bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meaning in the Use of Unconventional Arthritis Therapies
Authors: Arcury Thomas A. , Gesler Wilbert M. , Cook Harold L. 
Published: December 2011

Purpose. To determine the meanings that rural adults have for 11 different unconventional arthritis remedies. Methods. Interviews were conducted with 219 adults from a nonmetropolitan North Carolina county. Open-ended responses to questions surrounding the use of 11 unconventional arthritis therapies were tape recorded and transcribed verbatim. A variable-based approach was used to analyze and interpret these qualitative data. Results. Several themes were present for the different unconventional therapies. The most extensive set of themes was present for religion, which included faith, transformation, communion, self-help, and spiritual healing. The mechanical aspect of rubbing used in the application of several therapies (ointments as well as turpentine) was also an important theme. Skepticism about the effectiveness of the unconventional therapies was another pervasive theme. Conclusions. The respondents had a consistent set of meanings about the unconventional therapies that transcended gender and ethnic groups. Understanding the meanings or belief systems of rural adults is essential to the development of culturally appropriate health education and intervention.
Current Trends in the Integration and Reimbursement of Complementary and Alternative Medicine by Managed Care Organizations (MCOs) and Insurance Providers: 1998 Update and Cohort Analysis
Authors: Pelletier Kenneth R. , Astin John A. , Haskell William L. 
Published: December 2011

Objectives. To assess the status of managed care and insurance coverage of complementary and alternative medicine (CAM) and the integration of such services into conventional medicine. Methods. A literature review and information search was conducted to determine which insurers had special policies for CAM. Telephone interviews were conducted with a definitive sample of 9 out of 10 new MCOs or insurers identified in 1998 and a cohort of eight MCOs and insurers who responded both to the original survey in 1997 and again in 1998 to determine trends. Results. This study constitutes the results of the second year of a 3-year ongoing survey. For 1998, 10 MCOs and insurance carriers initiated CAM coverage. Survey results are analyzed for these 10 new providers as well as the results of a cohort of eight insurers surveyed in both 1997 and 1998 to determine current trends. A majority of the insurers interviewed offer some coverage for the following: nutrition counseling, biofeedback, psychotherapy, acupuncture, preventive medicine, chiropractic, osteopathy, and physical therapy. All new MCOs and insurers said that market demand was their primary motivation for covering CAM. Factors determining whether insurers would offer coverage for additional therapies included potential cost-effectiveness, consumer interest, demonstrable clinical efficacy, and state mandates. Among the most common obstacles listed to incorporating CAM into mainstream health care were lack of research on efficacy, economics, ignorance about CAM, provider competition and division, and lack of standards of practice. Conclusions. Consumer demand for CAM is motivating more MCOs and insurance companies to assess the benefits of incorporating CAM. Outcomes studies for both conventional and CAM therapies are needed to help create a health care system based upon treatments that work, whether they are conventional, complementary, or alternative.
The Effects of an Educational Intervention on Calcium Intake and Bone Mineral Content in Young Women with Low Calcium Intake
Authors: Peterson Britt Ann , Klesges Robert C. , Kaufman Elizabeth M. , Cooper Theodore V. , Vukadinovich Christopher M. 
Published: December 2011

Purpose. This study evaluated whether a combined behavioral and dietary intervention would affect young women's calcium intake and bone mineral content (BMC). Design. The design was a two by three mixed design with one between-subjects factor (treatment vs. control) and one within-subjects factor (time—baseline, 3-month, and 6-month). Setting. The study was conducted in a university setting in Memphis, Tennessee. Participants. A total of 80 premenopausal women (ages 18 to 30) with low baseline calcium intake (< 700 mg/d) were included in the analyses. There were 40 women in the treatment group and 40 women in the control group. Measures. Hertzler and Frary's rapid assessment questionnaire was employed to evaluate calcium intake, and dual-energy x-ray absorptiometry (DEXA) was employed to assess BMC. Results. Repeated measures analysis of variance (RM ANOVA) was employed to analyze results. Results indicated that women in the treatment group made greater increases in total calcium intake and supplemental calcium than women in the control group and that all women made significant increases in dietary calcium intake. Additionally, analyses of BMC revealed that women in the treatment group did not experience significant changes in total BMC, and women in the control group experienced significant losses in total BMC. Conclusions. In the current study, women were losing BMC, and the women who made the largest increases in calcium intake were able to retard this bone loss. There is increasing evidence that dietary calcium intake in young people is extremely low, and the results of the current study highlight the need for much more intensive evaluations investigating the factors that are positively associated with premenopausal bone mineral change.
Effects of Educational Materials concerning Osteoporosis on Women's Knowledge, Beliefs, and Behavior
Authors: Blalock Susan J. , Currey Shannon Smith , DeVellis Robert F. , DeVellis Brenda M. , Giorgino Karen B. , Anderson John J. B. , Dooley Mary Anne , Gold Deborah T. 
Published: December 2011

