bluuebunny/crossref_metadata_2025 huggingface dataset:
Restaurant Menu Labeling: Impact of Nutrition Information on Entree Sales and Patron Attitudes
Authors: Albright Cheryl L. , Flora June A. , Fortmann Stephen P.
Published: February 2007

This study examined changes in sales of low fat/low cholesterol foods targeted in a restaurant menu labeling program. Sales of labeled items were tracked before and after the program was introduced, and a subsample of patrons were surveyed for information on visibility and comprehension of the menu labels. Two of the four restaurants had significant increases in the sales of targeted foods following labeling.

Comparisons between patrons dining in restaurants which had an increase in sales (I—increase restaurants) to those dining in restaurants which had no overall shift in sales (NI—no increase restaurants) revealed no differences in patron awareness or compre hension of the menu labels. There were age and gender differences between I and NI restaurants, with I restaurants having proportionally more males, and a younger clientele. Taste was the primary reason given by patrons for their entree choice, regardless of whether or not it was labeled. In all four restaurants women and older patrons were more aware of the program and more responsive to its recommendations.

These findings suggest that environmental strategies may be an effective method of encouraging dietary changes in the general population, but patron characteristics such as age and gender may influence receptivity to this type of intervention. Future studies aimed at developing effective point of purchase education programs should evaluate these patron characteristics and include more powerful behavior change strategies.
A Center-Based Program for Exercise Change among Black-American Families
Authors: Baranowski Tom , Simons-Morton Bruce , Hooks Paul , Henske Janice , Tiernan Kathy , Kay Dunn J. , Burkhalter Harold , Harper John , Palmer Judy
Published: February 2007

A center-based program was designed and implemented to promote aerobic physical activity among healthy Black-American families with children in the fifth through seventh grades. Ninety-four Black-American families were actively recruited and randomly as signed to an experimental or control group. Families in the experimental group were encouraged to participate in a program with the following features: one education and two fitness sessions per week for 14 weeks; educational sessions that included individual counseling, small group education, aerobic activity, and snack components; located in a convenient building cherished by the community; aerobic activity sessions in a fitness center outfitted and staffed according to modern characteristics; a variety of incentives including free transportation and babysitting and reminders to promote attendance. Per cent participation was low, with about 20% participating in the desired fitness center sessions by the end of the program. As a result of low participation, no differences were detected beween experimental and control groups on indicators of cardiovascular fitness. In postprogram interviews, conflicts with work and school events were the most commonly reported reasons for nonattendance. We concluded that because of difficulties in at tendance, center-based programs appear to have limited value as the sole modality for intervention in public health programs for promoting physical activity among healthy,
Risk for DWI: A New Look at Gender Differences in Drinking and Driving Influences, Experiences, and Attitudes among New Adolescent Drivers
Authors: Farrow James A. , Brissing Peter
Published: February 2007

Adolescent drivers are over-represented in fatal auto accidents, especially those in volving alcohol (DWI). Young male drivers appear to be at higher risk than adolescent female drivers because of a variety of important influencing factors. The current study takes a new look at the gender differences in these factors as they relate to driving behavior. Three hundred forty-three tenth-grade students (mean age: 15.8 years; 52% male, 48% female) were studied measuring demographics, family characteristics and influences, drug and alcohol use, perception of driving skill, sensation-seeking, other personality factors and responses to DWI vignettes for decision-making skill. Female respondents more often had difficulty with parents ( p = 0.03) than males and more often used drugs and alcohol ( p = 0.05). Boys more often attended speed competitions ( p = 0.003). had legal problems ( p = 0.004), and dated at a younger age ( p < 0.001). Males perceived greater driving skill in risky situations and used the automobile to enhance self-efficacy more than females ( p = 0.001/ p = 0.05). Male drivers scored higher on anger/hostility and sensation-seeking scales ( p = 0.05). There were few significant gender differences in the way respondents analyzed risky DWI situations. Even though female subjects used more alcohol/drugs and came from more disturbed family backgrounds, their attitudes and behavior with respect to DWI appear more socially acceptable. Spec ulation as to some of the reasons for this effect are discussed with implications for prevention and further research.
Identifying Strategies for Increasing Employee Physical Activity Levels: Findings from the Stanford/Lockheed Exercise Survey
Authors: King Abby C. , Taylor C. Barr , Haskell William L. , DeBusk Robert F.
Published: February 2007

