Showing papers in "Health Education & Behavior in 1981"
TL;DR: The history, commonalities, assumptions, and effects of planned large- scale campaigns to communicate information to the general population to encourage moderation or abstinence in the use of alcohol, drugs, or tobacco are reviewed.
Abstract: The use of mass media has long been an attractive method for implementing and discharging institutional responsibility for the promotion of good health practices and the prevention of various social and health problems. Although there is a long history of such efforts, relatively little is known about the effects such campaigns might have. The large number of programs currently being conceived and implemented on local, state, and federal levels have not benefited as much as they might have from the experience of past mass media efforts. This paper reviews the history, commonalities, assumptions, and effects of planned largescale campaigns to communicate information to the general population to encourage moderation or abstinence in the use of alcohol, drugs, or tobacco. The concept of experimental design is critiqued regarding the appropriateness of such a model for evaluation of mass media campaigns. Suggestions are offered for making evaluations of such campaigns more able to generate useful information for program and planning purposes. This includes expanding evaluation questions through additional forms of inquiry rather than constricting the information obtained through methods based on assumptions of experimental design.
152 citations
TL;DR: There was no cumulative impact of the interventions and different aspects of regimens were not signiticantly related to one another.
Abstract: Low rates of adherence to hypertensive therapy limit patients' securing the full benefits of treatment. While some factors related to adherence have been identified research on the effectiveness of interventions to increase adherence levels is sparse. The present study was designed to assess the impact of a series of different interventions on a group of some 400 patients, all under the care of private physicians in a small community. A factorial design was employed to deliver four, sequential educational interventions, about four months apart, to randomly selected sub-groups. Interviews before and after each intervention provided information concerning self-reported adherence, health status, health beliefs, and personal characteristics. Pertinent medical records and pharmacy data were also obtained. The first intervention - printed material - did not significantly affect adherence. The second and fourth interventions - nurse telephone calls and social support - each increased medication taking and the third intervention - self-monitoring - led to better weight control. There was no cumulative impact of the interventions and different aspects of regimens were not significantly related to one another.
74 citations
TL;DR: This paper has been prepared to review, synthesize, and apply current and relevant information about educational innovations and social change to provide a conceptual base for the design, execution, and analysis of efforts to implement health education in schools.
Abstract: The effectiveness of health education is ultimately determined by whether it is implemented, and how it is implemented. Although a given health education innovation may be designed and experimentally assessed to promote well-being with some measure of effectiveness and efficiency, the actual impact of the innovation will depend upon the manner in which it is disseminated, initiated, and maintained. The implementation of health education programs in schools or elsewhere is a function of the types of innovations available, certain characteristics of those innovations that influence their use, and the manner in which the innovations are brought into practice. This paper has been prepared to review, synthesize, and apply current and relevant information about educational innovations and social change to provide a conceptual base for the design, execution, and analysis of efforts to implement health education in schools. The American system of public and private schools could be an agent vitally important to the realization of a second public health revolution. Indeed, in a democratic society, the implementation of health education in schools seems a condition necessary for such a revolution. By analyzing and learning from our own health education efforts, as well as the efforts of those experienced with implementing other types of educational innovations in schools, we might ensure that future populations are informed sufficiently about factors that influence their health and well-being.
70 citations
TL;DR: Attention is focused on the need for looking beyond social networks to the social policy and environmental contexts within which they operate, and the importance of facilitating change in those social and institutional policies which mitigate against network development and maintenance among the elderly.
Abstract: The large body of evidence linking social support and health provides an important supplement to earlier theory and research suggesting the more direct role social contacts may play in influencing health behavior. Three major hypotheses have been set forth concerning the precise mechanism of action through which social support may work to maintain health and decrease susceptibility to illness. Each of these theoretical positions is described and its empirical base examined. The particular relevance of social support theory for work with the elderly is discussed. The concept of social marginality, and such network properties as strength of ties, reciprocity and network size are examined in light of their implications for the design of programs aimed in part at fostering social support among the elderly. Several examples of innovative health education programs are used to illustrate the relevance of different theoretical principles in practice settings. Attention finally is focused on the need for looking beyond social networks to the social policy and environmental contexts within which they operate. Facilitating change in those social and institutional policies which mitigate against network development and maintenance among the elderly is suggested as an important task for health education theorists and practitioners.
