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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 […]

Violence has numerous negative implications for women's health. (1) For pregnant women, violence may affect the course of pregnancy and fetal health. Studies have reported that 1% to 21% of […]

The popularity of tattoos has increased dramatically in recent years. Modern tattooing is performed with an electric machine; a cluster of rapidly oscillating needles deposits liquid pigment into the upper […]

Issues regarding perceived stress and depressive symptoms as predictors of smoking cessation during pregnancy are discussed. Prenatal healthcare providers should continue providing intensive cessation interventions based on level of addiction. Interventions reducing psychological symptoms may also help women still smoking in early pregnancy.

Objectives. This study examined whether pregnancy intention was associated with cigarette smoking, alcohol drinking, use of vitamins, and consumption of caffeinated drinks prior to pregnancy and in early pregnancy. Methods. Data from a telephone survey of 7174 pregnant women were analyzed. Results. In comparison with women whose pregnancies were intended, women with unintended pregnancies were more likely to report cigarette smoking and less likely to report daily vitamin use. Women with unintended pregnancies were also less likely to decrease consumption of caffeinated beverages or increase daily vitamin use. Conclusions. Pregnancy intention was associated with health behaviors, prior to pregnancy and in early pregnancy, that may influence pregnancy course and birth outcomes. (Am J Public Health. 1998; 88:663-666)

Pediatricians may not be acting as effective child advocates for drowning prevention. A total of 560 pediatricians responded to a survey on drowning prevention. Only 4% were involved in community or legislative efforts aimed at preventing drowning. Forty-one percent gave out written materials, half offered anticipatory guidance for children 12 years old or younger, and one-third offered advice to patients over 12 years old. Pediatricians who had received education on drowning prevention during residency training were more likely to educate patients and families, but only 18% had received such education., Objective. To assess pediatricians' knowledge about the epidemiology of childhood drowning, their opinions and current practices regarding its prevention, and their interest in taking on more responsibility for its prevention. Design. A self-administered questionnaire was mailed to 800 pediatricians in the United States, randomly selected from the American Academy of Pediatrics' approximately 18 000 full fellows. Results. A total of 560 completed surveys were returned, a response rate of 70.1%. Although 85% of respondents believe it is the responsibility of pediatricians to become involved in community and/or legislative efforts to prevent childhood drowning, only 4.1% were involved in such efforts. Only a minority of respondents provided written materials and anticipatory guidance on drowning prevention to their patients. Women were more likely than men to discuss drowning prevention with their patients. Younger physicians were more likely than older physicians to discuss drowning prevention with their patients. Physicians who received formal education on drowning prevention during their pediatric residency training were more likely to provide written materials and anticipatory guidance on drowning prevention to their patients. However, only 17.9% of respondents received formal education on drowning prevention during their pediatric residency training. Seventy-four percent of all respondents felt that further education on the prevention of childhood drowning and near-drowning would be useful to them. Conclusion. Although drowning is the second leading cause of death by unintentional injury in the pediatric population (aged 0 to 19 years), most pediatricians do not routinely provide information to their patients, or to their patients' parents, on drowning prevention. Implication. Pediatricians have been effective child advocates in many areas of injury prevention. If the prevention of drowning is made a priority in pediatric practice, many more children's lives will be saved. Pediatrics 1997;99:169-174; drowning, near-drowning immersion, swimming pools., ABBREVIATIONS. US, United States; AAP, American Academy of Pediatrics. Drowning and near-drowning (we define a "drowning" as an immersion incident that leads to death within 24 hours of the incident, [...]

A simple modification in the social support intervention can increase the proportion of smoking-contest participants who select a support person to help them quit smoking. This strategy affects the smoking-cessation outcomes of this minimal contact intervention. Identifying a support person is particularly beneficial for those whose spouses either smoke or are unsupportive of quitting.

