Search

Direct support professionals (DSPs) play a large social role in the lives of people with developmental disabilities (DD) and have the potential to influence their health behaviors. Six qualitative focus groups (n = 48) were conducted with DD community agency administrators, DSPs, family members and adults with DD to better understand the perceived role of DSPs in the health promotion efforts of those with DD. Findings from this study suggest that DSPs experience several barriers when trying to promote the health of those with DD, one of which is fear of violating the rights of people with DD. Future work should identify ways to overcome the barriers experienced by DSPs, so that they can better assist people with DD with health promotion efforts.

Objectives The United States Department of Agriculture's Child and Adult Care Food Program (CACFP) provides meals and snacks to low-income children in child care. This study compared nutrition and physical activity practices and policies as well as the overall nutrition and physical activity environments in a sample of CACFP and non-CACFP child care settings. Methods A random stratified sample of 350 child care settings in a large Midwestern city and its suburbs, was mailed a survey on obesity prevention practices and policies concerning menu offerings, feeding practices, nutrition and physical activity education, activity levels, training, and screen time. Completed surveys were obtained from 229 of 309 eligible child care settings (74.1 % response rate). Chi square tests were used to compare practices and policies in CACFP and non-CACFP sites. Poisson and negative binomial regression were used to examine associations between CACFP and total number of practices and policies. Results Sixty-nine percent of child care settings reported CACFP participation. A significantly higher proportion of CACFP sites reported offering whole grain foods daily and that providers always eat the same foods that are offered to the children. CACFP sites had 1.1 times as many supportive nutrition practices as non-CACFP sites. CACFP participation was not associated with written policies or physical activity practices. Conclusions for Practice There is room for improvement across nutrition and physical activity practices and policies. In addition to food reimbursement, CACFP participation may help promote child care environments that support healthy nutrition; however, additional training and education outreach activities may be needed., Author(s): Sherry T. Liu[sup.1] [sup.3] , Cheryl L. Graffagino[sup.2] , Kendall A. Leser[sup.1] , Autumn L. Trombetta[sup.2] , Phyllis L. Pirie[sup.1] Author Affiliations: (1) Division of Health Behavior and Health [...]

Theory-driven, mass media interventions prevent smoking among youth. This study examined effects of a media campaign on adolescent smoking cessation. Four matched pairs of media markets in four states were randomized to receive or not receive a 3-year television/radio campaign aimed at adolescent smoking cessation based on social cognitive theory. The authors enrolled 2,030 adolescent smokers into the cohort (n = 987 experimental; n = 1,043 comparison) and assessed them via annual telephone surveys for 3 years. Although the condition by time interaction was not significant, the proportion of adolescents smoking in the past month was significantly lower in the experimental than comparison condition at 3-year follow-up when adjusted for baseline smoking status. The media campaign did not impact targeted mediating variables. A media campaign based on social cognitive constructs produced a modest overall effect on smoking prevalence among adolescents, but the role of theory-based constructs is unclear. (Contains 4 tables.)

Smoking among young women is associated with a variety of negative health outcomes. Gender-specific influences on smoking, quitting, and attempting to quit were hypothesized and surveyed. More women than men currently smoke, but quitting attempts are equally common. Programs addressing issues of concern to young women smokers are needed. (AF)

