Showing papers in "Health Education & Behavior in 2001"
TL;DR: Ethical issues raised by the use of photovoice are addressed: the potential for invasion of privacy and how that may be prevented; issues in recruitment, representation, participation, and advocacy; and specific methodological techniques that should be used to minimize participants’ risks and to maximize benefits.
Abstract: Photovoice is a participatory health promotion strategy in which people use cameras to document their health and work realities. As participants engage in a group process of critical reflection, they may advocate for change in their communities by using the power of their images and stories to communicate with policy makers. In public health initiatives from China to California, community people have used photovoice to carry out participatory needs assessment, conduct participatory evaluation, and reach policy makers to improve community health. This article begins to address ethical issues raised by the use of photovoice: the potential for invasion of privacy and how that may be prevented; issues in recruitment, representation, participation, and advocacy; and specific methodological techniques that should be used to minimize participants' risks and to maximize benefits. The authors describe lessons learned from the large-scale Flint Photovoice involving youth, adults, and policy makers.
708 citations
TL;DR: The success of the two sun protection programs is described as having been built on two key foundations: the vital integration of research and evaluation, on one hand, and a strong basis of consistency and continuity, on the other.
Abstract: The Anti-Cancer Council of Victoria has been running sun protection programs for more than 20 years: Slip! Slop! Slap! from 1980 to 1988 and SunSmart from 1988 to the present. The Victorian Health Promotion Foundation has provided funding for the SunSmart program for the past 13 years. These programs have played an important role in changing the whole society's approach to the sun and have resulted in marked reductions in sun exposure. This article describes the social, political, economic, and organizational context within which these programs developed. Then 10 areas are discussed that illustrate a critical aspect of the development and implementation of this successful systemwide health promotion program. These areas focus on key aspects of the context within which the program operates and on issues that derive from the experience of implementing program strategies. In summary, the success of the two programs is described as having been built on two key foundations: the vital integration of research and evaluation, on one hand, and a strong basis of consistency and continuity, on the other.
357 citations
TL;DR: Positive independent associations with smoking and drinking were found for direct peer pressure and associating with problem-behaving friends and for parent involvement, parent expectations, and parent regard.
Abstract: Social influences can promote or discourage adolescent substance use. The authors surveyed 4,263 sixth- to eighth-grade students to assess the effect of peer and parent influences on adolescent substance use. The authors conducted separate multiple logistic regression analyses for smoking and drinking, controlling for grade, sex, and race. Positive independent associations with smoking and drinking were found for direct peer pressure and associating with problem-behaving friends. Independent negative associations with smoking and drinking were also found for parent involvement, parent expectations, and parent regard. In an analysis of interactions, peer pressure was positively associated with drinking for girls but not for boys and problem-behaving friends was positively associated with drinking for both boys and girls. The findings are consistent with the hypothesis that associating with deviant peers promotes and that authoritative parenting protects against smoking and drinking.
348 citations
TL;DR: Findings from a 5-year study of 637 children with asthma and their care-taking parents supported that the self-regulation elements of the model were reasonably stable over time and baseline values were predictive of important disease management outcomes.
Abstract: Chronic disease poses increasing threat to individual and community health. The day-to-day manager of disease is the patient who undertakes actions with the guidance of a clinician. The ability of the patient to control the illness through an effective therapeutic plan is significantly influenced by social and behavioral factors. This article presents a model of patient management of chronic disease that accounts for intrapersonal and external influences on management and emphasizes the central role of self-regulatory processes in disease control. Asthma serves as a case for exploration of the model. Findings from a 5-year study of 637 children with asthma and their care-taking parents supported that the self-regulation elements of the model were reasonably stable over time and baseline values were predictive of important disease management outcomes.
204 citations
TL;DR: The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem.
Abstract: Over the past two decades, household food insecurity has emerged as a significant social problem and serious public health concern in the “First World.” In Canada, communities initially responded by establishing ad hoc charitable food assistance programs, but the programs have become institutionalized. In the quest for more appropriate and effective responses, a variety of community development programs have recently been initiated. Some are designed to foster personal empowerment through self-help and mutual support; others promote community-level strategies to strengthen local control over food production. The capacity of current initiatives to improve household food security appears limited by their inability to overcome or alter the poverty that under-pins this problem. This may relate to the continued focus on food-based responses, the ad hoc and communitybased nature of the initiatives, and their origins in publicly funded health and social service sectors.