Hospitals with psychiatric and abuse treatment wards present the greatest dilemma to establishing nationwide smoke-free hospitals. Of 934 accredited hospitals surveyed, 313 had psychiatric beds. Only 134 (43%) had smoke-free psychiatric wards. Of 190 hospitals with inpatient substance abuse beds, only 66 (35%) were smoke-free in those wards. Hospitals that did not require smoke-free policies in psychiatric wards cited difficulty relating to enforcement, such patient management and negative treatment outcomes. Most hospitals surveyed (76%) were able to enforce smoking bans within a year. Having a person at the hospital dedicated to enforcing the no-smoking policy greatly improved the chances of success. The problem of compliance among psychiatric patients and the chemically dependent needs to be resolved before hospitals can be totally smoke-free. In 1992, the Joint Commission on Accreditation of Healthcare Organizations began requiring acute care accredited hospitals to prohibit smoking., Objective.--To determine the extent of compliance with the new Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard requiring acute care hospitals to be smoke-free, and to identify predictors of adoption of smoke-free hospital policies. Design.--We conducted a survey of a national sample of acute care hospitals and developed a predictive model for implementation of smoke-free policies using multiple logistic regression. We examined numerous factors that might predict adoption of smoke-free policies, such as hospital characteristics, patient care services, and experience with smoke-free initiatives. Setting and Participants.--A systematic 20% sample of JCAHO-accredited hospitals in the United States (n=1278). Military, Department of Veterans Affairs, Indian Health Service, psychiatric, substance abuse treatment, and children's hospitals were excluded. Main Outcome Measure.--Compliance with the JCAHO standard. Results.--The response rate was 85%. Sixty-five percent of hospitals were in compliance with the standard 16 months after it was introduced. Factors that were independently and positively associated with implementation of smoke-free policies were administrative support (odds ratio [OR], 7.82; 95% confidence interval [CI], 2.05 to 29.65) and inpatient smoking cessation services (OR, 1.24; 95% CI, 1.02 to 1.52). Factors negatively associated with implementation of smoke-free policy were the number of psychiatric treatment beds (OR, 0.57; 95% CI, 0.41 to 0.81), number of substance abuse treatment beds (OR, 0.17; 95% CI, 0.11 to 0.26), and presence of an active task force to address smoking policy (OR, 0.56; 95% CI, 0.40 to 0.77). Conclusions.--The majority of acute care hospitals are in compliance with the JCAHO national smoke-free policy initiative. The standard is well accepted by most patients and employees. It is critical to address the challenges presented by special populations, such as psychiatry patients, to accomplish the goal of completely smoke-free hospitals. (JAMA. 1995; 274:491-494)

The association of parity and infant mortality was studied using linked birth-death files for 46 985 infants born to 11- to 19-year-old Minnesota residents between 1980 and 1988. Compared with infants of primiparas, infants of multiparas were at twice the risk for infant and postneonatal death but at no increased risk for neonatal death. They were also at two to three times the risk for deaths due to accidents, infections, and sudden infant death syndrome. The higher sociodemographic disadvantage and poorer prenatal care of multiparas did not explain the excess infant mortality risk that was concentrated in causes of death that are potentially preventable through primary care and parent education. (Am J Public Health. 1995; 85:1139-1142), Second or subsequent babies of teenaged mothers appear to have a higher risk of infant death than first-born babies. This is the reverse of the case in adults. Birth and death records were analyzed for 46,985 births to 11- to 19-year-olds between 1980 and 1988. Sixteen percent of the births were second and subsequent children of which 89% were second children. Overall, 548 infants (1.2%) died within the first year. One-fourth of these deaths were infants of mothers with more than one child. After the first month of life, second or subsequent children had 2.4 times the death rate of first-born children. The causes of death in second or subsequent children appear to be preventable. Risks of death due to infections, accidents, and sudden infant death syndrome were two to three times higher in second or subsequent children.

