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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. [ABSTRACT FROM AUTHOR]

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.) [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]

Focuses on a study that investigated infection control knowledge, beliefs and practices of professional tattooists in Minneapolis and Saint Paul, Minnesota. Health risks posed by tattoos; Methodology used; Results and implications for public health.

Assesses the 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. Provision of written materials and anticipatory guidance on drowning prevention to parents.

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. [ABSTRACT FROM AUTHOR]

Objectives. The present study used telephone support both to sustain abstinence and to encourage renewed quit attempts in smokers who had completed an intensive smoking cessation clinic. Methods. Subjects were hardcore smokers (n = 1083) who had attended a multisession cessation clinic. They were then assigned randomly to receive telephone support (intervention calls 3, 9, and 21 months after the targeted cessation clinic quit date) or no further intervention. Results. In the intervention condition, subjects who relapsed were significantly more likely to resume abstinence (that is, to recycle) than those in the comparison condition at follow-up (6 months: 17.8% vs 11.3%; 24 months: 25.7% vs 18.2%). Telephone support was not effective in preventing relapse, and overall differences in abstinence outcome were not significant. Conclusions. The major hypothesis of the current study--that telephone support would enhance the resumption of abstinence--received partial support. However, there was no evidence either of an overall treatment effect or of an effect in preventing relapse. Telephone outreach may be more effective in the context of self-help or other less intensive interventions. [ABSTRACT FROM AUTHOR]

The association of parity and infant mortality was studied using linked birth-death files for 46985 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. [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]

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]

This article offers background on the Bloomington Heart and Health Program, one of the three education communities that are included in the Minnesota Heart Health program. The Bloomington Heart and Health program is aligned with the Bloomington Public Health Division to continue the activities and objectives of the Minnesota Heart Health program. A major component of the Minnesota Heart Health program is the community contest aimed at promoting smoking cessation. For its part, the Blooming Public Health Division had successfully conducted the 1990 and 1991 contests.

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. [Copyright &y& Elsevier]

Investigates tattooists' attitudes regarding government regulation and the relationship between existing tattooing regulation and tattooists' knowledge and practice of infection control in Minnesota. Characteristics of the subjects; Attitudes toward government regulation; Characteristics of tattoo shops.

Objectives. The Minnesota Heart Health Program was a research and demonstration project designed to reduce risk factors for heart disease in whole communities. This paper describes smoking-specific interventions and outcomes. Methods. Three pairs of matched communities were included in the study. After baseline surveys, one community in each pair received a 5-year education program, while both cross-sectional and cohort surveys continued in all sites. Adult education programs for smoking cessation included Quit and Win contests, classes, sell-help materials, telephone support, and home correspondence programs. Remits. Encouraging short-term results were obtained for several adult education programs. Overall long-term outcomes were mixed, with evidence of an intervention effect only for women in cross-sectional survey data. Unexpectedly strong secular declines in smoking prevalence were observed in comparison communities. Conclusions. The findings suggest that community education may be unlikely to exceed dramatic secular reductions In smoking prevalence. The success of several key interventions and the incorporation of Minnesota Heart Health Program interventions by education communities are encouraging, however. [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]

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 article presents a study regarding the tobacco dependence curricula in medical schools in Middle Eastern and North African (MENA) regions. The author states that there is a general lack of information on how tobacco dependence and treatment is incorporated in the schools' curriculum. For this study, information on the tobacco education curriculum content in medicals schools from 19 countries in the region is collected.

Objectives We examined the breastfeeding attitudes and practices in an American Indian population in Minnesota. Methods We interviewed women prenatally ( n = 380), at 2-weeks ( n = 342) and at 6-months postpartum ( n = 256). We conducted multivariable analyses to examine the demographic, behavioral, and attitudinal correlates of breastfeeding initiation and duration. Results Factors positively associated with breastfeeding initiation included positive breastfeeding attitudes and social support for breastfeeding from the woman’s husband/boyfriend and her mother. Factors positively associated with breastfeeding at 2-weeks postpartum were support from the woman’s mother and positive attitudes about breastfeeding. The prenatal use of traditional American Indian medicines and cigarette smoking were both significantly associated with breastfeeding at 6-months postpartum. Conclusions Programs to encourage breastfeeding in American Indian communities may be strengthened with protocols to encourage social support, recognition of the perceived health, developmental, and practical benefits of breastfeeding, and a focus on traditional American Indian health practices. [ABSTRACT FROM AUTHOR]

Examines women's perceived and partners' reported social support for smoking cessation during pregnancy. Comparison between the mean levels of the women's and partners' perceptions of support; Need for further examination of couples' perceptions of support; Relationship between women's own smoking status and perceptions of support.

Objectives. This study is an evaluation of relapse prevention interventions for smokers who quit during pregnancy. Methods. Pregnant smokers at 2 managed care organizations were randomized to receive a self-help booklet only, prepartum relapse prevention, or prepartum and postpartum relapse prevention. Follow-up surveys were conducted at 28 weeks of pregnancy and at 8 weeks, 6 months, and 12 months postpartum. Results. The pre/post intervention delayed bat did not prevent postpartum relapse to smoking. Prevalent abstinence was significantly greater for the pre/post intervention group than for the other groups at 8 weeks (booklet group, 30%a; prepartum group, 35%b; pre/post group, 39%b. P = .02 [different superscripts denote differences at P < .05]) and at 6 months (booklet group, 26°a; prepartum group, 24%a; pre/post group, P = .04) postpartum. A nonsignificant reduction in relapse among the pre/post group contributed to differences in prevalent abstinence. There was no difference between the groups in prevalent abstinence at 12 months postpartum. Conclusions. Relapse prevent ion interventions may need to be increased in duration and potency to prevent postpartum relapse. [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]

Self-reports of cigarette smoking in a sample of young adults, aged 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended. [ABSTRACT FROM AUTHOR]