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Biomedical subjects

A W Cross

Publications and source records attributed to A W Cross.

26 records · Page 2Linked to original sources
PubMed1982

Comparisons between inner-city and private school adolescents' perceptions of health problems.

A youth health survey was administered to 247 students in an inner-city ghetto high school and 404 students in a private boarding school. Significant differences between the two socioeconomic groups were found for responses about health information, health concerns and problems, and health status and service utilization. Sex-related issues were of greater concern to the private school youth and they desired more help with depression-sadness and birth control. Inner-city youth had more health worries and indicated a desire for more help with physical problems such as toothaches, headaches, and stomach aches, and social problems such as racial discrimination and parent relations. From a list of 22 health problems, the inner-city youth ranked dental problems, acne, and health worries highest while the private school youth ranked depression-sadness, tiredness, and acne highest. Regardless of social class, most adolescents perceived large gaps in their health education. One implication of our data is that the specific self-reported needs and concerns of adolescents should be considered in planning health services and education programs.

Adolescent↗
PubMed1982

Ethical and cultural dimensions of informed consent. A case study and analysis.

A case of a patient with angina who was considered for coronary bypass surgery illustrates the issue of informed consent. Ethical and legal aspects and the inherent limitations of achieving consent must be considered. Physicians may have personal biases, which may lead to coerced consent, or may overwhelm the patient with information on potential complications of a proposed procedure, which may lead to consent without hope. Patient bias or misinformation may lead to misunderstood consent or, if the patient's judgment is distorted, to crisis consent. The patient's desire to defer the decision to the physician raises the question of whether such requested paternalism violates patient self-determination and invalidates consent or is an exercise of the patient's right to have his physician decide. The case presented exemplifies the patient-physician interaction needed for responsible paternalism.

Aged↗
PubMedDate not supplied

Comprehensiveness of well child checkups for children receiving Medicaid: a pilot study.

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is a Medicaid program designed to provide comprehensive well child care for children from low-income families. Each EPSDT checkup should include a physical examination; medical history; assessment of development, nutrition, and immunizations; assessment of hearing, vision, and dental status; and anticipatory guidance. This pilot study of the medical records of 76 children receiving EPSDT checkups in six rural counties in North Carolina provided a preliminary assessment of whether EPSDT checkups included the required components. The study showed that health care providers frequently did not provide adequate documentation of the care provided at the checkup, and it raised questions as to whether children received the required components of the EPSDT checkup.

Adolescent↗
PubMedDate not supplied

Health outcomes of children receiving EPSDT checkups: a pilot study.

This pilot study used medical records to examine the health outcomes of children receiving care in Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Medical records from 76 children seen for EPSDT visits during a 6-month period were reviewed to assess whether health problems were identified and whether treatment, follow-up, or referral care was provided. Health problems were identified for 43% of the children; 22% received treatment, and 18% were referred for specialty care. Checkups uncovered fewer problems than would be expected in a poor, largely minority population. Almost one third of the children referred for specialty care apparently did not receive such care. The study verified the need for further research and provides direction for future study.

Adolescent↗
PubMedDate not supplied

Social support and psychological functioning among high-risk mothers: the impact of the Baby Love Maternal Outreach Worker Program.

This study compared two groups of high-risk Medicaid-eligible mothers, 221 who participated in a maternal home visitation program and 198 who did not, to determine whether program participation was associated with improvements in the mothers' psychological functioning 1 year after delivery, and whether these improvements were associated with the type and intensity of support provided by home visitors. The results suggest that, compared to nonparticipants, participants provided with more intensive home visitor support had significantly higher self-esteem (p = 0.039) and were less depressed (p = 0.015). Participants with less intensive home visitor support, however, did not differ significantly from nonparticipants in their self-esteem or depression levels. No significant differences were observed in the perceived stress levels of participants as compared with nonparticipants, regardless of the intensity of home visitor support. Mothers who had support from the baby's father, however, had significantly lower perceived stress levels than mothers with no support from the baby's father (p = 0.046). Moreover, the type of support provided by home visitors (emotional, instrumental, informational) did not appear to be related to the mothers' psychological functioning. This study suggests that the intensity of support is an important component of maternal home visitation programs that aim to improve women's psychological functioning.

Adaptation, Psychological↗
PubMedDate not supplied

State health department and university evaluation of North Carolina's Maternal Outreach Worker Program.

INTRODUCTION: The Maternal Outreach Worker (MOW) Program is a social support intervention using lay helpers to provide support, health education, and outreach to Medicaid eligible women at risk for poor pregnancy and parenting outcomes. State Health Department and University collaborators designed a two-pronged evaluation comprised of programwide and interview study components to assess the impact of the program on pregnancy outcomes, health behaviors, and infant health status. METHODS: Programwide evaluation data are based on 1992-1995 N.C. birth files for the original 24 participating counties and include 1,726 MOW participant births and 12,988 comparison births whose records were linked to birth files and met the study criteria. For the interview study 373 MOW participants and 332 comparison women were personally interviewed three times: during pregnancy, one month postpartum, and one year after delivery. RESULTS: Risk factors associated with poor pregnancy and parenting outcomes were greater among MOW participants than comparisons in both the programwide and intensive study components. Caucasian MOW participants had slightly higher rates of adequate prenatal care. African Americans were found to have less adequate prenatal care. Fewer than expected LBW and VLBW births were observed for African-American MOW participants. MOW Program participation did not affect the utilization of health and social services for infants. African Americans, regardless of whether they received MOW services, fared better than Caucasians in terms of having their pregnancy needs fulfilled. CONCLUSIONS: Findings show the need to further explore appropriate measures of maternity support program outcomes and indicate inconsistent program benefit among subpopulations.

Adolescent↗