While worksite exercise programs offer a number of potential advantages with respect to increasing physical activity levels in American adults, typical participation rates remain relatively low. The purpose of this study was to explore employee preferences and needs related to physical activity programming in a major work setting in northern California. Two-thirds (399) of a randomly selected sample of employees responded to a mailed survey. Male and female employees reporting no regular aerobic activity over the past two years more strongly endorsed a number of erroneous beliefs concerning exercise, reported less support for engaging in exercise both at home and at work, and avoided even routine types of activity to a greater extent than more active individuals ( p values <0.001). Current exercisers reported use of a greater number and variety of motivational strategies as part of their exercise program than past exercisers who were not currently active ( p < 0.001). Respondents, regardless of exercise status and age, reported pref erences for moderate-intensity activity occurring away from the workplace which could be performed on one's own rather than in a group or class. Implications of the findings with respect to development of educational and behavioral programs for the current employee population are discussed.
Attitudes and Behaviors of Hispanic Smokers: Implications for Cessation Interventions
Authors: Marin Barbara V. , Perez-Stable Eliseo J. , Marin Gerardo , Sabogal Fabio , Otero-Sabogal Regina
Published: February 2007

The smoking behavior of Hispanics, especially Mexican Americans, has been reported to differ from that of non-Hispanic whites, in both large gender differences in prevalance as well as a lower self-reported number of cigarettes smoked per day. This study compared the responses of a convenience sample of 263 Hispanic (44% Mexican American and 38% Central American) and 150 non-Hispanic white smokers, in order to identify other ethnic, gender, and acculturation differences in smoking behaviors. Hispanic women smoked fewer cigarettes and initiated smoking at a comparatively later age than Hispanic men; they were also less likely to smoke during pregnancy than non-Hispanic white women. Hispanics smoked more cigarettes on Saturday than other days, but this was not true for non-Hispanic whites. Will power (voluntad propia) and knowing the negative effects of smoking were considered the most helpful techniques for quitting by Hispanics. Considering that light smokers are able to quit with less intensive cessation techniques, these data suggest that a properly developed health education community intervention may have an impact on smoking rates among Hispanics.
A Validity Problem in Measuring Exposure to Mass Media Campaigns
Authors: Brown Jane D. , Bauman Karl E. , Padgett Connie A.
Published: February 2007

Recognition of radio and television messages included in three mass media campaigns designed to keep adolescents from starting to smoke cigarettes was measured in six treatment and four control cities (Standard Metropolitan Statistical Areas) in the south- eastern United States. The telephone survey of 574 randomly selected adolescents found high recognition of campaign messages even in the areas where the campaigns had not been broadcast. Campaign messages that differed significantly from other anti-smoking messages were less likely to be falsely recognized. These results reinforce the need to include true control groups in mass media evaluations and to construct distinctive mes sages if exposure is an important aspect of campaign evaluation.
Essential Elements of Self-Help/Minimal Intervention Strategies for Smoking Cessation
Authors: Glynn Thomas J. , Boyd Gayle M. , Gruman Jessie C.
Published: February 2007

Two decades of research suggest that self-help/minimal intervention strategies for smoking cessation* may be the preferred means by which smokers stop and can produce success rates approximating those of more formal programs, at lower cost and with greater access to relevant populations. In order to make the best possible use of these self-help/ minimal intervention approaches, the National Cancer Institute (NCI) supported a series of randomized, controlled intervention trials and, in June of 1988, convened an Expert Advisory Panel to address the question "What are the essential elements of self-help/ minimal intervention strategies for smoking cessation?". The panel's recommendations were that: (1) Intervention efforts should focus on increasing smokers' motivations to make serious quit attempts; (2) Delivery of programs be broadened to include all smokers; (3) Programs be targeted to stages of cessation and specific populations; (4) All programs include (a) elements focused on health and social consequences of smoking, and (b) strategies and exercises aimed at quitting, maintenance of nonsmoking, relapse preven tion, and recycling; (5) Materials and programs be made widely available rather than "fine tuning" existing programs or developing new ones; and (6) Programs make use of specific adjunctive strategies. In this way, a reacceleration of the decline in smoking prevalence may be realized in the 1990s and significantly contribute to the NCI's Year 2000 goals and the Surgeon General's aim of a smoke-free society.
A Multisectoral Approach to Primary Health Care in Fujian, China
Authors: Yang Honglian  , Mei Yiheng  , Qiu Xiuchen  , Zhang Hualin  , Lin Qibin  , Guan Jihui  , Clayton Serena
Published: February 2007