56 citations
TL;DR: Preliminary findings in a convenience sample of one half the population enrolled in a study of self-management in low income families where a child has asthma report significantly less fear and anxiety associated with their children's wheezing episodes than did control families.
Abstract: This paper reports preliminary findings in a convenience sample of one half the population enrolled in a study of self-management in low income families where a child has asthma. In initial evaluation data, parents participating in self-management education reported significantly less fear and anxiety associated with their children's wheezing episodes than did control families. They also reported that their children exhibited fewer signs of stress during wheezing episode. A trend toward reduced school absences and emergency room visits was noted among participating families. The actions taken by a family to manage the illness increased with the number of sessions attended.
53 citations
TL;DR: There is clear evidence that the addition of an epidemiologic cause/effect dimension to school health education is consistent both with the tenets of major educational philosophers as well as the goals of health education as stated by scholars in the field.
Abstract: We have tried to raise several issues in this paper. First, schools are very complex systems. It is as difficult to generalize about schools as it is to generalize about the children in them. Second, because of this complexity, any serious discussion of outcomes resulting from any educational program requires a commitment to specificity in problem identification and planning. Third, the current national interest in health promotion, disease prevention and risk reduction has given rise to a greater emphasis on the principles of epidemiologic analysis. This kind of analysis facilitates a focus on outcomes which are, to varying degrees, contributing factors to specific health problems. Fourth, while there are those who fear that this emphasis may compromise the traditional goals of schools, there is clear evidence that the addition of an epidemiologic cause/effect dimension to school health education is consistent both with the tenets of major educational philosophers as well as the goals of health education as stated by scholars in the field. Fifth, the process of decision-making (the assessment of which is admittedly primitive at this point) represents the bridge across which the science of epidemiology can cooperatively join hands with the art of education toward the goal of enhancing the competence of children and youth.
22 citations
TL;DR: When I attended high school, the authors were required to complete a four month health course taught by an athletics instructor who perceived his assignment as a disagreeable chore.
Abstract: Health education has often been sadly neglected in the public schools. When I attended high school, we were required to complete a four month health course taught by an athletics instructor who perceived his assignment as a disagreeable chore. Everyone could easily pass the course by memorizing a few simple facts and words. We students were beginning to make decisions that could influence our health, but most of us failed to see the relevance of the information that was presented in health education classes. We were eager to communicate frankly with one another, and many erroneous notions concerning drugs and sexual conduct
19 citations
TL;DR: This paper examines factors which may influence successful preventive health education for all persons and especially poor persons and includes cognitive factors, affective factors and skills.
Abstract: This paper examines factors which may influence successful preventive health education for all persons and especially poor persons. The discussion is organized within a tramework which includes cognitive factors, affective factors and skills. Types of health information and methods for information dissemination are discussed within the cognitive area. The discussion of emotional responses to preventive care examines organizational and individual factors which may be related to utilization. Finally, specific skills which enable an individual to utilize services are defined. Within each section a general presentation is followed by a discussion of implications for poor populations.
14 citations
TL;DR: The previous national conference on school health sponsored by the Public Health Service was the 1977 meeting in Minneapolis, convened by the School of Public Health at the University of Minnesota under a grant from the Office of Maternal and Child Health (BCHS).
Abstract: The previous national conference on school health sponsored by the Public Health Service was the 1977 meeting in Minneapolis, convened by the School of Public Health at the University of Minnesota under a grant from the Office of Maternal and Child Health (BCHS). At that meeting, Dr. Vince Hutchins reflected on the similarity of the recommendations and proceedings of the 1977 meetings to those of a federally sponsored meeting 30 years earlier, in 1945. The 1945 report boiled matters down to three things that must happen:
14 citations
12 citations
TL;DR: Based in part on Chapter 1 from Guidelines for Health Education and Promotion Services: Completing an HMO Program Washington, D.C.: Office of Health Information, Health Promotion, and Physical Fitness and Sports Medicine, Department of Health and Human Services, 1981.
Abstract: Based in part on Chapter 1 from Guidelines for Health Education and Promotion Services: Completing an HMO Program Washington, D.C.: Office of Health Information, Health Promotion, and Physical Fitness and Sports Medicine, Department of Health and Human Services, 1981 and on Mullen’s background paper for the Select Panel for the Promotion of Child Health, \"Behavioral Aspects of Maternal and Child Health: Natural Influences and Educational Interventions\" in Better Health for Our Children, v. 4, Background Papers, Washington DC: Government Printing Office, 1981. The authors’ work on this paper was in their private capacities, and no official endorsement by the Department of Health and Human Services is intended or should be inferred.