193 citations
TL;DR: Researchers and practitioners conducting health survey research with college students or other homogeneous populations who have access to e-mail and the Web should consider using a Web-based survey design as an alternative to a mail, self-administered survey.
Abstract: This study examined the feasibility of collecting health risk behavior data from undergraduate students using a Web-based survey. Undergraduates were randomly selected and assigned randomly to a mail survey group and a Web survey group. There were no statistically significant differences between the two groups for demographics, response rates, item completion, and item completion errors. Yet differences were found for response time and sensitive item completion. This is the first study to demonstrate the feasibility of collecting health risk behavior data from undergraduates using the Web. Undergraduates are just as likely to respond to a Web survey compared with a mail survey and more likely to answer socially threatening items using this method. Also, the Web format and protocol required less time to administer. Researchers and practitioners conducting health survey research with college students or other homogeneous populations who have access to e-mail and the Web should consider using a Web-based survey design as an alternative to a mail, self-administered survey. In such a population, a Web-based survey should not discourage participation, particularly if participants are interested in the questionnaire content.
180 citations
TL;DR: The authors argue that using theory to investigate the full spectrum of determinants offers a more complete range of intervention and research options for maximizing employee and worksite levels of participation.
Abstract: Low participation at the employee or worksite level limits the potential public health impact of worksite-based interventions. Ecological models suggest that multiple levels of influence operate to determine participation patterns in worksite health promotion programs. Most investigations into the determinants of low participation study the intrapersonal, interpersonal, and institutional influences on employee participation. Community- and policy-level influences have not received attention, nor has consideration been given to worksite-level participation issues. The purpose of this article is to discuss one macrosocial theoretical perspective--political economy of health--that may guide practitioners and researchers interested in addressing the community- and policy-level determinants of participation in worksite health promotion programs. The authors argue that using theory to investigate the full spectrum of determinants offers a more complete range of intervention and research options for maximizing employee and worksite levels of participation.
180 citations
TL;DR: A emic perspective of how a diverse sample of adults conceptualize and manage healthy eating is provided, exposing the implicit and multiplistic nature of healthy eating conceptions provides information useful to health educators promoting behavior changes.
Abstract: This study sought to enhance understanding of how people conceptualize and manage healthy eating. An interpretivist approach employed the constant comparative method to analyze 79 open-ended interviews with individuals about food choices and eating behaviors for health-related themes. Participant reports depicted cognitive systems for defining healthy eating, where personal meanings evolved through ongoing exposure to a variety of experiential and informational sources. Participants' definitions of healthy eating clustered around seven themes forrelating food and eating to their personal health. Healthy eating definitions shaped how participants categorized food and eating situations as healthy and unhealthy. Participants described healthy eating strategies that were differentially associated with various healthy eating themes. These findings provide an emic perspective of how a diverse sample of adults conceptualize and manage healthy eating. Exposing the implicit and multiplistic nature of healthy eating conceptions provides information useful to health educators promoting behavior changes.
174 citations
TL;DR: Findings support and extend previous findings, reliably cluster residents by the degree of connectedness in their participatory experiences, and reveal that social cohesion is related to intrapersonal empowerment.
Abstract: Empowerment theory represents an expansive view of individual and collective behavior that includes the active participation of individuals and groups in altering and shaping the socioenvironmental context. Critical to health educators are local interventions that yield participation of community members and empowerment for participants. The concept of social cohesion embraces participation but expands this behavioral emphasis to incorporate notions of trust, connectedness, and civic engagement. This study presents two data sets on the relationship of participation to empowerment. The first replicates and extends previous research by examining participation with interactional as well as intrapersonal empowerment. Second is the examination of how the quality of the participatory experience--the cohesive nature of participation--is related to interactional and intrapersonal empowerment. Findings support and extend previous findings, reliably cluster residents by the degree of connectedness in their participatory experiences, and reveal that social cohesion is related to intrapersonal empowerment.
162 citations
TL;DR: Inclusion of ethnicity in the design showed that the program, when administered by specialists, had delayed effects on mediating variables for African American and Hispanic students, however, no consistent effects were found for student problem behaviors in either condition.
