bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of Employee Involvement in Planning and Implementing the Treatwell 5-a-Day Work-Site Study
Authors: Hunt Mary K. , Lederman Ruth , Potter Steven , Stoddard Anne , Sorensen Glorian
Published: February 2007

When work-site health promotion programs incorporate theories of community organization, it is likely that employee ownership and participation are enhanced. This article reports quantitative indicators of involvement of Employee Advisory Board (EAB) members in the Treatwell 5-a-Day work-site study and examines relationships between EAB member time spent on project activities and work-site size, with indicators of the extent of implementation and variables associated with behavior change and work-site support. The results reported here indicate that a greater number of EAB member hours spent on program activities was associated with a greater number of events implemented. Smaller work-site size was associated with greater employee awareness of the program and greater participation in project activities as reported on the employee survey. These results suggest that the number of hours employee representatives devote to project activities might be an important consideration in planning employee involvement in work-site health promotion programming.
Toward Totally Smokefree Schools and Beyond: The Crown Public Health Smokefree Schools Grant Program
Authors: Heckert Karen A. , Matthews Kate
Published: February 2007

A three-year small grants scheme in Canterbury and the West Coast, New Zealand aims to influence the health promoting climate of schools by adopting totally smokefree policies. The Smokefree Environments Act of 1990 established the legal imperative for school policies. The principles of the Treaty of Waitangi and the strategies of the Ottawa Charter provide the programmatic and evaluation framework. Evaluation indicators include the organizational and policy context, status of school smoking policies, reasons for participation, stakeholder involvement, the value of additional funding, and the extent of media coverage. Partnerships among local smokefree partners, schools and whanau/communities, and between the health and education sectors are a priority. Interim findings indicate the Crown Public Health Smokefree Schools Grant program has positively influenced policy development toward totally smokefree schools. Based on these results and the changing environment, the smokefree efforts are being integrated into the broader context of health promoting schools.
The Impact of a Culturally Appropriate STD/AIDS Education Intervention on Black Male Adolescents’ Sexual and Condom Use Behavior
Authors: Delamater John , Wagstaff David A. , Havens Kayt Klein
Published: February 2007

A culturally appropriate, theoretically based videotape was developed to promote condom use among African American males, ages 15 to 19, attending a municipal sexually transmitted disease (STD) clinic. The video-tape’s impacts were compared to those achieved by an African American health educator who delivered the same messages during a face-to-face session and by standard care. Data were obtained on participants’ ( N = 562) condom use knowledge, self-efficacy, and intentions; sexual and condom use behaviors; and perceived risk of infection. At posttest, “videotape” and “health educator” participants demonstrated greater condom use knowledge; “health educator” participants indicated greater self-efficacy and stronger condom use intentions with steady partners. At 6 months, participants in all conditions reported more partners and acts of vaginal intercourse (past month); however, they were more likely to report consistent condom use with steady partners (18% vs. 53%) and casual partners (26% vs. 50%). Perceived risk of infection was lower at the posttest and declined during the study period.
A Meta-Analysis of Fear Appeals: Implications for Effective Public Health Campaigns
Authors: Witte Kim , Allen Mike
Published: February 2007

The fear appeal literature is examined in a comprehensive synthesis using meta-analytical techniques. The meta-analysis suggests that strong fear appeals produce high levels of perceived severity and susceptibility, and are more persuasive than low or weak fear appeals. The results also indicate that fear appeals motivate adaptive danger control actions such as message acceptance and maladaptive fear control actions such as defensive avoidance or reactance. It appears that strong fear appeals and high-efficacy messages produce the greatest behavior change, whereas strong fear appeals with low-efficacy messages produce the greatest levels of defensive responses. Future directions and practical implications are provided.
Go Girls!: Results from a Nutrition and Physical Activity Program for Low-Income, Overweight African American Adolescent Females
Authors: Resnicow Ken , Yaroch Amy Lazarus , Davis Anissa , Wang Dongqing Terry , Carter Sakinah , Slaughter Larisa , Coleman Desiree , Baranowski Tom
Published: February 2007

This article describes the development, implementation, and results of an intervention designed for inner-city, overweight African American adolescent women. Fifty-seven participants were recruited from four public housing developments. Participants were administered physiologic, dietary, and cognitive assessments at baseline and immediately postintervention. Each session comprised three elements: (1) an educational/behavioral activity, (2) 30 to 60 minutes of physical activity, and (3) preparation and tasting of low-fat meals. In the absence of a control group, results were compared for high and low attenders, the former defined as attending at least 50% of the sessions. High attenders ( n = 26) showed more favorable 6-month posttest values for most outcomes compared with low attenders ( n = 31). These effects achieved statistical significance for nutrition knowledge, low-fat practices, perceived changes in low-fat practices, and social support.
Dealing with Diversity: Recruiting Churches and Women for a Randomized Trial of Mammography Promotion
Authors: Derose Kathryn Pitkin , Hawes-Dawson Jennifer , Fox Sarah A. , Maldonado Noris , Tatum Audrey , Kington Raynard
Published: February 2007