TL;DR: Dr. Zimmerli is Director of the Health Education Resource Center, University of Maine at Farmington, and has helped establish health education programs in hospitals, ambulatory care centers, workplaces, and communities at large-as well as schools.
Abstract: Dr. Zimmerli is Director of the Health Education Resource Center, University of Maine at Farmington. One-third of all students in Maine schools now have greatly increased opportunities to learn how to protect and improve their health. Comprehensive school health education programs have been developed since 1977 in 29 school districts that serve about 70,000 students. Some programs cover all grades from kindergarten through senior high school; others serve only part of the school system. This activity has been guided by the Health Education Resource Center (HERC), which is located at the University of Maine at Farmington. The overall mission of H E RC is to work as a catalyst in facilitating development of health education services that are acceptable, accessible, comprehensive, coordinated, and effective. HERC has helped establish health education programs in hospitals, ambulatory care centers, workplaces, and communities at large-as well as schools. Using Federal Maternal and Child Health funds made available through the Maine Department of Human Services, HERC provided grants on a competitive basis to local school districts for planning and carrying out three year health education demonstrations. Interested school districts submitted proposals to HERC and those selected hired their own health education coordinators. Af-
TL;DR: Solid, though unspectacular, growth of the HMO concept and its concomitant health education components is noted in the 1970s and is expected to continue through the 80s, while two strategies for containment, competition and regulation, are examined.
Abstract: Solid, though unspectacular, growth of the HMO concept and its concomitant health education components is noted in the 1970s. This trend is expected to continue through the 80s. The overarching priority concern in this decade is cost containment. Two strategies for containment, competition and regulation, are examined for their health education implications. The growth of IPA's brings forth problems in the delivery of health education services within that type of HMO. Other implications and issues within health education practice are identified. These include multiple definitions of health education, the interactive behavioral model, incongruent values among professionals, the relationship of patient education to the quality of care, the marginality of health education, financing, and consumer rights. Realistic, immediate expectations coupled with strong vision of the future potential for health education is urged.
TL;DR: The Panel is still in the process of hammering their recommendations, but I can give an idea of the terrain and the points of major emphasis the report will cover, and the report entitled Better Health for The authors' Children: A National Strategy is to be presented to Congress and to the Secretary of Health and Human Services on December second.
Abstract: Dr. Mullen is a Consultant to the Select Panel for the Promotion of Child Health at the Office of Health Promotion. Reprint requests should be addressed to her at Office of Health Promotion, Room 721B, Humphrey Building, 200 Independence Avenue, S. W., Washington, D. C. 20201. The origins of the Select Panel for the Promotion of Child Health are in legislation enacted by the Congress nearly two years ago, providing that a broadly representative group of citizens be appointed by the Secretary of HEW to develop &dquo;a comprehensive plan to promote the health of children and pregnant women in the United States ... and to recommend such administrative, legislative, and other actions it deems appropriate to implement this plan.&dquo; Although the Panel is still in the process of hammering our their recommendations, I can give you an idea of the terrain and the points of major emphasis the report will cover. The report entitled Better Health for Our Children: A National Strategy is to be presented to Congress and to the Secretary of Health and Human Services on December second. In addition to a full volume of discussion and policy recommendations, there will be coverage of
TL;DR: Donna H. Dean is the Regional Health Educator at the Oregon Region Kaiser-Permanente Medical Care Program in Portland, Oregon and writes about how work is an integral part of both personal and professional life.
Abstract: Donna H. Dean is the Regional Health Educator at the Oregon Region Kaiser-Permanente Medical Care Program in Portland, Oregon. Reprint requests to Donna H. Dean, 11295 S.W. Meadowbrook Drive, Apt. 1, Tigard, Oregon 97223. Working Americans spend 36% of their lives &dquo;on the job.&dquo; Countless hours are also spent preparing for work, commuting to and from work, recuperating after work or vacationing from work. We are dominated by our work. Work is an integral part of both
TL;DR: Survey findings show that certain program areas such as nutrition educa tion and weight reduction programs have received greater emphasis than other patient education areas.
