We present a model of the cardiovascular system used to teach patients about the nature, risks, and treatment of hypertension. We designed the model to help providers explain abstract principles of cardiovascular function through graphic representations that patients can see, feel and hear. This article describes the model, discusses the concepts that providers can illustrate to patients, and includes an outline followed by providers of our community health centers in educating hypertensive patients.

Humans↗

PubMedDate not supplied

AIDS knowledge in low-income and minority populations.

A convenience sample of 587 subjects was selected from the waiting areas of community health centers in Harris County, TX. They completed a structured interview that included questions on their knowledge of acquired immunodeficiency syndrome (AIDS) transmission and prevention. Hispanic patients were interviewed in their preferred language. They were given a cumulative correct score for 10 questions on AIDS. An ANOVA showed significant differences in knowledge between each radial group. Cumulative scores were whites, 78 percent correct; blacks, 68 percent correct; and Hispanics, 61 percent correct. Only 58 percent of Hispanics reported that using a condom during sexual intercourse lowered the risk of contracting AIDS, compared with 84 percent of whites and 83 percent of blacks. A regression analysis showed significant effects for both education and racial group, but not for age and sex. These findings show that knowledge of AIDS can be predicted according to the race and education of the population using these community health centers. Additional attention should be focused on educating low-income blacks and Hispanics about AIDS.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Advances in controlling hypertension in low-income patients.

Since hypertension is the foremost problem in minority and low-income populations treated in our community health centers, in 1976 we introduced a protocol that standardized diagnostic criteria and a step-care approach to the treatment of hypertension. In 1980, we modified the original protocol with guidelines for dietary management and an outline for improving physician-patient communication and health education. We hypothesized that implementing the protocol (and later modifications) would be associated with improved identification and control of hypertension. We conducted a cross-sectional study of hypertensive patients' charts in three community health centers in 1973, 1978, and 1982, and determined the status of blood pressure (BP) control of those patients by the end of the year. In 1973 (before protocol), 4 percent of hypertensives were undiagnosed and untreated, and 20 percent were lost to follow-up. Among those who remained under care, only 33 percent were under control (BP less than 160/95 mm Hg). In 1978, two years after the protocol was introduced, there were fewer undiagnosed and untreated patients (2 percent), but the number lost to follow-up increased to 31 percent. The proportion of hypertensives under control increased to 70 percent. In 1982, two years after the modifications to the protocol were introduced, the proportion of patients lost to follow-up decreased to 28 percent, and the proportion of patients with controlled blood pressure increased to 79 percent. The improved level of control was statistically significant at p less than .0001 (chi-square test).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

The health-illness profile: an essential component of the ambulatory medical record.

Explore the source record for details and available documents.

Ambulatory Care↗

PubMedDate not supplied

Analysis of the QRS vector loop in muscular dystrophy.

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

A diabetes control program in a public health care setting.

The Houston Diabetes Control Program is part of an effort by the State of Texas and approximately 30 other programs throughout the United States to ensure that persons with diabetes-related complications receive ongoing state-of-the-art preventive care and treatment. For the past 5 years, this program has served an urban, high-risk patient population with special cultural, ethnic, and economic challenges. The intervention has included the development and implementation of protocols for the prevention and care of diabetes-related complications of the eyes, lower extremities, and cardiovascular system, as well as general management of diabetes and patient and professional education. The program is ongoing in nine community health centers located in low-income neighborhoods of a large metropolitan area. The results thus far indicate an increase in sensitive eye examinations from 8 percent to 26 percent of the patient population, a reduction in incidence of legal blindness from 9.5 to 2.7 per 1,000 during a 4-year period, an increase in foot examinations from 18 percent to 44 percent of the patient population, and 77 percent of hypertensive patients in good control of blood pressure at less than 160 over 95 mmHg (millimeters of mercury). On the average, there have not been significant long-term improvements in weight reduction or blood glucose control. The major challenges for this program are (a) improvement in control of glycemia, hypertension, and cholesterol; (b) more effective diet and physical activity interventions; and (c) more effective education approaches that help patients to understand metabolic and cardiovascular functions. These challenges will require collaboration of health care professionals in constructive and imaginative ways through their unselfish commitment toward common goals.

Aged↗

PubMedDate not supplied

AIDS knowledge in minorities: significance of locus of control.

A convenience sample of 587 subjects from the community health centers of Harris County, Texas, completed a structured interview that included questions on knowledge of AIDS transmission and prevention and on the Wallston Health Locus of Control (HLOC) Scale. HLOC score was a strong independent predictor of AIDS knowledge, with high externality associated with less knowledge. In a regression equation predicting AIDS knowledge, HLOC contributed 3% of the variance after education and ethnicity were accounted for. Hispanic and black individuals had a higher external orientation than white individuals. These findings suggest the need to address personal beliefs and perceptions concerning risk and to consider HLOC when educating patients and the public about AIDS.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Response rates to random digit dialing for recruiting participants to an onsite health study.

OBJECTIVE: To evaluate the response rates when random digit dialing was used as a substitute for geographic area sampling and household interviews to recruit 2100 African Americans for a blood pressure measurement and hypertension-related knowledge and attitudes survey. METHODS: Random digit dialing was used to identify African American adults living in 12 low-income ZIP code areas of Houston, Texas. A brief survey of hypertension awareness and treatment was administered to all respondents. Those who self-identified as African American were invited to a community location for blood pressure measurement and an extended personal interview. An incentive of $10 was offered for the completed clinic visit. A substudy of nonrespondents was carried out to test the effectiveness of a $25 incentive in increasing the response rate. Data from the initial random telephone interview were used to identify differences between those who did and did not attend the measurement session. RESULTS: Ninety-four percent of eligible persons contacted completed the telephone survey, and 65% agreed to visit a central community site for blood pressure measurement. In spite of the financial incentive and multiple attempts to reschedule missed appointments, only 26% of the 65% who agreed to attend completed the scheduled visit. In the substudy of the higher financial incentive, all of those who missed the original appointment agreed to another appointment, and 85% of this subgroup kept it. Not being employed full-time and a history of hypertension were consistently associated with agreement to be measured and keeping an appointment. In spite of the low response rate for scheduled appointments, differences--other than in employment status and a history of hypertension--between responders and nonresponders were small and consistent with what is usually observed in health surveys. CONCLUSIONS: The use of random digit dialing as a substitute for area sampling and household screening resulted in unacceptably low response rates in the study population and should not be undertaken without further research on ways to increase response rates.

Adult↗