The government of Yongan in Fujian province has developed a multisectoral primary health care program in the rural community of Dahu with the aim of reaching "Health for All" by 1993. In keeping with the spirit of the Alma Ata declaration and the tradition of local self-reliance in China, the program has involved the entire community and is financed almost exclusively at the local level. Community leaders were trained in the importance of primary health care so that they could serve as role models. The project includes school health education, domestic hygiene education, reconstruction of homes to separate the kitchen, toilet and animals pens, road construction to eliminate dust, environmental sanitation, occupational health, and the upgrading of health care facilities. A number of local ordinances regarding construction, zoning and smoking have also been instituted. The results of the project's first year of implementation in two villages indicate that construction of the new road is near completion, and access to clean water is almost universal. Gains are also reported in the percentage of the population receiving physical examinations, the number of health stations that now meet state standards, and the number of homes that are constructed according to the new guidelines.
Health Challenges for the Year 2000: Health Promotion and AIDS
Authors: Erben Rosmarie
Published: February 2007

This article examines how the concept of health promotion can be of value to professionals who have a special responsibility to promote the health of young people and adults. What does it mean to address the issue of AIDS within the broad concept of health promotion? A key message of health promotion is that health cannot be ensured by the health sector alone. The confrontation with AIDS—the new global threat to health— and the response to it with the Global AIDS Strategy have underlined the necessity for a broad involvement of many different sectors of society. Health promotion needs a comprehensive strategy of action oriented towards the development and implementation of various measures concerning the prevention of HIV/AIDS. The five activity areas of the Ottawa Charter for Health Promotion provide a framework to introduce concrete examples of good practice. The main objective of these activities is the development of personal skills that will enable young people and adults to make choices conducive to health, to cope with problems, to find imaginative solutions, and to become aware of the interdependence that exists between all individuals. This means involvement and participation. In turn, participation opens up on a broad perspective of community action, of supportive environment, and of social public policy. This is the framework of action that the health promotion concept can provide.
The Healthy Cities Project: A Challenge for Health Education
Authors: Ashton John
Published: February 2007

The World Health Organization Healthy Cities Project assists participating cities in developing and implementing plans to create health promoting policies, programs, and environmental conditions. The project, which has its origins in the strategy of Health for All by Year 2000, seeks to bring the rhetoric down to earth and ground it in policy and practice. So far the project has been very successful in interesting and involving people at the local level. What began as a small European project in 1986 has become part of a global movement four years later. This movement is based on a recognition of the ecological context of health and the need to reconcile human lifestyles with their environmental and planetary impact. In the process of involving many people from nonmedical sectors in urban health promotion, the continuing relevance of health education to public health is becoming apparent. The challenge to Health Education is to broaden its perspective from the individual and biological, to the social and environmental if it is to play a full part in tackling the ecological crises which confront us.
Health Education in England: A Five-Year Strategy for the Health Education Authority
Authors: Hagard Spencer , Chambers Jacky , Killoran Amanda
Published: February 2007

The Health Education Authority in England has published its first Strategic Plan, covering the years 1990-1995. The origins and functions of the Authority are described, as are the various factors contributing to the Plan. The strategic objective is defined as being "to ensure that by the year 2,000 the people of England are more knowledgeable, better motivated, and more able to acquire and maintain good health," as suggested by six criteria for program effectiveness. Selected programs include HIV/AIDS, coronary heart disease, cancer, smoking, alcohol, nutrition, and family and child health. Complementary delivery methods are examined, such as use of the mass media, the National Health Service, schools and colleges, and the workplace, utilizing partnerships with health, education and other agencies, promoting professional development, and dissemination of research and local initiative results.
Health Education through Interactive Radio: A Child-to-Child Project in Bolivia
Authors: Fryer Michelle L.
Published: February 2007

In developing countries it is common for older children to assume much of the responsibility for care of their younger siblings. Based on this observation, the "child-to-child" approach to health education targets these older children as a means of improving child health. As the initial phase in the development of a radio health curriculum in Bolivia, a module on diarrheal disease was developed and field-tested among fourth- and fifth-grade students in Cochabamba. The module consists of 10 interactive radio lessons in which the students respond orally to drill and practice, sing songs, or write key concepts in their notebooks. Following the 25-minute radio broadcast, the teacher conducts a 20-minute session that focuses on application and practice of the new behaviors. The module includes lessons on personal hygiene, water and oral rehydration, home sanitation, and nutrition. The field evaluation revealed the need for modifications in the teachers' role and greater attention to teacher training. Students responded enthusiastically and achieved significant knowledge gains as a result of the program. Plans are underway to expand the radio health program.
The Acceptability of Childhood Immunization to Togolese Mothers: A Sociobehavioral Perspective
Authors: Eng Eugenia , Naimoli Joseph , Naimoli Gail , Parker Kathleen A. , Lowenthal Nancy
Published: February 2007

