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Biomedical subjects

A Steckler

Publications and source records attributed to A Steckler.

30 records · Page 2Linked to original sources
PubMed1986

Locus of control and smokeless tobacco use among adolescents.

Seventh-grade students from two school districts in rural North Carolina were surveyed to determine the prevalence and correlates of smokeless tobacco use. The survey was carried out as part of a larger project intended to study prevalence of "risky" behaviors, specifically alcohol and tobacco use. Data were collected from 322 students: 49% male, 36.6% nonwhite. Of those reporting use of smokeless tobacco (11.4%), virtually all were male; most reported weekly use, with a small proportion (1.3%) reporting daily use. Locus of control of "occasional" users was significantly more internal than those reporting "regular" use (p less than .05).

Adolescent↗
PubMed1985

Evaluation of the North Carolina Risk Reduction Program for smoking and alcohol.

Seventh grade students in two school systems in rural North Carolina were subjects for a program designed to reduce health risks associated with use/abuse of tobacco and alcohol. One school system was located in the central area of the state, and the other in the western mountains. Both groups were assessed before and after introduction of novel teaching programs dealing with alcohol and tobacco. Knowledge about smoking and alcohol increased in both sites (p less than .05). Attitudes toward alcohol did not change. Attitudes toward smoking eroded in both sites, with attitudes at one site showing a severe erosion (p less than .05). Smoking education in these communities may have conflicted strongly with ambient attitudes toward smoking, eliciting a "boomerang" effect.

Adolescent↗
PubMed1982

The role of health education in public policy development.

Health educators should view policy development as a unit of professional practice analogous to the individual, the small group, the community, and the organization. The impact of policy on other units of practice and on people served by health educators is too great and the competition for scarce resources for health and human services is too keen to be disregarded. An increasingly active role in the policy process is, therefore, vital to the profession. Unfortunately, many health educators find an active role strange and lack guidelines for effective policy intervention. This paper attempts to mediate that situation. First a conceptual framework is offered. Operational definitions of important terms are given, including policy, public policy, social policy, health policy, and health education policy. A model of the policy development process is presented, detailing the purpose and dynamics of several steps: establishing problem awareness, setting goals and objectives, selecting a course of action, designing alternative courses of action, analyzing policy, assigning implementation responsibility, implementing, and evaluating. Then five categories of intervention strategies encompassing 16 individual suggested roles ranging from indirect influence to direct political involvement are presented. The categories are: acting as a source of policy information, providing technical assistance, organizing, influencing policymakers, and taking direct political action.

Consultants↗
PubMed1981

Consumer participation and influence in a Health Systems Agency.

Consumer participation and influence were studied in one Health Systems Agency in the southeastern United States over a 20-month period (July 1976--February 1978). Consumer board members were found to be significantly less influential in agency decision making than were provider board members. This difference in influence existed even though virtually no difference existed between consumers' and providers' levels of participation. Consumer board members, while representing minority and nonminority, and both rural and nonrural groups, tended nevertheless also to be middle-class, middle-income individuals. Low-income and working-class groups were underrepresented on the board of the Health Systems Agency. Furthermore, consumer representatives tended to be satisfied with and have access to health care.

Adolescent↗
PubMed1980

Analysis of health education sections of health systems plans.

Health Systems Agencies are required by federal guidelines to plan for and provide educational opportunities for residents of their health service areas. A study was conducted of 9 health education components of health systems plans developed by HSAs in Region III. The health education plans were analyzed and scored using the "Health Education Plan Scorecard" developed by Sullivan and adapted by the present authors. Specifically this modified scorecard consists of eight dimensions of the health education planning process: Involvement, Principles and Practice of Health Education, Defining Problems, Setting Goals and Objectives, Recommending Actions, Obtaining Resources, Planning for Implementation, and Planning for Evaluation. Ratings were generally higher on the first five dimensions of the scorecard. The last three dimensions produced lower scores. The overall average score was 41 points out of a possible 100. Thus indicating the general overall low scores received by the plans. The paper includes 18 recommendations to HSAs for improving the quality of health education plans. A key recommendation is that the Health Education Plan Scorecard should be used as a guide and check list during the plan development process.

Evaluation Studies as Topic↗
PubMed1978

Determinants of consumer influence in a health systems agency.

An 18-month study of consumer participation and influence in a Health Systems Agency (HSA) found consumer board members to be less influential than provider board members in agency decision-making. In an effort to investigate causes of the influence deficit experienced by consumer HSA board members three issues were studied: staff attitudes toward consumer participation; board member degree of representative accountability; and board member attitudes concerning commitment to consumer participation, commitment to health planning, health services attitude, and feelings of social powerlessness. Results indicated that staff members were favorable toward the concept of consumer participation. They recognized a lack of low-income minority participation, but they did not provide support or allocate resources to enhance consumers' ability to participate. Providers were less committed to consumer participation, felt more socially powerful, and had greater representative accountability than did consumers. Several strategies for increasing consumer influence in HSA decision-making processes are proposed.

Attitude of Health Personnel↗
PubMedDate not supplied

Measuring the diffusion of innovative health promotion programs.

Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.

Adolescent↗
PubMedDate not supplied

A critique of contemporary community health promotion approaches: based on a qualitative review of six programs in Maine.

PURPOSE: This article reports on a process evaluation of three Planned Approach to Community Health (PATCH) projects and three Community Chronic Disease Prevention Programs (CCDPP) that operated in the State of Maine. PATCH and CCDPP are similar approaches to community health promotion developed and disseminated by the Centers for Disease Control. The evaluators studied how the Planned Approach to Community Health and the Community Chronic Disease Prevention Program models worked as community health strategies across the six field sites. RESEARCH METHODS USED: Qualitative methods were used in a cross-case comparison of the six field sites. In studying each site, the evaluators focused on six stages common to both the Planned Approach to Community Health and the Community Chronic Disease Prevention program models: Stage 1: conducting a community needs assessment; Stage 2: analyzing needs assessment data; Stage 3: setting priorities for the project based on the data; Stage 4: implementing activities; Stage 5: producing process outcomes; and Stage 6: institutionalizing the project. The analysis focused on how each of the six communities traversed these stages. SUMMARY OF FINDINGS: Eight recommendations for refining Planned Approach to Community Health and Community Chronic Disease Prevention strategies resulted from the study: 1) do a community capacity assessment prior to initiating a community needs assessment; 2) do not overly rely on Behavioral Risk Factor Surveys; 3) analyze needs assessment data rapidly for community consumption; 4) allow flexibility and community input in determining priority health objectives; 5) provide technical assistance throughout a project, not just in the beginning; 6) fund at least one full-time local coordinator and extensive capacity building; 7) emphasize multiple interventions around one chronic condition at a time; and 8) emphasize program institutionalization. CONCLUSIONS: Community development approaches like Planned Approach to Community Health and Community Chronic Disease Prevention are promising health promotion strategies. To be optimally effective, however, these strategies need refinement based on systematic study in field settings. Because this study was limited to six sites in Maine, some of these findings may have limited generalizability.

Chronic Disease↗