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Biomedical subjects

B Chewning

Publications and source records attributed to B Chewning.

11 recordsLinked to original sources
PubMed2001

Protective factors associated with American Indian adolescents' safer sexual patterns.

OBJECTIVES: This paper presents findings from a research partnership with rural American Indian communities to identify protective factors associated with their adolescents' health-related behaviors including 1) delay of sexual debut; 2) not having had intercourse in the past 3 months; 3) birth control use among sexually active adolescents in the past 3 months; 4) condom use in the past 3 months. Our goal was to identify salient characteristics of students and their perceptions of family, school, and friends which could be incorporated or supported in future program planning for adolescents. METHODS: A written survey was administered to 484 Indian students in Grades 6-12 from five rural schools. The survey measured several potential protective factors identified by Problem Behavior Theory, along with self-efficacy and cultural interest and knowledge. Logistic regression assessed the relationship of the protective factors and positive sexual behaviors. RESULTS: Factors significantly associated with abstention from intercourse and/or consistent use of birth control included perceived lower health-risk behavior of friends, higher perceived parental support, higher perceived parental knowledge and monitoring of the adolescent's activities and friends, a higher value on scholastic achievement, higher reported academic performance, and higher self-efficacy for safer sexual behaviors. CONCLUSIONS: This research suggests that Indian adolescents have several protective factors indigenous to their communities which are modifiable. Building on the unique cultural heritage of Indian communities, many of these factors may be addressed through community planned prevention programs.

Adolescent↗
PubMed1999

Evaluation of a computerized contraceptive decision aid for adolescent patients.

Recent efforts to involve patients more actively in therapeutic decisions have suggested the relevance of computer-based interventions at clinic visits. This paper presents a longitudinal, experimental study evaluating a computer-based contraceptive decision aid in Chicago and Madison family planning clinic visits. Patient interviews at three time points evaluated patient acceptance by and program impact on 949 young women. Both Chicago and Madison patients reported high acceptance. The program resulted in improved short-term knowledge and confidence in oral contraceptive (OC) efficacy for Chicago and Madison patients. In addition, compared to their control group, Madison experimental group patients had higher OC knowledge 1 year after the initial visit and a trend for fewer pregnancies (P < 0.074). Compared to their control group, a higher percent of the Chicago experimental group patients adopted OC's after stating their intention to do so at the initial visit. Exposure to the computer program had no observable impact on the number of months on the oral contraceptive for Chicago or Madison patients. Overall findings suggest the usefulness of informatics tools as a supplement to patient-provider interactions.

Adolescent↗
PubMed1999

Asking questions about medication: analysis of physician-patient interactions and physician perceptions.

OBJECTIVES: The purpose of this research was to examine physicians' and patients' question-asking about medications during medical encounters. METHODS: A dataset of 467 audiotapes and transcripts of outpatient visits, as well as postvisit interviews with chronic disease patients and their primary care physicians, was analyzed. RESULTS: All patients took at least one prescribed medication and were using an average of 3.9 continued medications. Physicians and patients spent an average of 3.94 minutes, or 20% of each medical visit, discussing medications. Physicians asked patients an average of 9.3 questions about medications during each medical visit. Physicians asked significantly more questions of non-white patients, lower-income patients, and patients using more continued medications. Almost half (47%) of the patients observed did not ask any medication questions at all even though they were currently taking at least one medication; for those patients who did ask questions, the average number asked was 2.4. Starting a new medication doubled a patient's likelihood of question-asking. Physicians perceive question-asking in a positive light; patients who asked questions about medication were rated by their physicians as more interested and assertive than patients who did not ask questions, but not any more irritated or angry. CONCLUSIONS: The findings of the study illustrate the importance of improving physicians' and patients' question-asking about medications in primary care settings so that potential problems with medications can be detected and avoided and patient compliance can be improved.

Adult↗
PubMed1996

Medication decision-making and management: a client-centered model.

Although the traditional medical model dominates how 'provider-patient' roles are viewed, research has documented that client medication behavior strongly influences health outcomes, health care utilization, and ultimately health care costs. This paper explores the position that medication management outcomes can be improved by adopting more client-centered approaches. To examine the implications of a client-centered relationship this paper reviews research regarding client involvement in: (1) identifying treatment goals; (2) choosing from regimen options; (3) monitoring symptoms and evaluating regiments; and (4) self care with nonprescription pharmaceutical products. Based on this literature review, a collaborative client-centered model of medication consultation is examined, and implications for health care provider roles and public policy in pharmaceutical care are discussed.

Drug Therapy↗
PubMed1996

Increasing clients' knowledge of community pharmacists' roles.

PURPOSE: The pharmaceutical care framework requires an active client-pharmacist partnership, particularly with respect to consultation about medications. With low client expectations for pharmacist consultation documented by several studies, this research sought to identify: 1) what information clients want from pharmacists, 2) what barriers prevent clients from asking pharmacists their questions, and 3) whether an inexpensive intervention could increase client short-term knowledge of pharmacist roles related to patient consultation and monitoring prescription appropriateness. Role theory provides a framework for this study. METHODS: Nineteen community pharmacies and 355 pharmacy clients participated in the study. Each client completed a survey on their needs for information and knowledge of pharmacist roles, with clients in the experimental arm receiving a short brochure on pharmacist roles while a control group did not. RESULTS: Sixty percent wanted information about side effects; 51% wanted directions for how to take the medication correctly. Most frequently listed barriers to asking pharmacists questions were client embarrassment and ignorance that it was appropriate to seek information from pharmacists. Significantly more experimental group clients than control group clients correctly answered survey questions about pharmacist roles and training. Only 52% of the control group believed the pharmacist always checks for possible drug interactions. Only 55% believed pharmacists were required to provide appropriate patient consultation for prescriptions under state law. CONCLUSIONS: Brief exposure to a short pamphlet about pharmacists' activities increased knowledge of pharmacist roles and training, suggesting that inexpensive interventions can impact on client short term knowledge of pharmacist roles.

Community Pharmacy Services↗
PubMed1993

Evaluating the computer as a data camera in family planning research.

"This chapter explores both the potential and limitations of the micro-computer as a research tool for unobtrusive data collection in the area of population and family planning.... To provide concrete examples of the computer's potential usefulness as well as its limitations, two research projects undertaken [in the United States] by the author and colleagues will be discussed.... Each program offers different applications of how the computer can be used to: (1) evaluate programs; (2) collect descriptive data about users' values, decisions, and previous behaviors regarding sexual issues, and (3) develop and test cognitive and behavior models. Each application also offers examples of the limitations of the computer in terms of external validity issues (i.e., how representative are samples of persons who use the computer voluntarily), the need to check the validity of responses typed by computer users, and ethical issues involved in using the computer to collect data."

Americas↗
PubMed1980

Staff manuals for teaching patients.

In addition to outlining what to teach patients, the Staff Manual for Teaching Patients with Diabetes and the Staff Manual for Teaching Patients with Hypertension outline how patient and family learning can be promoted. A chapter specifically on the teaching-learning process is included in each manual with concrete examples relevant to the disease process being discussed. Each manual also includes a brief chapter on how to organize and set up patient education in a hospital setting using a team approach.

Diabetes Mellitus↗