Purpose. This study examined the effects of brief written educational materials on osteoporosis-related knowledge, beliefs, and behaviors. The study also examined whether observed effects varied as a function of one's stage in the precaution adoption process. Design. The study used an experimental research design. Setting. Participants were identified from North Carolina driver's license records. Subjects. Of the 1476 women in the initial sample, 536 (36.3%) enrolled in the study and 307 completed all follow-up assessments. Intervention. Participants were randomly assigned to one of four groups. One group received an information packet containing general information about osteoporosis. One group received an action plan packet containing instructions on how to increase one's level of exercise and calcium intake. One group received both packets. The final group received neither packet. Measures. Primary study variables were beliefs related to osteoporosis, calcium, and exercise; osteoporosis knowledge; calcium and exercise stage; calcium intake; and exercise level. Results. Overall, receipt of the information packet was associated with changes in knowledge and beliefs (F[18,283] = 2.11, p < .01) irrespective of participants' stage of change. No effects on behavior were observed. Conclusions. These findings suggest that brief written educational materials can facilitate knowledge and belief change but that they do not promote behavior change. The generalizability of these findings is limited by the low study response rate.
Process Tracking Results from the Treatwell 5-a-Day Worksite Study
Authors: Hunt Mary K. , Lederman Ruth , Stoddard Anne , Potter Steven , Phillips Judy , Sorensen Glorian 
Published: December 2011

Purpose. To report findings from Treatwell 5-a-Day process tracking. Design. Worksites were randomly assigned to a minimal intervention control, worksite-only condition, or worksite-plus-family condition. Setting. Twenty-two small community health centers in Massachusetts. Subjects. Employees of the community health centers. Intervention. Both intervention conditions included the formation of employee advisory boards; activities such as nutrition discussions and taste tests targeting individual behavior change; and point-of-purchase labeling as an environmental strategy. Worksite-plus-family sites incorporated activities such as family contests, campaigns, and picnics. Measures. Documentation of the number and type of activities for extent of implementation; number of participants in activities for reach; program awareness and participation from the follow-up employee survey (n = 1306, representing 76% [range, 56%–100%] of the sample); change in fruit and vegetable consumption from a comparison between the follow-up and baseline surveys (n = 1359, representing 87% [range, 75%–100%] of the sample). Results. A higher number of activities per employee was significantly correlated with greater program awareness (. 68; p = . 006) and greater change in fruit and vegetable consumption (.55; p = .04). Greater participation in activities was significantly correlated with greater awareness (.67; p = .007), higher participation (.61; p = .02), and increase in fruit and vegetable consumption. (.55; p = .04). Conclusions. These results provide quantitative indicators of a dose-response relationship between the number of intervention activities per employee and higher percentage of employee participation and observed increases in fruit and vegetable consumption.
Work-Family Spillover and Health during Midlife: Is Managing Conflict Everything?
Authors: Grzywacz Joseph G. 
Published: December 2011

Purpose. To examine the association between multiple dimensions of work-family spillover, and physical and mental health among working midlife adults. Design. Cross-sectional analyses of self reported data. Setting. The National Survey of Midlife Development in the United States (MIDUS), 1995. Subjects. Employed adults aged 35–65 years (n = 1547) who participated in the telephone interview and returned the mail-back questionnaires of the MIDUS (overall response rate of 60.8%). Measures. Independent variables included negative spillover from work to family, positive spillover from work to family, negative spillover from family to work, positive spillover from family to work. Self-rated physical health, chronic conditions, obesity, self-rated mental health, negative psychological well-being, and positive psychological well-being were outcomes. Results. Independent of negative spillover between work and family, more positive spillover from work to family was associated with better physical health (odds ratio [OR] = 1.17, p ≤ .05) and mental health (OR = 1.28, p ≤ .01). More positive spillover from family to work was associated with less chronic conditions (OR = .85, p ≤ . 05), less negative well-being (OR = .67, p ≤ 001), as well as better mental health (OR = 1.45, p ≤ .01) and more positive well-being (OR 1.76, p ≤ 001). Conclusions. Health promotion or employment programs and policies may need to focus on minimizing negative spillover between work and family and promoting positive spillover between work and family.
Effects of Leadership Style and Group Dynamics on Enjoyment of Physical Activity
Authors: Fox Lesley D. , Rejeski W. Jack , Gauvin Lise 
Published: December 2011