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. (Am J Public Health. 1992;82:1238-1243)

Current Status of Health Promotion Activities in Four Midwest Cities Synopsis Community-wide surveys were conducted in Winona and St. Cloud, MN, Eau Claire, WI, and Sioux Falls, SD, in 1986 […]

Background. 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, suecessful 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. (Am J Public Health 1991;81:324-327), Women are not quitting smoking at the same rate as men; indeed, among very young adults, the proportion of female smokers is beginning to exceed the proportion of male smokers. Since women smokers jeopardize not only their own health, but also that of their children, programs to help them quit smoking should be given a high public health priority. To learn more about smoking and quitting behavior in young adults, a study was carried out of 3,455 males and 3,256 females who were initially enrolled in the seventh grade in suburban Minneapolis-St. Paul, Minnesota in 1979 and 1980. The subjects were interviewed by telephone regularly between 1984 and 1988; the data presented are from the 1986 to 1987 survey, when the subjects were just out of high school (average age, 19.2 years). Most were white, and all except 7 percent had graduated from high school. A greater proportion of women (26.5 percent) than men (22.6 percent) currently smoked, and more had smoked at some time. Similar proportions of men and women had tried to quit. Women who had tried to quit and failed reported similar withdrawal symptoms as men, except women said they had gained more weight when trying to quit and that they wanted to eat more than usual. Female quitters had not gained more weight than those who had failed; however, among males, quitters were heavier than smokers. Quitting was associated with fears of gaining weight for women, who also expressed a sense of social pressure about quitting. The results may imply that quitting is no less often successful for women than for men, indicating that a trend toward fewer women smokers could be anticipated. However, the fact that more young women than men currently smoke is disheartening. Public health programs for female smokers should take into account their expressed concerns, particularly those about weight gain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Eosinophilia-myalgia syndrome is an illness involving abnormal blood levels of eosinophils (a type of white blood cell) and muscle pain; it can be serious and even fatal. The condition was first reported in three patients in October 1989, and was soon linked to consumption of tryptophan supplements. Tryptophan is an amino acid present in many proteins; the supplements have been used for treating depression, insomnia, and other health problems. Scientists had not previously determined whether the tryptophan itself, or some substance used in the production of the supplements, caused eosinophilia-myalgia syndrome. An investigation was conducted into the relationship between tryptophan products and eosinophilia-myalgia syndrome. The investigation included surveillance of cases of the syndrome in Minnesota, and a survey of tryptophan use in Minneapolis-St. Paul. It was found that more women than men used tryptophan products, and increasing numbers of people used the products from 1980 to 1989. For some of the study subjects, the manufacturer of the supplement was known; of these, 29 of 30 people with eosinophilia-myalgia took products manufactured by one specific company, Showa Denko K.K. There was only one case of the illness among persons who used tryptophan from other manufacturers, and it appears that in this case the product was probably mislabeled and was actually manufactured by Showa Denko K.K. Of 35 people who did not get eosinophilia-myalgia, 21 consumed supplements made by Showa Denko K.K. It was concluded based on these data and laboratory analysis of tryptophan samples that the illness was caused by an unidentified chemical constituent resulting from altered manufacturing processes of the company. There were two manufacturing changes that may have produced the unknown chemical constituent: reduced amounts of powdered carbon were used in a purification step; and a new strain of Bacillus amyloliquefaciens was utilized in a fermentation process. These two changes in procedure appeared to be linked. The unidentified chemical constituent thought to have caused the illness was probably present in tiny quantities because the tryptophan products made by Showa Denko K.K. are 99.6 percent pure tryptophan, which exceeds United States requirements. (Consumer Summary produced by Reliance Medical Information, Inc.)

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]

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 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. (Am J Public Health. 1994;84:1148-1150), Children exposed to anti-smoking messages both in school and through the mass media appear less likely to become smokers than children exposed to only to school-based anti-smoking messages. A total of 2,086 children completed six surveys about their smoking habits. The first survey took place between grades four through six. Children in two communities were exposed to four years of anti-smoking messages both in school and through the mass media. Children in another two communities received four years of school-based anti-smoking messages only. When the students were in grades 10 through 12 they completed additional questionnaires about smoking habits. Children exposed to anti-smoking messages through the mass media and in school had a significantly reduced risk of becoming smokers than those who received only school-based interventions.

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]