There is little documentation about the recruitment process for church-based health education programs. In this study, the authors recruit African American, Latino, and white churches and women members (age 50 to 80) for a randomized church-based trial of mammography promotion in Los Angeles County. Efforts to enhance recruitment began 10 months before churches were invited to participate and included a variety of community-based strategies. Subsequently, 45 churches were recruited over a 5-month period through group pastor breakfast meetings and church-specific follow-up. In close collaboration with the 45 churches, the authors administered church-based surveys over 6 months and identified 1,967 age-eligible women who agreed to be contacted by the program team. It was found that an extended resource intensive period of relationship-building and community-based activities were necessary to conduct church-based programs effectively, particularly among older and ethnically diverse urban populations.
The Effect of the Maryland WIC 5-a-Day Promotion Program on Participants’ Stages of Change for Fruit and Vegetable Consumption
Authors: Feldman Robert H. L. , Damron Dorothy , Anliker Jean , Ballesteros Michael , Langenberg Patricia , Diclemente Carlo , Havas Stephen
Published: February 2007

The Maryland Women, Infants and Children (WIC) 5-A-Day Promotion Program examined the effect of a multifaceted nutrition intervention on changing the fruit and vegetable consumption of low-income women in the WIC program in Maryland. The sample consisted of 3,122 participants (1,443 intervention and 1,679 control) with a mean age of 27.2. Fifty-six percent were Black/African American. This article focuses on the effect of the intervention on the stages of change of the participants. Intervention participants showed significantly greater positive movement through the stages than control participants. Stages of change were measured for two specific target behaviors: eating five servings of fruits and vegetables a day and eating more servings of fruit and vegetables a day. Results demonstrated significant differences in the stage status of intervention and control women and in movement through the stages. The effectiveness of the intervention across groups depended on which staging measure was used.
The Content and Accessibility of Sex Education Information on the Internet
Authors: Smith Meghan , Gertz Emily , Alvarez Sarah , Lurie Peter
Published: February 2007

The objective of this studywas to describe Web sites with sex education material and assess the accessibility of specific information on the Internet. First, the authors conducted a review of Web sites using specific sex education keywords. Second, 27 undergraduate students were asked to locate information on proper condom use and sexually transmitted disease (STD) symptoms. The time, number of search attempts, and number of clicks needed to identify each piece of information were recorded. The authors identified 41 sites with sex education material from almost 6 million pages yielded by the keywords. Sixty-three percent of the 1,556 most compatible pages were categorized as pornography. The students found the information on condom use and STD symptoms in an average of 4 minutes, using fewer then six clicks and two searches. The authors concluded that general information on sex education is difficult to locate on the Internet and often lacks essential elements, but accurate and useful information on specific topics can be more easily obtained.
A Theory-Based Motivational Approach for Reducing Alcohol/Drug Problems in College
Authors: Miller William R. , Toscova Radka T. , Miller Joseph H. , Sanchez Victoria
Published: February 2007

The Campuswide Alcohol and Drug Abuse Prevention Program (CADAPP) was implemented and evaluated over a 1.5-year span at the University of New Mexico (UNM). Drawing on self-regulation theory as a basis for understanding motivation for change, the program was designed to increase risk perceptions and thereby reduce the use of alcohol and other drugs among university students. The program was evaluated from 1988 to 1989 through repeated anonymous random sample surveys of all enrolled students on the UNM campus and on a similar control campus not implementing newprevention efforts during the same period. As predicted, relative to the control campus, students on the CADAPP campus after the program showed significantly higher perceived risks from substance use and significantly reduced levels of alcohol and marijuana use. These findings provide encouraging evidence for this theory-based approach to primary and secondary prevention.
A Relative Risk–Based, Disease-Specific Definition of Sexual Abstinence Failure Rates
Authors: Pinkerton Steven D.
Published: February 2007