Abstract: The effects of All Stars, a character education and problem behavior prevention program, on variables theorized to mediate problem behaviors and on the problem behavior variables of substance use, sexual behavior, and violence among middle school students are reported. In an independent, randomized, single-cohort, longitudinal evaluation of the program, 1,655 students completed pretest, posttest, and 1-year follow-up surveys measuring demographics, mediating variables, and behavioral outcome variables. Results indicate that the All Stars program, when administered by teachers, had an immediate effect on mediating variables that did not persist over time. Inclusion of ethnicity in the design showed that the program, when administered by specialists, had delayed effects on mediating variables for African American and Hispanic students. However, no consistent effects were found for student problem behaviors in either condition. Implications for prevention practice and directions for future research are discussed.
148 citations
TL;DR: Qualitative, key informant interviews with 41 people involved at all levels of community-based research projects in Seattle found Meaningful collaboration between communities and researchers is characterized by early involvement of communities, power sharing, mutual respect, community benefit, and cultural sensitivity.
Abstract: In the process of initiating a new community-based research project, the authors wanted to understand the experiences of community members and researchers in community-based research projects and to develop guidelines to improve future projects. They conducted qualitative, key informant interviews with 41 people involved at all levels of community-based research projects in Seattle. Respondents were identified using a snowball sampling technique. More problems than successes were discussed by informants, including dissatisfaction with the focus of research, which some said is marked by a lack of cultural appropriateness and relevance. Power imbalances, lack of trust, and communication difficulties impeded collaboration. According to respondents, many problems could be avoided if the community were involved from the beginning in setting research priorities and developing and implementing interventions. Meaningful collaboration between communities and researchers is characterized by early involvement of communities, power sharing, mutual respect, community benefit, and cultural sensitivity.
TL;DR: Examination of factors that contribute to the delayed use of medical care among Hispanics when chronic disease–related symptoms (warning signs) occur finds faith in God and seriousness of symptoms both are related to the search for a doctor one can trust.
Abstract: This study examines factors that contribute to the delayed use of medical care among Hispanics when chronic disease-related symptoms (warning signs) occur. As an adjunct to a larger project funded by the National Cancer Institute, this study accessed a population of primarily Hispanic, mostly male employees at public work sites in two Arizona counties. Through focus groups and a survey of employees, a model describing the factors underlying health care use was tested. Seriousness of symptoms has the most effect on visits to doctor, with more serious symptoms leading to prompter visits. Faith in God and seriousness of symptoms both are related to the search for a doctor one can trust. Also, a cluster of variables describing past bad experiences, practical barriers, and emotional avoidance are related to the desire to get advice or medical help from someone who is close; these influence the search for a trusted doctor, which in turn leads to prompter visits to doctor.
TL;DR: This article describes and accounts for how system-level changes have been made in schools through a process of capacity building, and encourages teachers, parents, and students to view the core business of education differently.
Abstract: The Gatehouse Project is an innovative, comprehensive approach to mental health promotion in secondary schools. It sets out to promote student engagement and school connectedness as the way to improve emotional well-being and learning outcomes. The key elements of the whole-school intervention are the establishment and support of a school-based adolescent health team; the identification of risk and protective factors in each school’s social and leaning environment from student surveys; and, through the use of these data, the identification and implementation of effective strategies to address these issues. The project evaluation used a cluster-randomized controlled trial design involving 26 schools with initial results demonstrating considerable success in reducing smoking rates among Year 8 children. This article describes and accounts for how system-level changes have been made in schools through a process of capacity building. This encourages teachers, parents, and students to view the core business of...
TL;DR: The nature of media advocacy is explored, with differences between the conceptualization of routine “programmatic” public health interventions and the modus operandi ofMedia advocacy highlighted.
Abstract: Australia has one of the world’s most successful records on tobacco control. The role of public health advocacy in securing public and political support for tobacco control legislation and policy and program support is widely acknowledged and enshrined in World Health Organization policy documents yet is seldom the subject of analysis in the public health policy research literature. Australian public health advocates tend to not work in settings where evaluation and systematic planning are valued. However, their day-to-day strategies reveal considerable method and grounding in framing theory. The nature of media advocacy is explored, with differences between the conceptualization of routine “programmatic” public health interventions and the modus operandi of media advocacy highlighted. Two case studies on securing smoke-free indoor air and banning all tobacco advertising are used to illustrate advocacy strategies that have been used in Australia. Finally, the argument that advocacy should emanate from com...
TL;DR: Schoolwide changes in condom use demonstrated that a school-based program can reduce the sexual risk behavior of adolescents.