Purpose. The primary purpose of this study was to examine the independent and combined effects of leadership style and group dynamics on the enjoyment of physical activity. Design. A completely randomized 2 × 2 factorial design was used in which the manipulation of “leadership style” (socially enriched vs. bland) was crossed with a manipulation of “group dynamics” (socially enriched vs. bland). Setting. The study was conducted in an aerobics studio on a university campus. Subjects. The sample included 48 male and 42 female undergraduate students who were moderately active. Intervention. Each participant was involved in a single session of step aerobics. A female graduate student provided either an enriched or bland series of interactions to manipulate leadership style, and a trained group of planted undergraduates was used to promote either an enriched or bland group environment. Measures. The outcome measures of interest were enjoyment and the probability of engaging in a similar activity in the future. Results. Participants in the enriched leadership style plus enriched group dynamics condition reported higher enjoyment than did participants in the other three conditions. On average, the level of enjoyment was 22.07% higher in this condition than in the other three conditions (p < .001). The probability of future involvement was 13.93% higher for participants in the enriched group environment, irrespective of leadership style (p < .03). Conclusions. Enjoyment during physical activity is optimized when a positive and supportive leadership style is coupled with an enriched and supportive group environment. Future research is required to extend these findings to other activities and populations.
The Impact of the Transcendental Meditation Program on Government Payments to Physicians in Quebec: An Update
Authors: Herron Robert E. , Hillis Stephen L. 
Published: December 2011

Purpose. To determine whether practice of the Transcendental Meditation (TM) technique can affect medical expenses. Design. The evaluation was a quasi experimental, longitudinal, cost-minimization study. Setting. Province of Quebec, Canada. Subjects. This study involved 1418 Quebec health insurance enrollees who practiced the TM technique compared with 1418 subjects who were randomly selected from enrollees of the same age, sex, and region. TM subjects had chosen to begin the technique prior to learning about and choosing to enter the study. Measures. This 14-year, pre- and postintervention study retrospectively assessed government payments to physicians for treating the TM and comparison groups. Other medical expense data for individuals were unavailable. Data were inflation-adjusted. For each subject, least squares regression slopes were calculated to estimate pre- and postintervention annual rates of change in payments. We compared the groups' means and 1%, 5%, and 10% trimmed means (robust estimators) of the slopes. Results. Before starting meditation, the yearly rate of increase in payments between groups was not significantly different (p > .17). After commencing meditation, the TM group's mean payments declined 1% to 2% annually. The comparison group's payments increased up to 11. 73% annually over 6 years. There was a 13. 78% mean annual difference (p = .0017). Conclusions. The results suggest that the TM technique reduced payments to physicians between 5 % and 13 % annually relative to comparison subjects over 6 years. Randomized studies are recommended.
Hispanic Women's Breast and Cervical Cancer Knowledge, Attitudes, and Screening Behaviors
Authors: Ramirez Amelie G. , Suarez Lucina , Laufman Larry , Barroso Cristina , Chalela Patricia 
Published: December 2011

Purpose. This study examined breast and cervical cancer knowledge, attitudes, and screening behaviors among different Hispanic populations in the United States. Design. Data were collected from a random digit dial telephone survey of 8903 Hispanic adults from eight U.S. sites. Across sites, the average response rate was 83%. Setting. Data were collected as part of the baseline assessment in a national Hispanic cancer control and prevention intervention study. Subjects. Analysis was restricted to 2239 Hispanic women age 40 and older who were self-identified as either Central American (n = 174), Cuban (n = 279), Mexican American (n = 1550), or Puerto Rican (n = 236). Measures. A bilingual survey instrument was used to solicit information on age, education, income, health insurance coverage, language use, U.S.-born status, knowledge of screening guidelines, attitudes toward cancer, and screening participation. Differences in knowledge and attitudes across Hispanic groups were assessed by either chi-square tests or analysis of variance. Logistic regression models assessed the influence of knowledge and attitudes on screening participation. Results. The level of knowledge of guidelines ranged from 58.3% (Mexican Americans) to 71.8% (Cubans) for mammography, and from 41.1% (Puerto Ricans) to 55.6% (Cubans) for Pap smear among the different Hispanic populations. Attitudes also varied, with Mexican Americans and Puerto Ricans having more negative or fatalistic views of cancer than Cuban or Central Americans. Knowledge was significantly related to age, education, income, language preference, and recent screening history. Overall, attitudes were not predictive of mammography and Pap smear behavior. Conclusions. Factors related to mammography and Pap smear screening vary among the different Hispanic populations. Limitations include the cross-sectional nature of the study, self-reported measures of screening, and the limited assessment of attitudes. The data and diversity of Hispanic groups reinforce the position that ethno-regional characteristics should be clarified and addressed in cancer screening promotion efforts. The practical relationships among knowledge, attitudes, and cancer screening are not altogether clear and require further research.
Tailoring and Targeting a Worksite Health Promotion Program to Address Multiple Health Behaviors among Blue-Collar Women
Authors: Campbell Marci Kramish , Tessaro Irene , DeVellis Brenda , Benedict Salli , Kelsey Kristine , Belton Leigh , Henriquez-Roldan Carlos 
Published: December 2011