Objectives. We examined relationships between otitis media risk factors, sociodemographic characteristics, and maternal knowledge and attitudes and early onset of otitis media. Methods. Pregnant women from Minnesota American Indian reservations and an urban clinic were enrolled in our study between 1998 and 2001. Follow-up was performed on enrollees' infants until the children were 2 years old. Research nurses collected data by ear examination, from interviews and questionnaires given to enrolled mothers, and otitis media episodes that were abstracted from medical records. Results. Sixty-three percent of infants had experienced an otitis media episode by 6 months of age. Logistic regression analyses showed that maternal otitis media history, infant history of upper respiratory infection, and compliance with study visits were significantly related to early otitis media onset. Although high percentages of infants were exposed to cigarette smoke and other children and were formula fed, these factors were not related to otitis media. Mothers' prenatal awareness of otitis media risks associated with environmental tobacco smoke exposure and formula feeding did not predict their postpartum behaviors. Conclusions. We found that infant history of upper respiratory infection and maternal otitis media history are risk factors for early otitis media in American Indian infants. Mothers' prepartum knowledge and attitudes regarding otitis media did not predict their postpartum avoidance of risk behaviors. (Am J Public Health. 2007;97:317-322. doi: 10.2105/AJPH.2004.052837)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.08.001 Byline: Laura J. Solomon (a)(b)(c), Janice Y. Bunn (c)(d)(e), Phyllis L. Pirie (f), John K. Worden (b)(c)(g), Brian S. Flynn (b)(c)(g) Keywords: Cigarette smoking; Adolescents; Self-efficacy; Outcome expectations Abstract: Relatively little is known about smoking cessation self-efficacy and outcome expectations for quitting smoking in adolescent smokers. In this study, we created measures of these two constructs and conducted factor analyses with data from a diverse sample of 1126 adolescent smokers. Results yielded a two-factor solution for the self-efficacy measure, and a four-factor solution for the outcome expectations scale. In a subset of the original sample (n =515), we re-administered the measures one year later and also examined the longitudinal associations between the baseline sub-scale scores and cigarettes smoked per week at follow-up. Results revealed significant relationships between the negative affect sub-scales of the self-efficacy and outcome expectations measures and weekly smoking level. These associations remained when adjusting for baseline smoking level and other sub-scales. The findings lend support for the possible role of affect regulation in smoking reduction in adolescents. Author Affiliation: (a) Department of Psychology, University of Vermont, Burlington, VT 05405, United States (b) Department of Family Medicine, University of Vermont, Burlington, VT 05401, United States (c) Vermont Cancer Center, University of Vermont, Burlington, VT 05401, United States (d) Department of Medical Biostatistics, University of Vermont, Burlington, VT 05405, United States (e) Department of Physical Therapy, University of Vermont, Burlington, VT 05405, United States (f) Department of Epidemiology, University of Minnesota, Minneapolis, MN 55454, United States (g) Office of Health Promotion Research, University of Vermont, Burlington, VT 05401, United States

A growing number of state health departments in the United States require tattoo artists to implement bloodborne pathogen precautions. In 1979, only two state health departments regulated tattooing. (1) By […]

Introduction. Despite increasing interest in structural (policy, systems, and environmental) changes to improve health, little attention has focused on the adoption, implementation, sustainability, and potential for dissemination of these changes among local community-based organizations. Method. A mixed methods approach was used for this process evaluation. Representatives of nine community-based organizations were surveyed using closed-ended questions and in-depth qualitative interviews to describe 32 policy changes. Diffusion of Innovation theory was used to inform the development of survey questions and the interview guide. Results. Policies adopted by local community-based organizations concerned types of food/beverages provided to staff/clients, methods to encourage physical activity, breastfeeding support, and tobacco control. The majority of the policies were either fully (66%) or partially (31%) implemented 1 year after their initial adoption. In general, participants somewhat/strongly agreed that policies had characteristics that predict sustainability/diffusion (relative advantage, compatibility, complexity, trialability, observability). In-depth interview responses described a generally smooth process for policy adoption and high levels of optimism for continued sustainability but revealed few efforts to disseminate the policies beyond the original organization. Conclusions. Structural changes in community-based organizations are a valuable tool for encouraging healthy changes in communities and have great potential to be adopted, sustained, and diffused. [ABSTRACT FROM AUTHOR]

Direct support professionals (DSPs) play a large social role in the lives of people with developmental disabilities (DD) and have the potential to influence their health behaviors. Six qualitative focus groups ( n = 48) were conducted with DD community agency administrators, DSPs, family members and adults with DD to better understand the perceived role of DSPs in the health promotion efforts of those with DD. Findings from this study suggest that DSPs experience several barriers when trying to promote the health of those with DD, one of which is fear of violating the rights of people with DD. Future work should identify ways to overcome the barriers experienced by DSPs, so that they can better assist people with DD with health promotion efforts. [ABSTRACT FROM AUTHOR]

