey, e.g., eating less salt and losing weight, and self-reported new moderate and new vigorous exercise. Implications of these lifestyle clusters for public health education and intervention planning, and the larger potential of lifestyle clustering techniques in public health efforts, are discussed.
Predictors of Risk Perceptions of Childhood Injury among Parents of Preschoolers
Authors: Glik Deborah , Kronenfeld Jennie , Jackson Kirby
Published: February 2007

This article assesses the relationship between parents' perceived risk of childhood injuries and familial, sociocultural, and situational variables. Data were obtained through a random digit dial telephone survey of 1,200 households with a preschool child in a southeastern metropolitan area. Perceived risks of childhood injury measures were based on social science theory and childhood injury epidemiology. Multiple item measures included dimensions of seriousness and likelihood for both injuries and hazards. When risk perceptions were viewed as individual items, parents underestimated the risk of some hazards and injuries and overestimated the risks of others, and parents whose children have sustained a recent injury had higher risk perception overall. When risk perceptions were viewed as summed scales, sociodemographic variables and parental safety behaviors were not significant predictors. Sociocultural factors of having a child previously injured, the parent reporting stress, having a household with self-reported risk factors, and the perception of the child as active and hard to manage are related to summed scales of risk perceptions, with some interactions by race of the parent. Findings illustrate the role of situational and sociocultural characteristics of respondents in risk perception research.
Communicating with Environmental and Health Risk Takers: An Individual Differences Perspective
Authors: Ferguson M.A. , Valenti JoAnn M.
Published: February 2007

This research explores the effects of different message strategies in interaction with individual differences in risk taking. The data are from two field experiments (2 x 2 x 3 factorial design) with 506 adults. The message variables are risk targets, media formats, and information sources. Results indicate individual differences in concern and information seeking for Adventurous, Impulsive, and Rebellious risk takers. Rebellious risk taking is negatively associated with information seeking and impulsive risk taking is negatively associated with both concern, and information seeking. For the rebellious risk taker, a newspaper article with a state agency source caused higher levels of concern and information seeking about the risk than a newspaper article with the Surgeon General as the source. In contrast, for the impulsive risk taker, concern about the risk is greatest when the message is from a state agency source and in a brochure. What is a successful source and media strategy with one type of risk taker may have no effects or even negative effects with another type of risk taker.
Communicating about Environmental Risks: How the Public Uses and Perceives Information Sources
Authors: McCallum David B. , Hammond Sharon Lee , Covello Vincent T.
Published: February 2007

Environmental risk communication is examined as a community-based public health issue in this study. It provides data on information dynamics in six communities prior to the implementation of national community right-to-know legislation. It also provides a baseline for measuring changes in knowledge, attitudes, information gathering activities and other behaviors. Respondents (3,129) from six communities, Albuquerque, New Mexico; Cincinnati, Ohio; Durham, North Carolina; Middlesex County, New Jersey; Racine, Wisconsin; and Richmond, Virginia, provided information about recall of environmental risk information and sources, as well as personal knowledge, attitudes and behaviors related to environmental health risks. Local media are the most pervasive source of environmental information. Interpersonal sources were reported by fewer than 12% of the respondents. Credibility appears to be the most valuable attribute of an environmental information source. Credibility and expertise are perceived as independent characteristics by the public. More and more diverse information sources and higher levels of consumer interest are needed to involve the public effectively in environmental issues. Future comparison studies in these communities will illustrate more fully how to achieve responsible community involvement in environmental health issues.
Risk Information for Public Consumption: Print Media Coverage of Two Risky Situations
Authors: Ryan Michael , Dunwoody Sharon , Tankard James
Published: February 2007

This study examines (1) the extent to which newspaper and magazine coverage of two risky situations included the kinds of cognitive information about risks that would help readers make risk judgments and (2) the extent to which the scientific sophistication of the audience would influence such inclusion. The two situations were a nuclear power plant accident that released a small amount of radioactive steam into the atmosphere and a report in the New England Journal of Medicine about a potential relationship between coffee consumption and pancreatic cancer. Stories about each topic in trade magazines, popular science magazines, general magazines, and both prestige and more typical daily newspapers were examined to determine the nature and extent of risk information included. The analysis found more detailed risk information in these stories than has been found in past studies, but it also suggested that sophistication of audience was not a good predictor of the presence/absence of such information. The most pronounced differences in communication strategies were found instead between topics, not across types of media. Closer examination of individual stories suggests that the variance may be attributable to differences in the way stories about the two incidents were framed by journalists.
Hey Girlfriend: An Evaluation of AIDS Prevention among Women in the Sex Industry
Authors: Dorfman Lori E. , Derish Pamela A. , Cohen Judith B.
Published: February 2007