A study was conducted in Togo to investigate the lack of acceptance of childhood immunization from a social science perspective. In each village focus group interviews were conducted with approximately 12 mothers to discuss their beliefs and knowledge, social and cultural norms and practices, and experiences with health services that hinder or promote the acceptability of childhood immunization. The problem of failure to complete the immunization series was explained in terms of mothers' lack of knowledge of when to return or their forgetfulness rather than inadequate knowledge about the importance of returning. Other barriers included the requirement to keep and present a vaccination card, waiting time at the clinic, lack of information about available services, and laziness. Rather than endorsing strategies that target individuals, mothers suggested increasing the level of social control exerted by decision makers in their communities (the village chief could direct the town crier to announce the passing of each week to help parents keep track of time between immunizations) and increasing the level of social
The AIDS Rapid Anthropological Assessment Procedures: A Tool for Health Education Planning and Evaluation
Authors: Scrimshaw Susan C. M. , Carballo Manuel , Ramos Laura , Blair Betty A.
Published: February 2007

Health education is an essential part of efforts to limit and manage the current AIDS pandemic. The information needed to develop meaningful and culturally appropriate educational interventions is often difficult to obtain because topics related to the prevention and treatment of AIDS are invariably culturally and/or personally sensitive. This article describes the data collection guidelines of the HIV/AIDS Rapid Anthropological Assessment Procedures developed by the Social and Behavioural Research Unit of the World Health Organization's Global Programme on AIDS. The guidelines apply anthropological methods of observation, participant observation, informal and formal interviews, and focus group interviews to the collection of information on AIDS-related beliefs and behaviors. When researchers focus on specific issues in countries, cultures, and languages with which they are already familiar, relatively rapid assessments can be made with a high degree of validity. This article briefly discusses these methods and their application to AIDS-related topics, together with the validity and reliability of the various methodological tools available to social and behavioral scientists.
Ghana Social Mobilization Analysis
Authors: Tweneboa-Kodua A. , Obeng-Quaidoo Isaac , Abu Katie
Published: February 2007

In order to increase communication channels for child survival and development, the government and UNICEF Ghana undertook a "social mobilization analysis." This analysis included three studies that aimed to identify individuals and existing organizations with the potential to serve as health communicators and to determine the type of assistance that they needed to maximize their effectiveness in this role. The first study surveyed governmental institutions, trade unions, revolutionary organizations, traditional leaders, and others and found a largely untapped reservoir of capacities to promote child health, with varying levels of current involvement. The primary need identified was for information and training materials. The second study focused on the mass media and revealed a low coverage of maternal and child health topics and the need for better cooperation between journalists and health professionals. The third study assessed sources of health information for parents and found several sources, such as religious organizations, women's groups, and school teachers that could be mobilized to promote child health. Recommendations are made for the use of the findings.
The Impact of a Health Education Course on Maternal Knowledge: A Comparative Study in a Low Socioeconomic Rural Region
Authors: Shoham-Yakubovich Ilana , Pliskin Joseph S. , Carr Daniel
Published: February 2007

A comprehensive health education course was designed for mothers in West Bank villages, a relatively low socioeconomic population. The course focused on nutrition, hygiene, child development, and first aid. It was taught by specially trained local instructors in small classes characterized by an individualized teaching method. To evaluate the contribution of the course, the level of knowledge in topics taught in the course was tested. The test was personally administered by trained interviewers to 241 course participants and to a comparison group of 284 mothers who had not participated. As expected, participants demonstrated higher level of knowledge than nonparticipants, regardless of the time since having taken the course. The course seems to have contributed to all participants, but mostly to women of lower education. In a multiple linear regression the two most significant predictors of knowledge were course participation and level of maternal formal education.
Tobacco Truths: The Impact of Role Models on Children's Attitudes toward Smoking
Authors: Meier Kathryn S.
Published: February 2007