Purpose. To outline the design and present select findings front an evaluation of a statewide anti-tobacco industry youth organizing movement. Design. A telephone survey was administered to teenagers to assess associations between exposure to anti-industry youth organizing activities and tobacco-related attitudes and behaviors. A group-level comparison between areas high and low in youth organizing activities was planned. Methodological obstacles necessitated a subject-level analytic approach, with comparisons being made between youth at higher and lower levels of exposure. Setting. Six rural areas (comprising 13 counties) and two urban regions of Minnesota were selected for survey. Subjects. The study comprised 852 youth, aged 15 to 17 years old, randomly selected front county-specific sampling frames constructed front a marketing research database. Measures. Exposure index scores were developed for two types of activities designed to involve youth in the anti-industry program: branding (creating awareness of the movement in general) and messaging (informing about the movements main messages,). Attitudinal outcomes measured attitudes about the tobacco industry and the effectiveness of youth action. Behavioral outcomes included taking action to get involved in the organization, spreading an anti-industry message, and smoking susceptibility. Results. Branding index scores were significantly correlated with taking action to get involved (p &iE; . 001) and spreading an anti-industry message (p &iE; . 001)). Messaging index scores were significantly correlated with all five attitudinal constructs (all associations, p &iE; .001), taking action to get involved (p &iE; .001), and spreading an anti-industry mess age (`p &iE; .01). The hypothesized association between messaging scores and susceptibility was not significant. conclusion. A youth organizing effort, in combination with an intensive counter marketing media campaign, can be an effective strategy for involving youth in tobacco prevention and generating negative attitudes about the industry. [ABSTRACT FROM AUTHOR]

Purpose. Prenatal smoking cessation will not eliminate health risks if women continue to be exposed to passive smoking. This study compared the risks of secondhand smoke (SHS) exposure for low-income prenatal nonsmokers, abstainers, and smokers. Methods. A questionnaire was administered to 225 pregnant women. Exposure to six sources of SHS was compared across smoking groups using chi-square and multivariate logistic regression. Results. In adjusted analyses, patterns of SHS exposure were consistent. Abstainers were at lower risk of exposure than smokers for all sources except for having a partner who smoked. Abstainers were at higher risk of exposure than nonsmokers for most sources. For example, 11.7% of nonsmokers were exposed to <4 hours of SHS daily compared with 33.3% of abstainers (adjusted odds ratio = .32, 95% confidence interval = .12-.88). Mean number of exposures for nonsmokers, abstainers, and smokers were 1.4, 2.7, and 4.2, respectively (p < .001). Discussion. Interventions need to address the full range of health risks posed by cigarette smoke exposure during pregnancy. [ABSTRACT FROM AUTHOR]

Little is known about lay advice on prenatal alcohol and cigarette use and how this advice may complement or counteract advice from health professionals. In this study we examine the advice-giving role of female friends and relatives ("confidantes"). Survey data were collected from 105 low-income pregnant women about prenatal alcohol and cigarette use and confidante advice about these behaviors. Focus groups with 9 confidantes of pregnant smokers examined the advice they offered about substance use, their perceptions of these behaviors, and their roles as advice-givers. The rate of prenatal drinking was low among pregnant smokers, consistent with confidantes' high risk perceptions and zero tolerance for drinking, but low risk perceptions and high tolerance for smoking. Confidantes described barriers to providing advice about smoking cessation. Because confidantes perceived their role to be distinct from, and in some ways more influential than, that of doctors their advice should be considered in the development of prenatal substance use interventions. [ABSTRACT FROM AUTHOR]

Background. Weight gain after smoking cessation is often cited by women smokers as a primary reason for not attempting to quit smoking or for relapsing after a cessation attempt. Methods. A randomized trial of 417 women smokers was conducted to test the addition of two weight control strategies to a smoking cessation program. Participants received the standard smoking cessation program, the program plus nicotine gum, the program plus behavioral weight control, or the program plus both nicotine gum and behavioral weight control. Weight and smoking status were measured at the end of treatment and at 6 and 12 months posttreatment. Results. Smoking cessation rates were highest in the group receiving the smoking cessation program plus nicotine gum. Weight gain did not vary by treatment condition, so its effect on relapse could not be examined by group. There was no significant relationship between weight gained and relapse in individuals. Conclusions. The added behavioral weight control program was attractive to the participants and did not reduce smoking cessation rates. However, it did not produce the expected effect on weight, thereby restricting our ability to examine the effect of weight control on smoking cessation and relapse. [ABSTRACT FROM AUTHOR]