Increasingly, acquired immunodeficiency syndrome (AIDS) prevention programs have been developed to reach and influence street-based populations. Standard methods of evaluation do not fit the conditions of such programs. This article describes a process and outcome evaluation of an AIDS prevention program for sex workers in which qual itative and quantitative methods were combined in order to mediate research problems endemic to street-based populations. Methods included epidemiological questionnaires, open-ended interviews with participants, and ethnographic field notes. Process evaluation findings show that field staff who were indigenous to the neighborhood and population readily gained access to the community of sex workers and simultaneously became role models for positive behavior change. Outcome findings show that sex workers do feel at risk for AIDS, but usually from clients rather than from husbands or boyfriends. Ac cordingly, they use condoms more frequently with clients than with steady partners. Increasing condom use among sex workers with their steady partners remains an important challenge for AIDS prevention. Combining qualitative and quantitative research data provided a more comprehensive assessment of how to reach sex workers with effective AIDS risk reduction messages than either method could have provided alone.
An Action Research Approach to Workplace Health: Integrating Methods
Authors: Hugentobler Margrit K. , Israel Barbara A. , Schurman Susan J.
Published: February 2007

Action research, which combines the generation and testing of theory with social system change, demands multiple sources of knowledge about the research setting and encourages the integration of data collection techniques. This article describes the im plementation of a longitudinal multi-methodological research and intervention project aimed both at examining the relationship between occupational stress and psychoso cial moderating factors (e.g., social support, participation, and influence over deci sion-making) and health outcomes; and reducing work stress and improving employee health. Combining qualitative and quantitative research techniques such as semi- structured individual and focus group interviews, field notes and survey data increases confidence in research findings and strengthens the process and outcomes of needs as sessment, program planning, implementation, and evaluation. Specific examples are pro vided that illustrate the usefulness of this approach in identifying and understanding problem areas and in developing and evaluating appropriate health education inter ventions.
The Implementation of a Restrictive Worksite Smoking Policy in a Large Decentralized Organization
Authors: Gottlieb Nell H. , Lovato Chris Y. , Weinstein Riki , Green Lawrence W. , Eriksen Michael P.
Published: February 2007

This study investigates the implementation of a restrictive smoking policy in decen tralized worksites. A model which includes four elements—concept, context, process, and outcomes—is used as a framework for identifying characteristics that influence im plementation. The organization studied was a state human services agency with approx imately 400 worksites spread across 12 geographic regions. Quantitative data collection included three cross-sectional surveys of employees and supervisors administered before and after the date the policy became effective. Qualitative data were collected from three sources, including written comments on surveys, focus groups, and structured interviews with supervisors and top administrators. Tabular analyses and one-way analyses of vari ance were used to analyze quantitative data. Qualitative data were examined for key themes and have been used to elucidate findings. Those characteristics related to concept, context, and process which appeared to have the strongest influence on expected and unexpected outcomes of the restrictive smoking policy were degree of policy restrictive- ness, job characteristics, perceived level of participation in formulation and implemen-
Self-Efficacy for AIDS Preventive Behaviors among Tenth Grade Students
Authors: Kasen Stephanie , Vaughan Roger D. , Walter Heather J.
Published: February 2007

To guide acquired immunodeficiency syndrome (AIDS) prevention program planning, 181 tenth grade students residing in or near an AIDS epicenter completed a survey measuring past year involvement in sexual intercourse and condom use, beliefs about self-efficacy for AIDS preventive behaviors, and beliefs about susceptibility to and severity of AIDS, and outcome efficacy of AIDS preventive actions. A degree of uncertainty existed for all areas of self-efficacy surveyed: refusing sexual intercourse under a variety of circumstances, questioning sex partners about past risky behaviors, and correct and consistent condom use. Students were most uncertain of their ability to refuse sex with a desirable partner, under pressure, or after drinking alcohol or using marijuana; to purchase condoms, or use them consistently after drinking alcohol or using marijuana; and to question partners about past homosexual history. Those students with lower self-efficacy for refusing sex were twice as likely to have had sexual intercourse. Similarly, those students with lower self-efficacy for correct, consistent condom use were five times less likely to have used condoms consistently. These associations remained even after adjusting for the influence of other AIDS-related beliefs. Implications of these findings focus on exploiting the link between self-efficacy and behavior by building a prevention program that emphasizes skills-building rather than the traditional knowledge-only approach.
Health Education and Injury Control: Integrating Approaches
Authors: Gielen Andrea Carlson
Published: February 2007