The present study assessed the impact of parents, peers, siblings, cigarette advertising, and sponsorship as role models influencing attitudes toward smoking and smoking behavior in seventh- and eleventh-grade students. The participants completed an anonymous questionnaire concerning their current and future smoking behavior, attitudes toward a cigarette advertising ban, general attitudes toward smoking, and smoking status of parents and siblings. Fifty-one percent of the smokers reported that they are not likely to be smoking in the future. Smokers were found to have less negative attitudes than never smokers. Seventh-grade students who admitted to being triers or smokers had less negative attitudes toward smoking than eleventh-grade students. Parent smoking had no impact on attitudes. However, if a sibling smoked, the respondents' attitudes toward smoking were less negative. Students appeared to be more aware of sport sponsorship than conventional advertising. Most never smokers favored a total cigarette advertising ban, versus only 35% of smokers. Results from this study suggest that intervention programs need to address nicotine addiction and be in place before grade seven. Investigation is further warranted in the shaping of attitudes toward smoking.
AIDS Education: The Rhode Island Experience
Authors: Brown Larry K. , Barone Vincent J. , Fritz Gregory K. , Cebollero Pedro , Nassau Jack H.
Published: February 2007

AIDS prevention, by public school education, is designed to change knowledge, attitudes, and future behavior. This study evaluated the impact of a state-mandated educational program on a sample of 2709 adolescents. Changes from pre to posttest were evaluated using standardized change scores and comparisons between the experimental and a delayed education control group were made. The experimental group, but not the control group, changed to a statistically significant degree (p < .001). They became more knowledgeable, endorsed slightly more tolerant attitudes, and reported an increased intention to avoid intercourse as a means of AIDS prevention. The extent of change was substantially greater for knowledge than for attitudes. Age, gender, and AIDS-related anxiety were found to be significant variables in the AIDS education process. The modest changes observed emphasize that the dissemination of AIDS information by public schools is only the first step in changing adolescent behavior as a means to AIDS prevention and that other, additional approaches are needed.
Reexamination of Eisen, Zellman, and McAlister's Health Belief Model Questionnaire
Authors: Bernstein Ira H. , Keith Judith B.
Published: February 2007

Eisen, Zellman, and McAlister 1 proposed a 22-item scale to measure four Health Belief Model (HBM) constructs as applied to adolescent contraceptive behavior. Their factor analysis led them to conclude that there were several discrepancies in their proposed scales. We suggest that they were unduly pessimistic. Although their proposed scales could stand improvement, they are adequate preliminary tools. The major reason they concluded that the scales were deficient was that they applied criteria that are generally appropriate for continuous data to their inherently discrete (categorical) item response data. A secondary consideration is that confirmatory methods of factor analysis can yield results that bear more directly on their proposed organization of items than the traditional exploratory methods that they used. A reanalysis of their data suggests that their proposed scales have fewer problems than they believed they had. Our results increase the likelihood of standardizing HBM measures.
Identification of Campaign Recruitment Strategies for a Stepped Smoking Cessation Intervention for a College Campus
Authors: Black David R. , Babrow Austin S.
Published: February 2007

A rapprochement of the Stepped Approach Model of health care delivery and Ajzen's Theory of Planned Behavior was used to identify campaign recruitment strategies for a stepped smoking cessation intervention for a college campus. The study examines outcome expectancies, outcome evaluations, and interest in participating in smoking cessation programs presented in graduated steps of intervention intensity. Telephone surveys were conducted with a probability sample of 191 student smokers. A significant negative trend indicates that the steps are ordered cost-effectively. Scheffé a posteriori tests also reveal that interest in Step 1 (pamphlets and brochures) was significantly higher than interest in any other step, including those representing traditional health care services (i.e., groups and individual treatments). The two strongest predictors of interest in each step were attitudes about participation and control beliefs; normative expectations about program participation discriminated between respondents with high or low interest in Steps 2 through 5. It was concluded that attitudes and control beliefs should be the focus of initial program promotion for college smoking cessation campaigns. Emphasis on attitudes, control beliefs, and especially perceived norms could be helpful in advancing unsuccessful participants to the next more intensive program in a stepped intervention.
Critical Thinking for Environmental Health Risk Education
Authors: Gregory Robin
Published: February 2007

This article proposes an approach for helping school-age children to think critically about environmental health risks. It discusses three key elements of a school curriculum— defining a decision perspective, making choices under uncertainty, and thinking about consequences—and recommends procedures to aid in classroom implementation of the proposed ideas. Critical thinking skills are shown to enhance childrens' ability to anticipate the health or safety consequences of a decision by distinguishing automatic from decision thinking, by detecting inconsistent objectives or neglected consequences, and by making explicit value-based tradeoffs. Training in critical thinking also should empower children because it acknowledges the power of personal initiatives in decreasing health risks and, in general, because it focuses the classroom experience on learning about how to think rather than merely learning about what to think.
The Relationship between Radon Knowledge, Concern and Behavior, and Health Values, Health Locus of Control and Preventive Health Behaviors
Authors: Kennedy Cassondra Jeanne , Probart Claudia K. , Dorman Steve M.
Published: February 2007

