Psychosocial epidemiology of rheumatoid arthritis in a rural population.
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Biomedical subjects
Publications and source records attributed to D F Duncan.
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Monitoring the implementation of a program being evaluated can improve the interpretability of data collected and help evaluators to avoid committing a Type III error: evaluating a program that has not been adequately implemented. This article describes an evaluation that analyzed the implementation of a school health education curriculum, assessed cognitive learning outcomes attributable to the curriculum, and examined the relationship between classroom implementation and changes in students' knowledge. Five fifth-grade classes (n = 101) participated in the curriculum, and five classes (n = 84) served as a comparison group. Data collection procedures involved a pretest and posttest of all students' health-related knowledge, daily monitoring of classroom implementation by the five teachers participating, and questionnaires completed by principals and teachers. Analysis methods included descriptive statistics, parametric and nonparametric tests of significance, and qualitative assessment procedures. Results indicated that the curriculum had a positive effect on learning in students; curriculum implementation varied considerably among the five classes participating; teaching/learning activities that were most and least likely to be implemented could be identified and described; both teachers and principals perceived the program favorably; some health instruction was occurring in the comparison classes, so it was not appropriate to consider them as pure controls; and no statistically significant relationship between curriculum implementation and cognitive outcomes was observed. This study provides evidence of the need for and value of measuring implementation of programs being evaluated. Implications for developing implementation measures and the role of formative evaluation in health education practice are considered.
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A standardized-item survey of drug taking was administered to 239 Nigerian students attending three American universities. Alcohol was the most widely used drug in the sample (current use by 64%), followed by tobacco (31.8% current use), cannabis (13.9%), and amphetamine and other stimulants (5.3%). Differences are reported between males and females, and among age groups and college levels. Levels of drug taking were high but no higher than those commonly reported for U.S. college students.
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A public health model for child abuse has been developed to assist in investigating and understanding the multiple factors in causation of the problem and in designing appropriate intervention strategies. The parents responsible for abuse of the child are viewed as the host, the physical and social setting in which the abuse occurred as the environment, and the child is seen as the agent. The vector is conceptualized as influences affecting relations between host and agent. Intervention strategies relate to identification of high-risk parents, high-risk environments and high-risk children, as well as development of non-specific approaches applicable to all three.
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Though drug dependence is often characterized as a stress-produced disorder, there seems to be little or no quantitative data relating stress and drug dependence. In this study a recognized instrument for the measurement of stress, Coddington's Life Event Record, was administered to 31 drug-dependent adolescents by estimating levels of life stress during the year preceding their first illicit drug use. The drug-dependent subjects showed significantly higher life stress scores than did a standard normal population of adolescents. The null hypothesis of no difference was rejected at the .005 level. A stress-reduction theory of drug dependence gains support from these results.
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DRUGNET was a cross-sectional survey of adult recreational drug users (i.e., not abusers) via the World Wide Web of the Internet. The purpose of this survey was to provide a unique, broad description of nondeviant adult recreational drug users. The survey instrument had four divisions: demographic and lifestyle indices, drug use history, legal history and attitudes about drug issues, and the General Well-being Schedule (GWBS). Responses were received from 1,473 self-identified drug users. Of these, 567 completed only the first section, leaving 906 respondents who completed the entire survey. The typical respondent was a White male who was well educated, employed full-time, a participant in recreational and community activities, and who described his physical health status as good. Their mental health, as measured by the GWBS, was similar to the general adult U.S. population. Their drug-taking behavior appeared to be well-controlled, at mild to moderate levels in both frequency of use and degree of intoxication. These findings have major implications for drug policy and indicate the need for further research on the majority of drug users, who may be expected to resemble this sample more than they do clinical populations of drug abusers.
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