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A Steckler

Publications and source records attributed to A Steckler.

At least 19 recordsLinked to original sources

Can health professionals learn qualitative evaluation methods on the World Wide Web? A case example.

The Enhancing Data Utilization Skills through Information Technology (EDUSIT) project trained Maternal and Child Health professionals to collect, analyze and interpret data via a year-long web-based course. The overall goal of the project was to strengthen the technology and analytic skills of the public health workforce. This article describes and analyzes a web-based module for training public health professionals to use qualitative research and evaluation methods that was one of six offered within the EDUSIT project. The qualitative module consisted of six units: overview of qualitative methods, planning qualitative studies, conducting field observations, qualitative interviewing, analyzing qualitative data and presenting qualitative findings. Evaluation results found no statistically significant changes in specific knowledge or beliefs about qualitative methods. However, the change in participants' self-efficacy was statistically significant. Participants' self-reports also showed significant changes in perceived skill levels in 'collecting qualitative data through an interview' and 'analyzing and interpreting qualitative data'. Most participants rated each lesson within the qualitative methods module as valuable, and most found the teaching methods used satisfactory, emphasizing the value of both the didactic teaching and the practical exercises and team project. The most common difficulty reported was finding the time to complete the module requirements while also working full-time. Implications of these findings for web-based teaching of public health professionals are discussed.

Adult↗

"We're living what we're learning": student perspectives in distance learning degree and certificate programs in public health.

The authors used surveys and interviews to study participants' motivations for enrolling and perceptions of the weaknesses and strengths of two distance learning programs administered by the University of North Carolina at Chapel Hill School of Public Health (SPH): the MPH in Public Health Leadership and a certificate program organized collaboratively with the Mahidol University SPH in Thailand. Chief motivations were career advancement, job performance improvement, convenience, and obtaining a degree from a reputable institution. Strengths included the curriculum, networking opportunities, and administrative and technical support. Concerns included quality of interaction with faculty and instructional methods.

Adult↗

Early detection of cervical cancer among Native American women: a qualitative supplement to a quantitative study.

The North Carolina Native American Cervical Cancer Prevention Project was a 5-year (1989-1995) National Cancer Institute-funded, community-based, early detection of cervical cancer intervention implemented among two Native American tribes in North Carolina: the eastern band of the Cherokee Indians and the Lumbee. The initial quantitative analysis of the intervention showed modest effects and found that the intervention had different effects in the two communities. Due to the equivocal findings, a retrospective qualitative study was conducted. The qualitative study found that two types of factors influenced the intervention's results. The first were project and intervention characteristics, and the second were community and cultural factors over which the project had no control. The community and cultural factors took two forms: enhancers, which contributed to greater intervention effect, and attenuators, which created barriers to success. Examples of each factor are presented, and implications for cervical cancer detection among Native American women are discussed.

Community-Institutional Relations↗

A multiple case study of implementation in 10 local Project ASSIST coalitions in North Carolina.

Community health promotion relies heavily on coalitions to address a multitude of public health issues. In spite of their widespread use, there have been very few studies of coalitions at various stages of coalition development. The purpose of this study was to identify factors that facilitated or impeded coalition effectiveness in the implementation stage of coalition development. The research design was a multiple case study with cross-case comparisons. Each of the 10 local North Carolina Project ASSIST coalitions constituted a case. Data collection included: semi-structured interviews, observation, document review, and surveys of members and staff. Some of the major factors that facilitated implementation included: the ability of the coalition to provide its own vision, staff with the skills and time to work with the coalition, frequent and productive communication, cohesion or a sense of belonging on the coalition, and complexity of the coalition structure during the intervention phase. Barriers to effective implementation included: staff turnover and staff lacking community organization skills, dependence on the state-level staff during the planning phase and lack of member input into the action plan. Conflict contributed to staff turnover, reluctance to conduct certain activities and difficulty in recruiting members, all of which had implications for implementation.

Communication↗

Factors that contribute to effective community health promotion coalitions: a study of 10 Project ASSIST coalitions in North Carolina. American Stop Smoking Intervention Study for Cancer Prevention.

The purpose of this study was to identify factors that contribute to the effectiveness of community health promotion coalitions. Member survey data from 10 coalitions formed as part of North Carolina Project ASSIST were analyzed at the coalition level to identify factors related to member participation, member satisfaction, quality of the action plan, resource mobilization, and implementation. The results suggest that coalitions with good communication and skilled members had higher levels of member participation. Coalitions with skilled staff, skilled leadership, good communication, and more of a task focus had higher levels of member satisfaction. Coalitions with more staff time devoted to them and more complex structures had greater resource mobilization, and coalitions with more staff time, good communication, greater cohesion, and more complex structures had higher levels of implementation. Neither member participation nor member satisfaction correlated with the other measures of coalition effectiveness.

Communication↗

"What the 'caine was tellin' me to do." Crack users' risk of HIV: an exploratory study of female inmates.

This study describes factors that place crack-addicted female jail inmates at risk for HIV infection. The study provides a portrait of the spheres of influences that directly and indirectly promote HIV risk-taking behaviors, women's efforts toward protecting themselves, and reported sexual behaviors. The study documents the far-reaching effects of crack addiction. One-and-a-half-hour interviews were conducted with 14 inmates recovering from crack addiction. The women were aged 19 to 39, and 13 were African American. The results of this study suggest that women's addictions are greatly shaped by their family and intimate relationships. Addictive behavior often precluded safer sex behaviors and increased a woman's likelihood of engagement in HIV-risky behaviors. Many women were victims of childhood and adulthood sexual and physical victimization. Women sought to protect themselves through sexual self-protection strategies, although these measures were often not effective HIV risk-reduction strategies.