Understanding similarities between health-related and radon-related knowledge, attitudes, and behaviors may suggest application of effective strategies of radon-related education in targeted populations. A mail survey was returned by 300 randomly selected homeowners in a community at risk for high home radon concentrations (50% response). While 64% were concerned, only 7% tested their homes. The expected association between radon knowledge, radon concern, and information-seeking was identified. In addition, those who tested their homes had greater knowledge and did more information seeking. Health values and radon concern were only weakly related. Environmental concern explained the greatest variance in radon concern (10%). Internal health locus of controls were more likely to have high radon concern. Of the preventive health behaviors, not smoking and seat belt use were the best predictors of variance in radon concern (5%). Segmenting the population is suggested for best educational outcome. Relating information to environmental issues may be helpful. Health-conscious people may need awareness of risks. Issues of self-control and radon testing and reduction may be helpful for some. Synergy between smoke and radon, compounded by smokers lack of concern suggests targeting smokers for education efforts.
Healthy Cities: The Indiana Model of Community Development in Public Health
Authors: Flynn Beverly C. , Rider Melinda , Ray Dixie W.
Published: February 2007

While the Institute of Medicine's Report on The Future of Public Health provokes debate on public health issues in the United States, the Healthy Cities movement is one approach to addressing many of these issues. Healthy Cities Indiana began in 1988 and adapts the European and Canadian healthy cities experience within the sociopolitical context of Indiana and the United States. Six Indiana cities are collaborating with Indiana University School of Nursing and the Indiana Public Health Association in a process of urban health promotion. The overall healthy cities process is presented including: city commitment, formation of healthy city committee, community leadership development, city action, provision of data-based information to policy makers, and action research and evaluation. Each step in the healthy cities process is described, highlighting examples from the Indiana experience, including an analysis of selected data describing the cities. The facilitators of a healthy city provide support to city leaders in other cities interested in becoming involved in the healthy cities process. Implications of healthy cities for health educators and other health professionals are suggested.
Newspaper Coverage of Cancer Clusters
Authors: Greenberg Michael , Wartenberg Daniel
Published: February 2007

This study reports an analysis of 176 newspaper articles about cancer clusters. The type of diseases, number of diseases, and status of ongoing health investigations were reported in the majority of articles. But background information such as, comparison of actual and expected number of cases, environmental causes and their confounders, and the existence of other clusters were not reported as often. Statements about risk were reported in most articles and, contrary to our expectations, were relatively balanced among risk asserting, risk denying, and mixed opinions. We noted a preponderance of risk asserting statements in the beginning of stories. Cluster stories cited an average of three sources, and two of these three sources were usually government officials. The remaining sources were divided among citizens, representatives of environmental advocacy groups and industry, and unaligned experts. Drawing on these data, we offer some suggestions to improve communication between scientists and journalists.
Etiology of Drinking and Driving among Adolescents: Implications for Primary Prevention
Authors: Klepp Knut-Inge , Perry Cheryl L. , Jacobs David R.
Published: February 2007

A prospective study was conducted to investigate what factors are predictive of self-reported drinking and driving (DD) among adolescents. The study employs a theoretical framework taken from Problem Behavior Theory; environmental, personality, and behavioral factors are explored for their predictability of DD. A cohort of 1482 high school students completed a written survey in spring of 1986 and again in fall of 1986. The findings confirm that Problem Behavior Theory provides a useful theoretical framework with which to identify etiological factors predictive of DD among adolescents. Identified personality, perceived environmental, behavioral, and demographic factors accounted for approximately 50% of the reported variance in DD at baseline. The same factors accounted for approximately 40% percent of the variance in follow-up DD and were predictive both among the students who did not drink and drive at baseline (incidence cases), and among those students who did drink and drive at baseline (continuation versus discontinuation of the behavior). Based on these etiological data, we recommend that school-based, peer-led educational prevention programs be designed to reach young adolescents prior to the age at which a driver's license is obtained. We further recommend that the programs be broad-based and consider DD within the larger context of drinking and driving related behaviors and traffic safety in general.
Development of a Health Education Program to Promote the Self-Management of Cystic Fibrosis
Authors: Bartholomew L. Kay , Parcel Guy S. , Seilheimer Dan K. , Czyzewski Danita , Spinelli Susan H. , Congdon Brenda
Published: February 2007