Sexual abstinence programs have the potential to reduce the incidence of unplanned pregnancies and sexually transmitted diseases (STDs) among adolescents. Effectiveness measures are needed to help researchers assess the impact of sexual abstinence promotion programs on STD and pregnancy rates and to enable comparisons of abstinence effectiveness with other contraception and STD prevention methods. Abstinence “failure rates” have been proposed as one measure of program effectiveness. However, the concept of abstinence failure rates has not been adequately operationalized. The present study examines a novel mathematical framework for estimating abstinence failure rates, both theoretically and empirically. Examples are provided, and the advantages and disadvantages associated with the mathematical model–based approach are discussed.
Selected Ethical Issues in Research and Publication: Perceptions of Health Education Faculty
Authors: Price James H. , Dake Joseph A. , Islam Rafat
Published: February 2007

A national random sample of 195 university health education faculty at graduate degree–granting programs completed a 31-item survey with regard to their perceptions of ethical issues in research and publishing. Most respondents were male (57%), tenured (75%), had graduate faculty status (92%), had presented original research at conferences (85%), and had published articles in health education journals (89%). Faculty members were requested to assess whether 21 scenarios dealing with ethical issues in research and publishing were ethical, unethical, questionable, or not an ethical issue. Of the scenarios, 3 were considered ethical and 7 unethical by the majority of respondents. The perceptions of how ethical the remaining 11 scenarios were varied considerably. Perceptions of the ethical scenarios did not differ among respondents by sex, academic rank, years taught as a faculty member, whether the department taught units/classes on research ethics, or whether the respondents were from doctoral-level versus master’s-level programs.
When the Perpetrator Gets Killed: Effects of Observing the Death of a Handgun User in a Televised Public Service Announcement
Authors: Bernhardt Jay M. , Sorenson James R. , Brown Jane D.
Published: February 2007

This study evaluates the cognitive effects of an anti–handgun violence public service announcement (PSA) on sixth-, seventh-, and eighth-grade students ( N = 294). Participants were randomly assigned to a treatment group, which viewed a PSA depicting the death of an aggressive handgun user, or a comparison group, which viewed identical content except that the PSA showed no negative consequence for the handgun user. Logistic regression analysis, adjusting for race and gender, revealed that the treatment group was more likely to report negative expected outcomes for aggressively using a handgun and lower behavioral intentions to aggressively use a handgun compared with the comparison group. These findings suggest that observing handgun violence on television that depicts death as a negative physical consequence for the perpetrator may produce lower handgun-encouraging beliefs compared with observing no consequence for the perpetrator—the norm for most televised violence today.
“I was not Invited to be a [CHW] … I asked to be one”: Motives for Community Mobilization among Women Community Health Workers in Mexico
Authors: Ramirez-Valles Jesus
Published: February 2007

Despite health educators’ revitalized interest in community mobilization for health, little attention has been given to participants’ motives for mobilizing. The purpose of this article is to contribute to the understanding of community mobilizing by analyzing the motives for mobilization among a group of women community health workers (CHWs), members of a community-based organization in Mexico. The study is guided by critical feminist and social constructivist theories. It aims at identifying the categories of motives used by women CHWs and exploring how these motives are created while presenting women’s own voices. Women’s motives fall into four categories: getting out, serving, learning, and women’s betterment. These motives blend personal and public motives. The analysis suggests that mobilization for health may be enhanced by addressing both the personal satisfaction of individuals and the accomplishment of public goods. The study of motives may be useful for the recruitment and retention of participants in community mobilization efforts.
Project ARM: Alcohol Risk Management to Prevent Sales to Underage and Intoxicated Patrons
Authors: Toomey Traci L. , Wagenaar Alexander C. , Gehan John P. , Kilian Gudrun , Murray David M. , Perry Cheryl L.
Published: February 2007

Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.
Older Women and Mammography Screening Behavior: Do Possible Selves Contribute?
Authors: Black Margaret E. A. , Stein Karen F. , Loveland-Cherry Carol J.
Published: February 2007

This study sought to explore the contribution of the self-concept to older women’s adherence to regular mammography screening behavior. The PRECEDE and health belief model concepts were incorporated with a measure of the women’s future selves to determine whether the self-concept adds to our ability to predict screening. A self-administered questionnaire was completed by 210 community-dwelling women ages 50 to 75 years, recruited from urban and rural women’s groups. Logistic regression analyses revealed that predictors of adherence were clinical breast examination, physician recommendation, age, barriers, benefits, feared health-related possible self, and self-efficacy in the feared domain. The addition of the self measures significantly improved the overall fit of the model. Implications for theory development, practice, and future research are discussed.
Searching for Evidence about Health Education and Health Behavior Interventions
Authors: Rimer Barbara K. , Glanz Karen , Rasband Gloria
Published: February 2007