The prevention of injuries, a major public health problem, is of interest to a growing number of public health professionals from a variety of disciplines. Historically, there has been tension between those who propose injury prevention strategies that focus on the adoption of protective behaviors by individuals and those who propose strategies that circumvent the role of individual behavior by providing automatic or passive protection. This tension may be counterproductive to finding comprehensive solutions to injury problems, and a better understanding of the inherent strengths and limitations of each of these approaches is needed.

The purposes of this paper are to: (1) describe the arguments over individual liberties and individual behavior that can occur in the design of injury prevention programs; (2) review the principles that typically guide the development of injury control programs and health education programs; and (3) integrate the two most widely used approaches in injury control and health education programs—Haddon's injury countermeasures and Green's PRECEDE framework—into one program planning framework that addresses both behavioral and nonbehavioral components of an injury problem. This unified framework is offered in the hope that its use will facilitate multidisciplinary, comprehensive approaches to developing injury prevention programs that are efficient and effective.
Process Evaluation of a Home-Based Program to Reduce Diet-Related Cancer Risk: The "WIN At Home Series"
Authors: Finnegan John R. , Rooney Brenda , Viswanath K. , Elmer Patricia , Graves Karen , Baxter Judith , Hertog James , Mullis Rebecca , Potter John
Published: February 2007

A random mailed survey (response N = 226; 75.3%) of participants in diet-related home-based learning evaluated exposure to recruitment channels and impact on salience, utility, level of participation, sharing the course with others, knowledge, and performing recommended behaviors. A post-only design, the study was conducted in a small Minnesota city (population = 20,000), part of the Cancer and Diet Intervention (CANDI) project.

About 18.5% of residents (3,711) enrolled during an 8-week media campaign; women, college graduates, and those over 44 years old were overrepresented. Participants learned about the program through mass media (97%); small media (41.9%); and interpersonal sources (50%). Women were more likely to learn about the course through interpersonal

sources. In analysis of variance (ANOVA) modeling, salience and utility predicted level of participation in course activities. Level of participation in turn predicted nutrition knowledge and with salience predicted performance of recommended behaviors. Although the course appealed to individuals who needed it less, there was evidence of diffusion to the unenrolled. About 57% of responding participants reported sharing it with spouses; about 67% reported sharing it with someone outside their households.
Practitioners' Use of Theory: Examples from a Workgroup
Authors: Burdine James N. , McLeroy Kenneth R.
Published: February 2007

There is a continuing discussion within the field of health education about the rela tionship between theory and practice. Much of this discussion, particularly that which appears in professional journals, has been developed by academicians and is prescriptive. That is, it identifies ways in which theory should be used by practitioners. The purpose of this article is to facilitate this ongoing discussion by providing descriptive information on how theory is used by a group of health educators who work for the same organization. This information is used as a springboard for discussion more generally about the nature of theory in health education.

This article represents the thinking and experiences of a dozen health professionals, in reaction to the question, "How do you use theory in your practice?" The authors believe this information will be useful in helping theoreticians develop more useful theory and helping practitioners increase their understanding of the utility of good theory. The division between theory and practice in the field of health education represents a sig nificant opportunity and challenge to the discipline if energy can be redirected from criticism of the other "camp" to effective collaboration and enhanced effectiveness of health education efforts.
Self-Regulation of Health Behavior: The "take PRIDE" Program
Authors: Clark Noreen M. , Janz Nancy K. , Dodge Julia A. , Sharpe Patricia A.
Published: February 2007

Social cognitive theory, in particular, the construct of self-regulation was the basis for developing an educational program for older adults with heart disease. This paper dis cusses the theoretical principles utilized and describes the program activities based on them. Data from an evaluation conducted with 246 older heart patients who took part in the education are used to illustrate how social cognitive theory constructs operated empirically.
The Integration of Theory with Practice: A 12-Year Case Study
Authors: Lorig Kate , González Virginia
Published: February 2007