The creative challenge of health education for chronic illnesses is the translation of theory-based intervention methods into practical strategies that can be organized into a logical series of learning activities to influence changes in environmental, cognitive, or behavioral factors. A case example describing the development and implementation of a comprehensive health-education intervention for the self-management of cystic fibrosis (CF) is presented. The design of intervention strategies began with an assessment of the educational needs for self-management of CF, followed by specification and validation of particular self-management behaviors. Behavioral and learning objectives then were formulated for each of the self-management behaviors. Constructs from social learning theory considered to be important influences on specified self-management behaviors in CF were identified. Taking into consideration the learning needs of the target population and the practical constraints of the system for providing health care, various intervention methods then were devised based on social learning theory. Lastly, the intervention methods chosen were translated into strategies organized into a series of practical learning activities for CF patients and their families. The process described here should prove useful to others who are planning and developing comprehensive health education programs for self-management of chronic illnesses.
Psychosocial Factors and Enrollment in a Televised Smoking Cessation Program
Authors: Kviz Frederick J. , Crittenden Kathleen S. , Belzer Laurie J. , Warnecke Richard B.
Published: February 2007

Registrants for a smoking cessation program on the evening television news in the Chicago metropolitan area were compared with other smokers in the population to identify psychosocial factors that distinguished registrants. Telephone interviews were conducted before the intervention with random samples of 641 registrants and 2,398 smokers who regularly viewed the evening news. A nested series of three contrasts compared registrants with (1) smokers who regularly viewed the evening television news on any channel, (2) smokers who were regular viewers of the evening news on the intervention channel, and (3) smokers who were regular viewers of the evening news on the intervention channel and were planning to quit smoking. Registration was associated with a smoker's cognitive appraisal of the quitting process, with registrants distinguished by (1) recognition of a need to act (perceived severity of and susceptibility to lung cancer), (2) high outcome expectancies for quitting as an effective means for health promotion, (3) realistic expectations about the effort required to quit, (4) concern about the burden of lung cancer on significant others and related social influence factors, and (5) motivation to quit smoking. The findings suggest that the effectiveness of minimal-contact intervention programs may be enhanced by targeting smokers according to their psychosocial characteristics and by cognitively preparing smokers to attempt to quit.
Using the Health Belief Model to Predict Safer Sex Intentions among Adolescents
Authors: Petosa Rick , Jackson Kirby
Published: February 2007

The purpose of this study was to use Health Belief Model (HBM) concepts to predict adolescents intentions to adopt safer sex behaviors. A stratified, random sampling technique was used to generate a sample of seventh-, ninth-, and eleventh-grade students representative of a southeastern state. A predictive model was constructed of the HBM variables. The model accounted for 43% of the variance in safer sex intentions among the seventh grade, 27% of the variance for the ninth grade and 17% of the variance for the eleventh grade. For the eleventh grade sample gender was the only significant predictor. The results of this study suggest that educational programs to promote safer sex intentions should focus on health related motivations among younger students. With older adolescents it may be more effective to expand education efforts to address factors directly relevant to their motivational schema and social environment. This study underscores the importance of using theory-based models in conducting health education research.
Enhancing Social Support at the Workplace: Assessing the Effects of the Caregiver Support Program
Authors: Heaney Catherine A.
Published: February 2007

Although the health-enhancing effects of social support have been well documented, little is known about how to increase the flow of social support among network members. This article describes and evaluates the Caregiver Support Program, a worksite program that attempts to improve the quality of work relationships among house managers and direct care staff who work in group homes for the developmentally disabled. The progam incorporates three strategies for increasing social support: (1) adding a new person or group of persons to the employee's social network, (2) enhancing existing relationships by improving the focal employee's skills for maintaining strong networks and mobilizing support, and (3) enhancing existing relationships by training members of the employee's social network in ways to be more supportive. The Caregiver Support Program was evaluated in a randomized field trial. Results indicate that the program was effective in improving the relationships between direct care staff participants and their house managers. However, other work relationships remained unaffected. The relationship between direct care staff and their house managers was the only work relationship for which both members of the interpersonal dyad participated in the program. The implications of these findings for health education practice and future research are discussed.
Training Breast Self-Examination: A Research Review and Critique
Authors: Pinto Bernadine , Fuqua R. Wayne
Published: February 2007