Evidence is fundamental to science, but finding the right evidence in health education and health behavior (HEHB) is often a challenge. The authors discuss some of the controversies about the types of evidence that should be considered acceptable in HEHB, the tension between the use of qualitative versus quantitative data, the need for measures of important but neglected constructs, and interpretation of data from experimental and nonexperimental research. This article discusses some of the challenges to the use of evidence and describes a number of strategies and some forces encouraging the use of evidence-based interventions. Finally, the authors suggest ways to improve the practice and dissemination of evidence-based HEHB. Ultimately, if evidencebased interventions are not disseminated, the interventions will not achieve their potential. The goal should be to develop more effective interventions and disseminate them to improve the public’s health.
Slip! Slop! Slap! and SunSmart, 1980-2000: Skin Cancer Control and 20 Years of Population-Based Campaigning
Authors: Montague Meg , Borland Ron , Sinclair Craig
Published: February 2007

The Anti-Cancer Council of Victoria has been running sun protection programs for more than 20 years: Slip! Slop! Slap! from 1980 to 1988 and SunSmart from 1988 to the present. The Victorian Health Promotion Foundation has provided funding for the SunSmart program for the past 13 years. These programs have played an important role in changing the whole society’s approach to the sun and have resulted in marked reductions in sun exposure. This article describes the social, political, economic, and organizational context within which these programs developed. Then 10 areas are discussed that illustrate a critical aspect of the development and implementation of this successful systemwide health promotion program. These areas focus on key aspects of the context within which the program operates and on issues that derive from the experience of implementing program strategies. In summary, the success of the two programs is described as having been built on two key foundations: the vital integration of research and evaluation, on one hand, and a strong basis of consistency and continuity, on the other.
Collaborative Intersectoral Approaches to Nutrition in a Community on the Urban Fringe
Authors: Webb Karen , Hawe Penelope , Noort Michelle
Published: February 2007

A case study is presented that describes the 10-year evolution of a local intersectoral project aimed at improving components of a community’s food system as an approach to improving nutrition. Aspects of innovation and good contemporary practice in collaborating for health promotion are illustrated. Key initiators of the project were a university public health department, a community health service, and a local government authority. Players brought into the process included the agricultural sector and food retailers. Several strategies have contributed to the success and institutionalization of the project. These include a specific focus on organizational development and capacity building among the key intersectoral partners and the use of formative evaluation methods to hasten the natural phases of collaborative problem solving. The project achieved many policy- and system-level changes. The impact on food consumption patterns is still to be evaluated.
Start Right–Eat Right Award Scheme: Implementing Food and Nutrition Policy in Child Care Centers
Authors: Pollard Christina , Lewis Janette , Miller Margaret
Published: February 2007

The Start Right–Eat Right award scheme implemented in Western Australia has been used to provide the incentive to bring about improvement in food service in line with government policy and regulations in the child care industry. Theories of organizational change were used to identify processes and strategies to support the industry in translating policy into practice. A baseline survey of food service management practices, as well as process evaluation, informed action and identified barriers. Impact evaluation demonstrated that the award scheme could bring about improvements in the quality of food service; 80% of centers made changes to their menus as a result of participating. Two years postlaunch, 40% of centers have registered in the scheme. The diffusion of innovation theory is used to explain uptake and discuss results. The success of the scheme was based on four factors: an understanding of the industry, collaboration between the child care industry and government, supporting resources, and incentives.
Reporting on Violence: Bringing a Public Health Perspective into the Newsroom
Authors: Dorfman Lori , Thorson Esther , Stevens Jane Ellen
Published: February 2007

The authors present a case study of a collaboration among the Berkeley Media Studies Group, the University of Missouri–Columbia School of Journalism, and journalist Jane Ellen Stevens to introduce to five metropolitan newspapers new violence-reporting techniques that include a public health perspective. A handbook was designed for journalists, and workshops were conducted to explore with editors and reporters how newspapers can report highly unusual crimes and yet avoid misrepresenting the patterns of violence in their communities and creating misguided fear in the public. This case study documents how journalists can be meaningfully engaged on this topic with people from public health despite typical barriers to access faced by public health practitioners and solid resistance from many editors and reporters. The authors describe goals, objectives, and activities across five daily newspapers along with journalists’ reactions, concerns, and resistance to the issues that were raised.
Correlates of Participation in a Family-Directed Tobacco and Alcohol Prevention Program for Adolescents
Authors: Bauman Karl E. , Ennett Susan T. , Foshee Vangie A. , Pemberton Michael , Hicks Katherine
Published: February 2007