Purpose. This study examined the relationship between health risks, health behaviors, stages-of-change, and behavior change priorities among blue-collar women participating in a worksite health promotion study. Design. Cross-sectional. Setting. Rural manufacturing worksites in North Carolina. Subjects. Participants were 859 women aged 18 and over. Measures. The self-administered questionnaire assessed smoking, exercise, nutrition (fat, fruits, and vegetables), and breast and cervical cancer screening behaviors. In addition, demographics, body weight, perceived health, stages-of-change, and priority for behavior change were measured. Chi-square tests and regression analysis were used to assess statistical significance. Results. Overall, 28% of women smoked, 37% were completely sedentary, 82% consumed less than five daily servings of fruits and vegetables, and the majority were overweight. The dominant stage of change for each of the lifestyle behaviors was contemplation, whereas most women were in the action stage for cancer screening. When asked to prioritize the behavior they most wanted to change, the majority of women chose healthy eating and/or exercise. Conclusions. The findings suggest that blue-collar women in this study had multiple health risks and were interested in changing multiple health behaviors. Allowing women to choose the behavior(s) on which they are ready to focus may be a promising approach to tailoring interventions for this population.
Health Promoting Effects of Friends and Family on Health Outcomes in Older Adults
Authors: Seeman Teresa E. 
Published: December 2011

Objective. To highlight the significant impact of social relationships on health and illness and suggest implications of these effects for health promotion efforts among older adults. Data Sources. Published studies on social relationships and health (or health behaviors) for the period 1970–1998 were identified through MEDLINE by using the key words social relationships, social support, and health, as well as review of health-related journals such as the American Journal of Epidemiology, Annals of Epidemiology, American Journal of Public Health, Journal of Health and Social Behavior, Social Science and Medicine, and the Journals of Gerontology. Study Selection. Major published original research was considered. Where published research was too extensive for full discussion of all studies, preference was given to studies focusing on older adults and those using stronger methodology (i.e., representative samples, longitudinal data, or multivariate analyses controlling for potential confounders). Data Extraction. Reported findings were organized in terms of three major categories: (1) results related to major health outcomes such as mortality, CHD, and depression; (2) findings related to health behaviors; and (3) findings related to potential biological pathways for observed health effects of social relationships. Data Synthesis. Protective effects of social integration with respect to mortality risk among older adults are the most thoroughly documented, although protective effects have also been documented with respect to risks for mental and physical health outcomes and for better recovery after disease onset. There is also now a growing awareness of the potential for negative health effects from social relationships that are characterized by more negative patterns of critical and/or demanding interactions, including increased risks for depression and angina. Biological pathways are suggested by evidence that more negative social interactions are associated with physiological profiles characterized by elevated stress hormones, increased cardiovascular activity, and depressed immune function, whereas more positive, supportive social interactions are associated with the opposite profile. Conclusions. Available data clearly indicate that social relationships have the potential for both health promoting and health damaging effects in older adults, and that there are biologically plausible pathways for these effects. Such evidence suggests that aspects of the social environment could play an important role in future health promotion efforts for older adults, although careful consideration of both potentially positive as well as negative social influences is needed.
Health Promotion for Older Americans in the 21st Century
Authors: Minkler Meredith , Schauffler Helen , Clements-Nolle Kristen 
Published: December 2011

Objectives. To provide a broad overview of the role of the individual, the physical environment, and the social environment on health and functioning in older adults (65 and older), and to highlight interventions and recommendations for action on each of these levels. Data Sources. Published studies and government reports on health and functioning in older Americans and on the individual, social, and physical environmental contributors to health were identified through journal and government documents review and computer library searches of medical and social science data bases for 1980–1999. Study Selection. Preference was given to published studies and government reports that focused specifically on behavioral and environmental contributors and barriers to health promotion in Americans 65 and older and/or that highlighted creative interventions with relevance to this population. Both review articles and presentations of original research were included, with the latter selected based on soundness of design and execution and/or creativity of intervention described. Data Extraction. Studies were examined and their findings organized under three major headings: (1) behavioral risk factors and risk reduction, including current government standards for prevention and screening; (2) the role of the physical environment; and (3) the role of the social environment in relation to health promotion of older adults. Data Synthesis. Although most attention has been paid to the role of behavioral factors in health promotion for older adults, a substantial body of evidence suggests that physical and social environmental factors also play a key role. Similarly, interventions that promote individual behavioral risk reduction and interventions targeting the broader social or physical environment all may contribute to health in the later years. Conclusions. With the rapid aging of America's population, increased attention must be focused on health promotion for those who are or will soon be older adults. Promising intervention strategies addressing the individual, the physical environment, and the social environment should be identified and tested, and their potential for replication explored, as we work toward a more comprehensive approach to improving the health of older Americans in the 21st century.