Abstract: A questionnaire was mailed to all HMOs which were either federally qualified or applying for federal qualification, as of May 1978. The survey, which attained a 77% response rate, collected information on the frequency, providers, methods and health problem areas of health edu cation programs in HMOs as well as other health education information. Survey findings show that certain program areas such as nutrition educa tion and weight reduction programs have received greater emphasis than other patient education areas. Certain organizational factors are shown to be useful in describing differences in plans' commitments to health educations. Recommendations are made for further research to identify clearer relationships between health education and other HMO character istics. HMOs are recommended to assess the health education needs of their memberships and to educate staff regarding their own health risks, health education skills and member expectations and rights.
TL;DR: When the authors turn to the question of the influence of mass media on the health of childrec, they very quickly come to focus on television, the first mass medium to reach children.
Abstract: When we turn to the question of the influence of mass media on the health of childrec, we very quickly come to focus on television. Television, of course, is only one among the many media-magazines, newspapers, comic books, radio, recordings, and movies-that touch on the lives of children. Nevertheless, television stands first in so many respects that, if it would be inaccurate to say that it stands alone it is absolutely correct to say that it is preeminent. Television is the first mass medium to reach children. It will, throughout their childhood and adolescence, consume more time than the classrooms of our schools and universities. Long before they will be able to attach the proper label to what they have seen, television will have introduced them to comedy, drama, news, and advertising. Its successful men and women will become their heroes and heroines, and its slogans and catchwords will enter their language. As they get older, they will turn more and more frequently to magazines and newspapers, and they will devote more and more hours to radio, to recordings, and going to the movies. Yet even then television will remain central, and when we look over the sweep of childhood and adolescence there is no question that it is television that principally commands our attention. Now the past decade has seen a remarkable change in public attitudes toward children and television. Since television joined the furniture in the American home in the 1950s, it has been a source of alarm and the target of criticism in regard to its possible influ-
TL;DR: The evolution of a school health program in Cambridge, Massachusetts has moved from the traditional approach to one that can be viewed as a model of primary care for preschool and school-age children who lack other sources of care.
Abstract: I wish to describe the evolution of a school health program to a primary care service for children. I n the last decade, school health in Cambridge, Massachusetts has moved from the traditional approach to one that can be viewed as a model of primary care for preschool and school-age children who lack other sources of care. This has been accomplished by integrating all public programs of child health services, by extending the role of the school nurse, and by establishing linkages to a senior group of hospital-based pediatricians. Cambridge is a city, unto itself, located across the Charles River from Boston with a population of 102,000; 16,000 of whom are children under the age of 16. In very broad socioeconomic terms, there are two communities: the western half of the city is university-affiliated, well-educated, and has been served for years by the private practice of medicine; the eastern half of Cambridge, numbering about 60,000 people, is not university-affiliated, has few practicing physicians, and the children in this community have not received comprehensive pediatric services. In 1965, the Harvard Medical School entered into an affiliation with the Cambridge City Hospital and faculty members were appointed in the clinical departments. I
TL;DR: There is a fundamental reason why the fields of public health education and health administration should integrate their curricula much more closely.
Abstract: Nicholas Parlette is Associate Dean, School of Public Health, University of California at Berkeley. Eli Glogow is Associate Professor, School of Public Administration, University of Southern California, Los Angeles. Carol D’Onofrio is Associate Professor, School of Public Health, University of California at Berkeley. Address reprint requests to N. Parlette, 36 Sereno Circle, Oakland, CA 94619. There is a fundamental reason why the fields of public health education and health administration should integrate their curricula much more closely. It is simply a recognition of reality. In
TL;DR: An empirical three-stage model is proposed as a generic development process that proposes more sophisticated and complex programmatic content evolving as the initial strategic organizational issues are resolved.
Abstract: With no standards for comparison, expectations for health education programs and judgments of their success are subjective. Regardless of initial differences in variables such as starting point of the program, resource allotment, and organizational characteristics and structures, all health education programs have some similar goals and development processes. The goals are: the need to establish long-term relationships, gain visibility, and appeal to the dominant domains within the organization in order to survive. An empirical three-stage model is proposed as a generic development process. The stages, formation, action, and stabilization, propose more sophisticated and complex programmatic content evolving as the initial strategic organizational issues are resolved.