Abstract: Few studies have tested schoolwide interventions to reduce sexual risk behavior, and none have demonstrated significant schoolwide effects. This study evaluates the schoolwide effects of Safer Choices, a multicomponent, behavioral theory–based HIV, STD, and pregnancy prevention program, on risk behavior, school climate, and psychosocial variables. Twenty urban high schools were randomized, and cross-sectional samples of classes were surveyed at baseline, the end of intervention (19 months after baseline), and 31 months after baseline. At 19 months, the program had a positive effect on the frequency of sex without a condom. At 31 months, students in Safer Choices schools reported having sexual intercourse without a condom with fewer partners. The program positively affected psychosocial variables and school climate for HIV/STD and pregnancy prevention. The program did not influence the prevalence of recent sexual intercourse. Schoolwide changes in condom use demonstrated that a school-based program can red...
TL;DR: Results of a principal components analysis conducted to investigate the interrelationships between these individual measures suggest that these measures measure separate phenomena.
Abstract: This study examined how different measures of individual perceptions of community social dynamics relate to each other and how these measures relate to self-reported general health and depressive symptoms. Results of a principal components analysis conducted to investigate the interrelationships between these individual measures suggest that these measures measure separate phenomena. In addition, in results of multiple-regression analyses conducted to examine associations between the various measures of individual perceptions of community social dynamics and the dependent variables of self-reported general health and depressive symptoms, sense of community, perceived neighborhood control, and neighborhood participation were all associated with the outcome variables in separate regression models. In a regression model with these three variables added to control variables, only sense of community was significantly, albeit modestly, associated with depressive symptoms and self-reported general health.
TL;DR: If evidencebased interventions are not disseminated, the interventions will not achieve their potential and the goal should be to develop more effective interventions and disseminate them to improve the public’s health.
Abstract: Evidence is fundamental to science, but finding the right evidence in health education and health behavior (HEHB) is often a challenge. The authors discuss some of the controversies about the types of evidence that should be considered acceptable in HEHB, the tension between the use of qualitative versus quantitative data, the need for measures of important but neglected constructs, and interpretation of data from experimental and nonexperimental research. This article discusses some of the challenges to the use of evidence and describes a number of strategies and some forces encouraging the use of evidence-based interventions. Finally, the authors suggest ways to improve the practice and dissemination of evidence-based HEHB. Ultimately, if evidence-based interventions are not disseminated, the interventions will not achieve their potential. The goal should be to develop more effective interventions and disseminate them to improve the public's health.
TL;DR: The findings show that health education activities brought home from school by children can positively influence parents’ self-management of a complex chronic disease such as asthma.
Abstract: The Open Airways for Schools (OAS) program has been shown to improve the self-management skills and health outcomes of students with asthma in Grades 3 to 5. This report examines the impact of OAS on students’ parents. Because pilot studies showed that parental attendance at school-based sessions was low, the authors held six sessions at school for children and gave children homework assignments to complete with parents at home to teach parents about asthma and build support for children’s self-management efforts. Analysis of 1-year follow-up data showed that children’s participation in OAS was a significant predictor of parental self-management skills (p < .03) and that OAS children’s communication was more strongly associated than controls’ with parents’ self-management (p = .05). The findings show that health education activities brought home from school by children can positively influence parents’ self-management of a complex chronic disease such as asthma.
TL;DR: A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.
Abstract: Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.
TL;DR: Findings of a multisite case study of the experience of nine federal Healthy Start Program sites in using consortia and other community involvement strategies in the fight against infant mortality are presented.
Abstract: This article presents findings of a multisite case study of the experience of nine federal Healthy Start Program sites in using consortia and other community involvement strategies in the fight against infant mortality. Using empowerment theory as a conceptual framework, qualitative data are employed to examine how community involvement in the program through community-based consortia and other means contributed to empowerment at the organizational level. The article concludes with implications of the study findings for practice both within Healthy Start and in the context of other community-based health initiatives.
TL;DR: The researchers used grounded theory methodology to study the implementation of a school-based alcohol and drug prevention project in secondary schools in British Columbia, Canada and found that preventionworkers encountered many practical dilemmas.