This study examined correlates of program initiation and completion in a family-directed program that involved families of adolescents throughout the United States. Correlates varied by whether program initiation, program completion, or the number of activities completed was the indicator of participation. In final regression models, participation was relatively likely by non-Hispanic whites when compared with persons of race/ethnicity other than white, black, and Hispanic; by families with a female adolescent as the program recipient; by families with mothers who had many years of education; and by families with both parents living in the household. There was more participation if parents thought their child would smoke in the future and if the parent thought the adolescent did not smoke currently. Participation was higher if the adolescent felt strongly attached to the parent and if parents did not smoke. The findings are considered in the context of similar programs and future research on family-directed programs to prevent adolescent tobacco and alcohol use.
Disentangling Measures of Individual Perceptions of Community Social Dynamics: Results of a Community Survey
Authors: Parker Edith A. , Lichtenstein Richard L. , Schulz Amy J. , Israel Barbara A. , Schork M. Anthony , Steinman Kenneth J. , James Sherman A.
Published: February 2007

This study examined how different measures of individual perceptions of community social dynamics relate to each other and how these measures relate to self-reported general health and depressive symptoms. Results of a principal components analysis conducted to investigate the interrelationships between these individual measures suggest that these measures measure separate phenomena. In addition, in results of multiple-regression analyses conducted to examine associations between the various measures of individual perceptions of community social dynamics and the dependent variables of self-reported general health and depressive symptoms, sense of community, perceived neighborhood control, and neighborhood participation were all associated with the outcome variables in separate regression models. In a regression model with these three variables added to control variables, only sense of community was significantly, albeit modestly, associated with depressive symptoms and self-reported general health.
Can Children Teach their Parents about Asthma?
Authors: Evans David , Clark Noreen M. , Levison Moshe J. , Levin Bruce , Mellins Robert B.
Published: February 2007

The Open Airways for Schools (OAS) program has been shown to improve the self-management skills and health outcomes of students with asthma in Grades 3 to 5. This report examines the impact of OAS on students’ parents. Because pilot studies showed that parental attendance at school-based sessions was low, the authors held six sessions at school for children and gave children homework assignments to complete with parents at home to teach parents about asthma and build support for children’s self-management efforts. Analysis of 1-year follow-up data showed that children’s participation in OAS was a significant predictor of parental self-management skills ( p < .03) and that OAS children’s communication was more strongly associated than controls’ with parents’ self-management ( p = .05). The findings show that health education activities brought home from school by children can positively influence parents’ self-management of a complex chronic disease such as asthma.
Evaluation of the All Stars Character Education and Problem Behavior Prevention Program: Effects on Mediator and Outcome Variables for Middle School Students
Authors: Harrington Nancy G. , Giles Steven M. , Hoyle Rick H. , Feeney Greg J. , Yungbluth Stephen C.
Published: February 2007

The effects of All Stars, a character education and problem behavior prevention program, on variables theorized to mediate problem behaviors and on the problem behavior variables of substance use, sexual behavior, and violence among middle school students are reported. In an independent, randomized, single-cohort, longitudinal evaluation of the program, 1,655 students completed pretest, posttest, and 1-year follow-up surveys measuring demographics, mediating variables, and behavioral outcome variables. Results indicate that the All Stars program, when administered by teachers, had an immediate effect on mediating variables that did not persist over time. Inclusion of ethnicity in the design showed that the program, when administered by specialists, had delayed effects on mediating variables for African American and Hispanic students. However, no consistent effects were found for student problem behaviors in either condition. Implications for prevention practice and directions for future research are discussed.
The Feasibility of a Web-Based Surveillance System to Collect Health Risk Behavior Data from College Students
Authors: Pealer Lisa N. , Weiler Robert M. , Pigg R. Morgan , Miller David , Dorman Steve M.
Published: February 2007

This study examined the feasibility of collecting health risk behavior data from undergraduate students using a Web-based survey. Undergraduates were randomly selected and assigned randomly to a mail survey group and a Web survey group. There were no statistically significant differences between the two groups for demographics, response rates, item completion, and item completion errors. Yet differences were found for response time and sensitive item completion. This is the first study to demonstrate the feasibility of collecting health risk behavior data from undergraduates using the Web. Undergraduates are just as likely to respond to a Web survey compared with a mail survey and more likely to answer socially threatening items using this method. Also, the Web format and protocol required less time to administer. Researchers and practitioners conducting health survey research with college students or other homogeneous populations who have access to e-mail and the Web should consider using a Web-based survey design as an alternative to a mail, self-administered survey. In such a population, a Web-based survey should not discourage participation, particularly if participants are interested in the questionnaire content.
Photovoice Ethics: Perspectives from Flint Photovoice
Authors: Wang Caroline C. , Redwood-Jones Yanique A.
Published: February 2007