Although the integration of health education theory with practice has always been taught, this linkage has not always occurred as a systematic part of program or theory development. This paper reflects the 12-year experience of one health education program which started from a base not soundly grounded in theory and moved to one tightly linked with theory. Throughout this process, outcome data were collected allowing for evaluations of both practice and theory.
Program Notes: Health Education in Practice
Authors: Lancaster Brick
Published: February 2007

"Program Notes" is intended to keep our readers informed about health ed ucation practice around the country. Periodically, papers presenting perspectives on practice-related issues are included in "Program Notes, " and in every issue examples of innovative and interesting programs are provided. If you would like your program considered for inclusion, an abstract can be submitted as described below.
Perspective
Authors: DeJong William , Wallack Lawrence
Published: February 2007

We review the "designated driver" concept and the current debate over its role in preventing alcohol-impaired driving. In our view, the focus on this strategy by broadcasters, the alcohol industry, and various public service groups has deflected attention from other alcohol-related problems that account for the vast majority of deaths and injuries associated with alcohol use. This focus has also distracted many public health advocates and policymakers from the bigger and more important jobs of increasing public awareness of the social, environmental, and economic factors that influence alcohol consumption and promoting debate on legislation and other public policy solutions to alcohol-impaired driving. As part of a comprehensive strategy, we strongly encourage a renewed focus on "sobriety checkpoints," strict enforcement of laws against alcohol sales to minors, alcohol advertising reform, increased excise taxes, and other public policy initiatives supported by the Surgeon General. These measures will curb underage and heavy alcohol consumption and will create a legal and social environment in which individuals are motivated to avoid impaired driving through several alternative strategies, including but not limited to the use of designated drivers.
A Three-Year Evaluation of the Know Your Body Program in Inner-City Schoolchildren
Authors: Resnicow Ken , Cohn Lisa , Reinhardt Jayne , Cross Donna , Futterman Robert , Kirschner Elly , Wynder E.L. , Allegrante John P.
Published: February 2007

The impact of the Know Your Body (KYB) comprehensive school health education program was evaluated in a sample of first through sixth-grade students from New York City, using two analytic strategies: a longitudinal cohort and a "posttest only" cohort. In both cohorts, program impact was examined between condition (i.e., KYB vs. no-treatment comparison group) as well as within condition (i.e., low, moderate, and high student exposure). Students in the longitudinal cohort (n = 1,209) who were exposed to high implementation teachers had significantly (p < .05) lower total plasma cholesterol and systolic blood pressure at 3-year posttest than comparison students. Students in the posttest only cohort (n = 3,066) who had high implementation teachers showed significantly (p < .05) lower total plasma cholesterol, systolic blood pressure, self-reported intake of meat and desserts, as well as higher health knowledge and self-reported intake of "heart healthy" foods and vegetables than comparison students. In both cohorts, program effects for several outcome variables were linearly related to level of student exposure to the curriculum, suggesting a dose-response effect. While several methodologic limitations may have influenced study outcomes, these data nonetheless appear to confirm that the KYB program can have a significant positive impact on the knowledge, behavior, and selected risk factors of students in primary grades and that efforts to disseminate and evaluate school health education programs should include strategies to monitor and enhance teacher implementation.
The Impact of Tailored Self-Help Smoking Cessation Guides on Young Mothers
Authors: Davis Sharon W. , Cummings K. Michael , Rimer Barbara K. , Sciandra Russell , Stone June C.
Published: February 2007

It has been suggested that tailoring self-help materials for specific target populations will increase their effectiveness. This study tested the value of a self-help guide tailored specifically for women with young children. These women were recruited through a media campaign that encouraged smokers to call the Cancer Information Service (CIS) for assistance in stopping smoking. Women smokers with young children (under the age of 6) who called the CIS were given telephone counseling on quitting and were mailed one of three stop smoking guides. One third of callers received Quitting Times, a guide written specifically for women with young children; one third received the American Lung Association guide, Freedom from Smoking for You and Your FamilyR; and one third received Clearing the Air, a guide developed by the National Cancer Institute. Six months after calling the CIS, these women were contacted by telephone to assess changes in smoking behavior. Overall, 12.5% of the women reported not smoking for at least 1 week at the time of the 6-month follow-up interview. There were no significant differences between subjects in the three groups in use of the self-help guides, methods used to attempt quitting, and quitting behavior. Findings from this study do not support the hypothesis that using a tailored stop smoking guide increases the targeted audience's cessation rate or affects quitting-related behavior. However, it should be noted that the smokers who called were predominantly in the contemplation or action stages.