Abstract: The researchers used grounded theory methodology to study the implementation of a school-based alcohol and drug prevention project in secondary schools in British Columbia, Canada. Prevention workers (PWs) were responsible for working with school and community personnel in a collaborative process to develop, implement, and evaluate prevention strategies in the school using an adaptation of the Precede-Proceed Model for health promotion planning. Before they could begin to do this, PWs had to establish their credibility in the school. Once accepted, the focus of the PWs' work was to reconcile the goals, values, and philosophy of the project with those of the school. In doing so, PWs encountered many practical dilemmas. The challenges in resolving these dilemmas are presented, and the implications for policy and practice are discussed.
TL;DR: Physical activity and eating a traditional diet were viewed as important for preventing diabetes and were used to develop a diabetes prevention home visit intervention currently being implemented and evaluated in Marshallese households.
Abstract: Formative research was conducted in the Republic of the Marshall Islands to help develop a diabetes prevention intervention. Methods included in-depth interviews, semistructured interviews, and direct observation of household behaviors in urban and remote settings. Foods were classified into two main conceptual spheres: foods from the islands/Marshallese foods and imported/American foods. Diabetes (nanimij in tonal) is a highly salient illness and is believed to be caused by foods high in fat and sugar, consumption of imported/American foods, family background, and the atomic bomb testing. Physical activity and eating a traditional diet were viewed as important for preventing diabetes. The traditional belief system links a large body with health, and a thin body with illness; however, perceptions are changing with increased acculturation and education about the health risks of obesity. These findings were used to develop a diabetes prevention home visit intervention currently being implemented and evaluated in Marshallese households.
TL;DR: By using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies, thus reducing exposure to environmental tobacco smoke.
Abstract: To facilitate the banning of tobacco industry sponsorship, Australian health promotion foundations were established to provide health sponsorship to sport, arts, and racing organizations. Health sponsorship dollars procure health sponsorship benefits such as naming rights, signage, personal endorsement of a (health) product by a performer or player, and structural controls such as smoke-free policies. Data are presented from surveys and observations of spectators attending events sponsored by the West Australian Health Promotion Foundation (Healthway) and surveys of Healthway-sponsored organizations and the community. The results demonstrate that by using health sponsorship, Healthway increased the prevalence of smoke-free policies in recreational settings, and there was growing support for these policies. There was evidence of good compliance with smoke-free policies, thus reducing exposure to environmental tobacco smoke. The introduction of smoke-free policies in recreational settings has involved working collaboratively with sectors outside of health, taking an incremental approach to change, and gaining the support of stakeholders by communicating evaluation results.
TL;DR: Correlates varied by whether program initiation, program completion, or the number of activities completed was the indicator of participation, and participation was higher if the adolescent felt strongly attached to the parent and if parents did not smoke.
Abstract: This study examined correlates of program initiation and completion in a family-directed program that involved families of adolescents throughout the United States. Correlates varied by whether program initiation, program completion, or the number of activities completed was the indicator of participation. In final regression models, participation was relatively likely by non-Hispanic whites when compared with persons of race/ethnicity other than white, black, and Hispanic; by families with a female adolescent as the program recipient; by families with mothers who had many years of education; and by families with both parents living in the household. There was more participation if parents thought their child would smoke in the future and if the parent thought the adolescent did not smoke currently. Participation was higher if the adolescent felt strongly attached to the parent and if parents did not smoke. The findings are considered in the context of similar programs and future research on family-direct...
TL;DR: The Start Right–Eat Right award scheme implemented in Western Australia has been used to provide the incentive to bring about improvement in food service in line with government policy and regulations in the child care industry.
Abstract: The Start Right-Eat Right award scheme implemented in Western Australia has been used to provide the incentive to bring about improvement in food service in line with government policy and regulations in the child care industry. Theories of organizational change were used to identify processes and strategies to support the industry in translating policy into practice. A baseline survey of food service management practices, as well as process evaluation, informed action and identified barriers. Impact evaluation demonstrated that the award scheme could bring about improvements in the quality of food service; 80% of centers made changes to their menus as a result of participating. Two years postlaunch, 40% of centers have registered in the scheme. The diffusion of innovation theory is used to explain uptake and discuss results. The success of the scheme was based on four factors: an understanding of the industry, collaboration between the child care industry and government, supporting resources, and incentives.
TL;DR: Estimates of school-level intraclass correlation for dietary measures based on data from the Teens Eating for Energy and Nutrition at School study are presented, showing how to use the estimates to determine sample size requirements for future studies.