Photovoice is a participatory health promotion strategy in which people use cameras to document their health and work realities. As participants engage in a group process of critical reflection, they may advocate for change in their communities by using the power of their images and stories to communicate with policy makers. In public health initiatives from China to California, community people have used photovoice to carry out participatory needs assessment, conduct participatory evaluation, and reach policy makers to improve community health. This article begins to address ethical issues raised by the use of photovoice: the potential for invasion of privacy and how that may be prevented; issues in recruitment, representation, participation, and advocacy; and specific methodological techniques that should be used to minimize participants’ risks and to maximize benefits. The authors describe lessons learned from the large-scale Flint Photovoice involving youth, adults, and policy makers.
Factors Related to Cancer Screening in Hispanics: A Comparison of the Perceptions of Hispanic Community Members, Health Care Providers, and Representatives of Organizations that Serve Hispanics
Authors: Puschel Klaus , Thompson Beti , Coronado Gloria D. , Lopez Lisa C. , Kimball Ann Marie
Published: February 2007

Hispanics have lower rates of screening for cervical, breast, and colon cancer than non-Hispanics. Activities to increase cancer screening in this population may not be informed by Hispanics, which may have implications for success rates of interventions. In this study, the perceptions about cancer screening behaviors in Hispanics are compared among three groups: a random sample of respondents (75% Hispanic) to a population-based survey, health care providers (primarily non-Hispanic), and representatives of organizations that serve Hispanics (36% Hispanic). While there was agreement that socioeconomic factors were important for cancer screening, differing views were expressed regarding the importance of cultural factors for cancer screening among Hispanics. Interventions developed by those who serve the Hispanic population may be based on inaccurate perceptions about the beliefs and practices of the population served. For effective interventions, it will be necessary to understand the factors important to Hispanics for cancer screening.
Using Theory to Understand the Multiple Determinants of Low Participation in Worksite Health Promotion Programs
Authors: Linnan Laura A. , Sorensen Glorian , Colditz Graham , Klar Neil , Emmons Karen M.
Published: February 2007

Low participation at the employee or worksite level limits the potential public health impact of worksite-based interventions. Ecological models suggest that multiple levels of influence operate to determine participation patterns in worksite health promotion programs. Most investigations into the determinants of low participation study the intrapersonal, interpersonal, and institutional influences on employee participation. Community- and policy-level influences have not received attention, nor has consideration been given to worksite-level participation issues. The purpose of this article is to discuss one macrosocial theoretical perspective—political economy of health—that may guide practitioners and researchers interested in addressing the community- and policy-level determinants of participation in worksite health promotion programs. The authors argue that using theory to investigate the full spectrum of determinants offers a more complete range of intervention and research options for maximizing employee and worksite levels of participation.
Health Risk Behavior of Rural Secondary School Students in Zimbabwe
Authors: Gwede Clement K. , McDermott Robert J. , Westhoff Wayne W. , Mushore Moses , Mushore Tsungai , Chitsika Elijah , Majange Charles S. , Chauke Peter
Published: February 2007

A socioculturally appropriate health risk behavior instrument, modeled after the U.S. Centers for Disease Control and Prevention’s Youth Risk Behavior Survey (YRBS), was administered to 717 secondary school students in a rural area of Zimbabwe. Comparisons of risk behaviors by gender and school grade were made using univariate procedures and multiple logistic regression. Males were significantly more likely than females to have had sexual intercourse (odds ratio = 5.02, p < .0001) and to report drug use behaviors. Males also were significantly more likely to report early initiation (by age 13 years) of alcohol use, cigarette smoking, and marijuana use. School site violence and drug use behaviors also were prevalent in this sample. An interaction between gender and grade was evident for some behaviors. Additional research may further the understanding of these risk behaviors and facilitate development of effective, culturally relevant risk reduction programs.
When is Sex Safe? Insiders’ Views on Sexually Transmitted Disease Prevention and Treatment
Authors: McDonald Mary Anne , Thomas James C. , Eng Eugenia
Published: February 2007