Despite an increase in knowledge about breast cnacer, a relatively low percentage of women practice breast self-examination (BSE) regularly and competently. This article reviews the BSE literature with a focus on training of BSE components, discrimination training, and the effectiveness of training procedures. Methodological issues such as the absence of control groups, lack of criteria for termination of training and reliance on self-reports of BSE frequency are identified weaknesses of BSE training studies. A theoretical analysis of BSE highlights potential difficulties in maintaining regular practice of BSE. Recommendations regarding training of proficient BSE skills and promoting regular practice of BSE are offered, and suggestions for further refinement of BSE training and directions for future research are discussed. Promising avenues of research in BSE training technology include discrimination training (on real or simulated breast tissue) together with computerized assessment of skill proficiency.
Explaining Differences between Qualitative and Quantitative Data: A Study of Chemoprophylaxis during Pregnancy
Authors: Helitzer-Allen Deborah L. , Kendall Carl
Published: February 2007

Experts acknowledge that communication projects would benefit from the use of open-ended interviews, focus groups, surveys, trials of behaviors, observation, and other research techniques to identify community and individual knowledge, beliefs, preferences, actual behavior, as well as a host of sociodemographic and economic characteristics necessary for planning and implementation. Communication planners often rely exclu sively on survey research for program planning, claiming ease of administration and reliability of results. Reliance on this single research method often results in less appro priate interventions than could be developed with multiple research methods. This article reports the use of multiple methods to examine the cultural and behavioral factors which influence the use of antimalarial chemoprophylaxis during pregnancy in Malawi, Central Africa. This article will demonstrate how quantitative techniques such as cross sectional interviews and chemical tests as well as qualitative ethnographic information were used in the study; demonstrate how diverse results from multiple research techniques may be integrated; discuss general sources of bias in this research; and show how the use of multiple research methods may be incorporated in formative research for health com munication programs.
The Utilization of Qualitative and Quantitative Data for Health Education Program Planning, Implementation, and Evaluation: A Spiral Approach
Authors: de Vries Hein , Weijts Wies , Dijkstra Margo , Kok Gerjo
Published: February 2007

The process of development of a Dutch smoking prevention project is described. An essential feature of the project is the combination and interaction of qualitative and quantitative research methods. It is advocated that each method has its own contribution and can be considered as a separate methodology contributing to social science in general and health education research in particular. Combining the two approaches in a spiral approach will result in a synergistic effect, because of the interaction of both approaches. The results of both methods suggest that qualitative methods enhanced the generation of ideas and theories. Qualitative methods were used to formulate ideas for improving quantitative data gathering, analyzing and comparing ideas with respect to program development, and for testing the internal validity of a quantitative design. The quantitative method enabled testing of results in different groups and detecting detailed differences. It also provided information that one of the assumptions of the program, the development of a teacher independent program, was not completely realized. The major advantage of using both methods is that this provides feedback between assumptions and data, thus enhancing comparison of results and critical reflection during the whole project.
An Uneasy Alliance: Combining Qualitative and Quantitative Research Methods
Authors: Buchanan David R.
Published: February 2007

The paper describes the difficulties encountered in trying to combine qualitative and quantitative research methods in a study of the relationship between moral reasoning and teenage drug use. Four problems that arose in the attempt to reduce qualitative data to a quantitative format are described. These problems are: (1) making analytic sense of singular responses; (2) a mistaken logical inference that demands that each pattern of judgment should have discrete behavioral indicators; (3) the construction and use of ideal types; and (4) making analytic sense of universal responses. The roots of these problems are then traced to the underlying philosophical premises that distinguish the qualitative and quantitative research paradigms. The implications of the different goals, assumptions, and standards of evaluation informing each of the respective methods for future research are discussed.
A Systems Model of Clinical Preventive Care: An Analysis of Factors Influencing Patient and Physician
Authors: Walsh Judith M. E. , McPhee Stephen J.
Published: February 2007

An ideal model for clinical preventive care must consider the physician, the patient and the many factors which influence each of them. In this paper, we review existing models, examining their strengths and weaknesses. We then propose a new model, the Systems Model of Clinical Preventive Care. This model is unique in its focus on the patient-physician interaction and details the factors impinging on each that promote or inhibit the completion of preventive care activities. These factors include patient and physician predisposing factors, such as health beliefs and attitudes; enabling factors, such as skills and resources; and reinforcing factors, such as social support. Additional factors include health care system organizational factors, such as access or availability; characteristics of the preventive activity, such as cost; and cues to action, such as symptoms or reminders. The proposed model contains components of behavioral, communication, health education and psychosocial theories. We then apply our model to mammography as an example of a screening activity. Finally, we describe the strengths and weaknesses of the proposed model, and identify areas for future research.