Abstract: This article presents the first estimates of school-level intraclass correlation for dietary measures based on data from the Teens Eating for Energy and Nutrition at School study. This study involves 3,878 seventh graders from 16 middle schools from Minneapolis-St. Paul, Minnesota. The sample was 66.8% White, 11.2% Black, and 7.0% Asian; 48.8% of the sample was female. Typical fruit and vegetable intake was assessed with a modified version of the Behavior Risk Factor Surveillance System questionnaire. Twenty-four-hour dietary recalls were conducted by nutritionists using the Minnesota Nutrition Data System. Mixed-model regression methods were used to estimate variance components for school and residual error, both before and after adjustment for demographic factors. School-level intraclass correlations were large enough, if ignored, to substantially inflate the Type I error rate in an analysis of treatment effects. The authors show how to use the estimates to determine sample size requirements for future studies.
TL;DR: In this study, the perceptions about cancer screening behaviors in Hispanics are compared among three groups: a random sample of respondents to a population-based survey, health care providers, and representatives of organizations that serve Hispanics.
Abstract: Hispanics have lower rates of screening for cervical, breast, and colon cancer than non-Hispanics. Activities to increase cancer screening in this population may not be informed by Hispanics, which may have implications for success rates of interventions. In this study, the perceptions about cancer screening behaviors in Hispanics are compared among three groups: a random sample of respondents (75% Hispanic) to a population-based survey, health care providers (primarily non-Hispanic), and representatives of organizations that serve Hispanics (36% Hispanic). While there was agreement that socioeconomic factors were important for cancer screening, differing views were expressed regarding the importance of cultural factors for cancer screening among Hispanics. Interventions developed by those who serve the Hispanic population may be based on inaccurate perceptions about the beliefs and practices of the population served. For effective interventions, it will be necessary to understand the factors important to...
TL;DR: The addition of the self measures significantly improved the overall fit of the model and revealed that predictors of adherence were clinical breast examination, physician recommendation, age, barriers, benefits, feared health-related possible self, and self-efficacy in the feared domain.
Abstract: This study sought to explore the contribution of the self-concept to older women's adherence to regular mammography screening behavior The PRECEDE and health belief model concepts were incorporated with a measure of the women's future selves to determine whether the self-concept adds to our ability to predict screening A self-administered questionnaire was completed by 210 community-dwelling women ages 50 to 75 years, recruited from urban and rural women's groups Logistic regression analyses revealed that predictors of adherence were clinical breast examination, physician recommendation, age, barriers, benefits, feared health-related possible self, and self-efficacy in the feared domain The addition of the self measures significantly improved the overall fit of the model Implications for theory development, practice, and future research are discussed
TL;DR: The authors surveyed patients at St. Louis HIV clinics to identify the importance of various sources of influence in their HIV medication decisions, and found Caucasian men were more likely than Caucasian women and African Americans of both genders to select a physician as the most important source.
Abstract: The authors surveyed 202 patients (54.5% male; 62.4% African American) enrolled at St. Louis HIV clinics to identify the importance of various sources of influence in their HIV medication decisions. Physicians were the most important source for 122 (60.4%) respondents, whereas prayer was most important for 24 respondents (11.9%). In multivariate tests controlling for CD4 counts, Caucasian men were more likely than Caucasian women and African Americans of both genders to select a physician as the most important source. African Americans were more likely than Caucasians to mention prayer as the most important source. Caucasians and those rating physicians as the most important source were more likely to be using antiretroviral medications. Respondents identified multiple important influences—hence the potential for conflicting messages about HIV medications. These findings have implications for health education practices and behavioral research in the medical setting.
TL;DR: Findings indicate that possession enforcement, as a component of comprehensive tobacco control, appears to help reduce youth tobacco use and may be a critical component of the most successful youth tobacco prevention program, documented in the previous decade.
Abstract: This study of tobacco possession law enforcement was conducted in four selected counties in Florida, the first state to report statistically significant annual declines in youth tobacco use during the 1990s. The primary objective of this study was to assess the impact of possession enforcement on youth attitudes, perceptions, and behaviors by comparing results of a survey administered in high-enforcement counties with results from low-enforcement counties and by examining the survey results for relationships of tobacco use to perceptions and awareness of laws and enforcement activity. The survey was administered to a sample of 2,088 randomly selected youth, in conjunction with a qualitative study of law enforcement officials reported elsewhere. Findings indicate that possession enforcement, as a component of comprehensive tobacco control, appears to help reduce youth tobacco use and may be a critical component of the most successful youth tobacco prevention program, documented in the previous decade.