STD prevention programs promote practices and messages that are presumed to fit with most conditions of U.S. communities. Yet, the social and cultural contexts for low-income ethnic communities may frame STD prevention differently, so that people calculate their risk and take actions based on what they have learned through their own observations and life experiences. To understand how people at high risk for STDs make decisions and take actions to protect themselves from these diseases, the authors conducted 38 ethnographic interviews with individuals living in a rural community in the South. Practices they reported include selecting “safe” partners on the basis of appearance, familiarity, or church attendance; washing before and after sex to prevent infection; self-treatment with antibiotics obtained without a prescription; and visiting the clinic frequently for checkups for asymptomatic infections. The authors compare and contrast their worldview with the public health concepts of primary and secondary STD prevention.
Designing Health Information Delivery Systems for Puerto Rican Women
Authors: Davis Ruth E. , Flannery Daniele D.
Published: February 2007

Although health information is important to the prevention of much illness, the health information needs of Puerto Rican women remain unaddressed, according to the results of this phenomenological study. Through audiotaped interviews, 21women evaluated various sources of health information. Analysis of the data revealed which health information sources they considered trustworthy and nontrustworthy. Health care providers were found to be one of the least helpful sources, as personal interactions were often hurried and inattentive to women’s needs. Yet, the women were able to present a vivid portrait of a culturally sensitive community environment conducive to the presentation of health information. Implications include the importance of including cultural values in any health information setting, as well as the importance of building cultural bridges between health educators and Puerto Rican women. More research is needed to examine community efforts to enhance health information sources for this population of women.
Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands
Authors: Cortes Leslie M. , Gittelsohn Joel , Alfred Julia , Palafox Neal A.
Published: February 2007

Formative researchwas conducted in the Republic of the Marshall Islands to help develop a diabetes prevention intervention. Methods included in-depth interviews, semistructured interviews, and direct observation of household behaviors in urban and remote settings. Foods were classified into two main conceptual spheres: foods from the islands/Marshallese foods and imported/American foods. Diabetes ( nanimij in tonal) is a highly salient illness and is believed to be caused by foods high in fat and sugar, consumption of imported/American foods, family background, and the atomic bomb testing. Physical activity and eating a traditional diet were viewed as important for preventing diabetes. The traditional belief system links a large body with health, and a thin body with illness; however, perceptions are changing with increased acculturation and education about the health risks of obesity. These findings were used to develop a diabetes prevention home visit intervention currently being implemented and evaluated in Marshallese households.
The Relationship between Social Cohesion and Empowerment: Support and New Implications for Theory
Authors: Speer Paul W. , Jackson Courtney B. , Peterson N. Andrew
Published: February 2007

Empowerment theory represents an expansive view of individual and collective behavior that includes the active participation of individuals and groups in altering and shaping the socioenvironmental context. Critical to health educators are local interventions that yield participation of community members and empowerment for participants. The concept of social cohesion embraces participation but expands this behavioral emphasis to incorporate notions of trust, connectedness, and civic engagement. This study presents two data sets on the relationship of participation to empowerment. The first replicates and extends previous research by examining participation with interactional as well as intrapersonal empowerment. Second is the examination of how the quality of the participatory experience—the cohesive nature of participation—is related to interactional and intrapersonal empowerment. Findings support and extend previous findings, reliably cluster residents by the degree of connectedness in their participatory experiences, and reveal that social cohesion is related to intrapersonal empowerment.
Impact Study of Tobacco Possession Law Enforcement in Florida
Authors: Livingood William C. , Woodhouse Carolyn D. , Sayre Judy Jopling , Wludyka Peter
Published: February 2007

This study of tobacco possession law enforcement was conducted in four selected counties in Florida, the first state to report statistically significant annual declines in youth tobacco use during the 1990s. The primary objective of this study was to assess the impact of possession enforcement on youth attitudes, perceptions, and behaviors by comparing results of a survey administered in high-enforcement counties with results from low-enforcement counties and by examining the survey results for relationships of tobacco use to perceptions and awareness of laws and enforcement activity. The survey was administered to a sample of 2,088 randomly selected youth, in conjunction with a qualitative study of law enforcement officials reported elsewhere. Findings indicate that possession enforcement, as a component of comprehensive tobacco control, appears to help reduce youth tobacco use and may be a critical component of the most successful youth tobacco prevention program, documented in the previous decade.
Contributions of Community Involvement to Organizational-Level Empowerment: The Federal Healthy Start Experience
Authors: Minkler Meredith , Thompson Mildred , Bell Judith , Rose Kalima
Published: February 2007

This article presents findings of a multisite case study of the experience of nine federal Healthy Start Program sites in using consortia and other community involvement strategies in the fight against infant mortality. Using empowerment theory as a conceptual framework, qualitative data are employed to examine howcommunity involvement in the program through community-based consortia and other means contributed to empowerment at the organizational level. The article concludes with implications of the study findings for practice both within Healthy Start and in the context of other community-based health initiatives.
The School Health Curriculum Project: Its Theory, Practice, and Measurement Experience
Authors: Green Lawrence W. , Heit Phil , Iverson Donald C. , Kolbe Lloyd J. , Kreuter Marshall
Published: February 2007