Acquired Immunodeficiency Syndrome↗

A process evaluation of the National Cancer Institute's Data-based Intervention Research program: a study of organizational capacity building.

This paper reports on a qualitative process evaluation of the Data-based Intervention Research (DBIR) program, that was funded by the National Cancer Institute (NCI) and operated in 21 states and the District of Columbia. The goal of DBIR was to build a foundation within state health agencies to ensure the translation of cancer control science into practice. NCI's objective reflected the readiness of cancer control research for public health application, the paucity of cancer control activity within public health settings and the recognition that state health agencies could play a critical role in the effective transfer of research results into public health practice. The qualitative process evaluation reported in this paper is based on one case study of four DBIR programs. The present study indicates that the four state health agencies executed the DBIR program with fidelity. Also, the four states offered a balanced assessment of NCI's role in enabling the state agency operation of DBIR, providing numerous citations illustrating how NCI successfully facilitated organizational capacity as compared to fewer mentions of ways NCI was less than successful. Thus, in funding the DBIR model, NCI was successful in raising state health agency capacity to implement cancer prevention and control programming. Implications for capacity building in state health departments are discussed.

Humans↗

The impact of the National Cancer Institute's Data-based Intervention Research program on state health agencies.

To assist state health agencies adopt a new role in cancer prevention and control, the National Cancer Institute (NCI) initiated the Data-based Intervention Research (DBIR) program. The goal of DBIR was to stimulate data-driven activities and to build capacity for ongoing programs within state health agencies to ensure the translation of cancer prevention and control science into practice across the US. Each state funded under the DBIR program was required to conduct four phases of activity: identifying and analyzing relevant data, using these data to develop a state cancer control plan, and implementing and evaluating prevention and control interventions at the local level. This paper presents the results of survey of the 22 states that participated in the DBIR program. The survey is intended as a supplement to the case study also reported in this issue of Health Education Research. Results indicated that states were able to implement the DBIR model and they show the process to be useful to their cancer prevention efforts. DBIR had a major impact on how states will use data in future planning for cancer prevention and control. States had a number of recommendations for how NCI could improve its working relationships with state health agencies.

National Institutes of Health (U.S.)↗

Health education intervention strategies: recommendations for future research.

While the ultimate goal of health education interventions is to positively influence health status, more proximal indicators of success are changes in intermediate outcomes, or impact. Because health education interventions work through intermediate outcomes, the linkage to health status is often assumed to be at a conceptual or theoretical level. The term health education intervention strategy is a heuristic device used to conceptualize and organize a large variety of activities. There is a wide range of studies and reports in the literature that either test specific intervention strategies or report on larger health education efforts combining several strategies. This article organizes the discussion to focus on individual-, community-, and policy-level interventions. Mass communications are also considered, and the authors comment on program planning issues that cut across specific interventions at the individual, community, and policy levels. Eleven recommendations are offered for future health education intervention research.

Community Health Services↗

Toward integrating qualitative and quantitative methods: an introduction.

Both the qualitative and quantitative paradigms have weaknesses which, to a certain extent, are compensated for by the strengths of the other. As indicated in this article, the strengths of quantitative methods are that they produce factual, reliable outcome data that are usually generalizable to some larger population. The strengths of qualitative methods are that they generate rich, detailed, valid process data that usually leave the study participants' perspectives in tact. This article discusses how qualitative and quantitative methods can be combined and it introduces the articles included in this issue.

Anthropology↗

Promoting comprehensive school health programs through summer health promotion conferences.

This study reports on the evaluation of the second North Carolina Healthful Living Institute (HLI), a statewide conference to promote comprehensive school health education. A comparison of year one and year two evaluation results is included. Based on a theoretical framework derived from the theory of diffusion of innovations within organizations, the impact of the HLI was assessed by studying characteristics of school districts sending representatives to the HLI and the composition of teams from each school district, and using pretest and posttest measures of participants' perceptions of the importance of health as a content area and participants' perceptions of the importance of the various components of comprehensive school health. Results indicate the effect of school health promotion conferences is linked to characteristics of school district teams, with the Institute needing to attract more varied teams, and teams from smaller, rural districts.

Adult↗

An ecological perspective on health promotion programs.

During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.

Community Health Services↗

Prevalence of health-risk behavior among seventh grade students in North Carolina.

Data from 386 seventh grade students, 48% male and 65% white, were collected at two sites in North Carolina. The purpose of the study was to estimate the prevalence of alcohol and drug use among adolescents as part of a continuing study of preventive health behaviors. The data were collected anonymously from self-completed questionnaires and were analyzed by race and sex to determine knowledge of and attitudes toward alcohol and smoking, self-concept, and locus of control. Black boys had the highest prevalence of alcohol (16%) and tobacco (20%) use and at the same time had the lowest amount of knowledge about the dangers of the substances. White boys, while knowing more about the potential dangers, reported similar patterns of use. In general, girls used much less alcohol and tobacco and had higher levels of knowledge and more prudent attitudes. Boys, particularly blacks, were found to be at greater risk than girls of developing patterns of behavior that are associated with abuse of alcohol and heavy smoking. The findings suggest that health education to inform adolescents of the dangers of alcohol and smoking needs to be specific to cultural and sex groups.

Adolescent↗