Smoking among young women is associated with a variety of negative health outcomes. Gender specific influences on smoking, quitting and attempting to quit are hypothesized to occur and may have implications for cessation programs. Methods. Telephone surveys were conducted in a large (n = 6,711) cohort of young men and women (average age 19.2 years) which was first established in 1979 and has been resurveyed several times since then. Questions concerned smoking, successful and unsuccessful attempts to quit, withdrawal symptoms during quit attempts, and concerns about quitting. Results. More women than men reported current smoking (26.5 vs 22.6 percent), but quitting attempts, successful and unsuccessful, were equally common. Withdrawal symptoms were reported equally, except for wanting to eat more than usual and weight gain, both of which were reported more often by women than men. Women smokers reported substantially more concern about weight gain if they quit smoking (57.9 vs 26.3 percent expressing concern). Conclusions. Targeted programs are needed to address issues of concern to young women smokers, particularly fear of gaining weight. [ABSTRACT FROM AUTHOR]

The Minnesota Heart Health Program was a community trial of cardiovascular disease prevention methods that was conducted from 1980 to 1990 in three Upper Midwestern communities with three matched comparison communities. A 5- to 6-year intervention program used community-wide and individual health education in an attempt to decrease population risk. A major hypothesis was that the incidence of validated fatal and nonfatal coronary heart disease and stroke in 30- to 74-year-old men and women would decline differentially in the education communities after the health promotion program was introduced. This hypothesis was investigated using mixed-model regression. The intervention effect was modeled as a series of annual departures from a linear secular trend after a 2-year lag from the start of the intervention program. In the education communities, 2, 394 cases of coronary heart disease and 818 cases of stroke occurred, with 2, 526 and 739 cases, respectively, being seen in the comparison communities. The overall decline in coronary heart disease incidence was 1.8 percent per year in men (p = 0.03) and 3.6 percent per year in women (p = 0.007). For stroke, there were no significant secular trends. The authors recently published findings showing minimal effects of sustained intervention on risk factor levels. In the current report, there was no evidence of a significant intervention effect on morbidity or mortality, either for coronary heart disease or for stroke. Am J Epidemiol 1996; 144: 351–62. [ABSTRACT FROM AUTHOR]

Background. Formal efforts to recruit smokers into cessation programs have failed to reach large segments of the smoking population. Telephone intervention may represent a viable strategy to promote smoking cessation. An even more promising approach may be a combination of brief telephone support and outreach to identified smokers. Methods. Telephone support for smoking cessation was provided to four identified smoker populations in Bloomington, Minn, one of three Minnesota Heart Health Program education communities. Smokers were randomly assigned to an intervention consisting of two 15-minute telephone calls approximately 1 to 3 weeks apart or to a nonintervention control. Results. At the 6-month follow-up, a significant overall effect was found in favor of the intervention condition for both self-reported and cotinine-validated quitting. Differences between intervention and control conditions were no longer significant at 18 months. Conclusions. Smokers' receptivity to telephone intervention was at least moderately encouraging. The cost of intervention could be relatively low if trained volunteers initiated telephone calls. However, more intensive telephone intervention has support may be needed to produce lasting changes in smoking prevalence. [ABSTRACT FROM AUTHOR]

Abstract: This study reports daily smoking rates among older adolescents obtained by a unique follow-up of a cohort originally identified in the seventh grade. Those no longer in their original school districts were located and interviewed by telephone. Smoking rates among dropouts exceeded 70 per ¢ in all age-sex groups. Smoking rates among transfers were as high as those among absentees. Including these subgroups raised smoking prevalence rates among older adolescents substantially. [ABSTRACT FROM AUTHOR]

Sixty-nine normotensive volunteers participated in an eight-week study to test the feasibility and acceptability of two low-sodium (<70 mEq), high-potassium (>100 mEq) diets. The diet groups differed only in the use of KCI salt substitute. Both dietary groups were able to reduce sodium and increase potassium intake compared to the control group. Urine sodium excretion decreased in the diet groups but no change was observed in potassium. Potassium chloride salt substitute was not used as recommended, suggesting its unacceptability. [ABSTRACT FROM AUTHOR]

The long-term cigarette smoking prevention effects of mass media and school interventions were assessed. Adolescents in two communities received both mass media and school interventions; those in two matching interventions; those in two matching communities received only school interventions. Surveys of 5458 students were conducted at baseline in grades 4 through 6 and 2 years after the 4-year interventions were completed. When students were in grades 10 through 12. Students exposed to the media-plus-school interventions were found to be at lower risk for weekly smoking (odds ratio = 0.62, 95% confidence interval = 0.49, 0.78) than those receiving school interventions only, indicating that the effects of the combined interventions persisted 2 years after the interventions' completion. [ABSTRACT FROM AUTHOR]