The School Health Curriculum Project(SHCP), initiated over a decade ago to provide a health education curriculum package for elemen tary students, has been widely and variously evaluated. In analyzing studies designed to assess the effectiveness of the SHCP, it was recognized that the measured impact of this project (or any health education intervention) would derive from the adequacy of the theory upon which the program is based, the adequacy of its implementation, and the adequacy of its measurement. Hence, an examination of the theoretical base of the SHCP and its variance in practice was conducted. In addition, a metaevaluation of 24 studies designed to access the effectiveness of the SHCP was completed. Results suggest that the project is effective in influencing health-related knowledge and attitudes. A rationale for future evaluation efforts in school health education is subsequently outlined.
A Framework for Optimizing Resource Allocation for Health Education Programs
Authors: Bartlett Edward E.
Published: February 2007

Health education programs conventionally are implemented in four sites: school, clinical, occupational, and community settings. One problem encountered by health education specialists, community health planners, and policy makers, is ascertaining the optimal allocation of health education resources to these four settings. This paper proposes a framework to assist in making this decision. The framework incorporates considerations of the target group, the health problem, the desired health behaviors, andad ministrative aspects of the program, which are broken down into 26 different "criteria", (e.g., age of target group, stage of disease intervention). Each of the 26 criteria has its respective "dimensions" (e.g., age of target group: pre school children, school children, and adults), and each dimension in turn suggests the optimal health education setting(s). An improved under standing of the advantages and disadvantages of implementing health edu cation programs in the different sites will facilitate better coordination be tween practitioners in school, clinical, occupational, and community settings.
Evaluating Patient Education: A Case Study of a Diabetes Program
Authors: Legge Jerome S. , Massey Veta M. , Vena Catherine I. , Reilly Bernard J.
Published: February 2007

This paper presents an evaluation of a diabetic education program for patients at Stephens County Hospital in Toccoa, Georgia. An analysis of covariance is employed along with multiple classification analysis to determine the effect of the program in reducing hospital readmissions. The major finding is that the teaching program is an important variable in the reduction of readmissions. A second outcome is that the occurrence of diabetic ketoacidosis (DKA) on initial admission is a second factor in determining readmissions. Patients having the benefit of instruction are less likely to experience readmission than those not being educated; those having DKA are more likely to be readmitted within six months from release than those not having this degree of loss of control. Implications of this study suggest that in designing a diabetic education program, greater attention must be focused upon the needs of the ketosis- prone patients.
The Effect of Contract Witnessing on Motivation and Weight Loss in a Weight Control Program
Authors: Ureda John R.
Published: February 2007

To investigate the impact which commitment has on the achievement of behavioral-change goals in a weight control program, a behavioral contracting process was used. One- hundred six adult volunteers were randomly identified as treatment or control group members and co- participated in a four-week, eight-hour, behavioral self-management weight control program. As part of homework assignments, all participants were provided with three take-home contracts which were to be returned either signed by the participant only (control group with baseline commit ment) or by the participant and at least one friend, relative, or peer(treatment group with enhanced commitment). Analyses of comparable treatment and control group members shows the treatment group holding significantly stronger behavioral intentions 10 to 15 weeks after the program ended and losing weight at a significantly faster rate. Implications for program plan ning, implementation, and evaluation are discussed.
Analysis of Health Education Sections of Health Systems Plans
Authors: Steckler Allan , Dawson Leonard , Herndon Sally
Published: February 2007

Health Systems Agencies are required by federal guidelines to plan for and provide educational opportunities for residents of their health service areas. A study was conducted of 9 health education com ponents of health systems plans developed by HSAs in Region III. The health education plans were analyzed and scored using the "Health Education Plan Scorecard" developed by Sullivan and adapted by the present authors. Specifically this modified scorecard consists of eight dimensions of the health education planning process : Involvement, Principles and Practice of Health Education, Defining Problems, Setting Goals and Objectives, Recommending Actions, Obtaining Resources, Planning for Implementa tion, and Planning for Evaluation. Ratings were generally higher on the first five dimensions of the scorecard. The last three dimensions produced lower scores. The overall average score was 41 points out of a possible 100. Thus indicating the general overall low scores received b y the plans. The paper in cludes 18 recommendations to HSAs for improving the quality of health education plans. A key recommendation is that the Health Education Plan Scorecard should be used as a guide and check list during the plan develop ment process.