PURPOSE: The purpose of this article is to describe the "employee advisory board model" applied in the Treatwell program, a worksite nutrition intervention program. DESIGN: The employee advisory boards of five of the seven intervention worksites participating in the Treatwell program were surveyed. Results were compared with results of employee surveys conducted in these five worksites. SETTING: The five worksites included in this study are among 16 participating worksites from Massachusetts and Rhode Island. SUBJECTS: Of the 95 board members represented in the five worksites, 88% responded to the survey. This article also presents results from the 698 respondents of the five intervention worksites where the board surveys were conducted. INTERVENTION: The boards in each worksite participated in planning, promoting, and implementing this program in each worksite. MEASURES: Respondents to the board survey were asked about their participation on and satisfaction with the board and factors they thought contributed to its effectiveness. A survey of all employees included information on demographics and program participation. RESULTS: Board members reported that they were highly satisfied with the board's functioning. Board member hours spent on Treatwell activities were directly related to the proportion of employees aware of the program. (r = .82). The boards' effectiveness was limited by conflicting priorities between the job and board responsibilities. CONCLUSION: The employee advisory board model provides promise for increasing worker awareness of worksite health promotion programs through enhanced worker ownership.

Adult↗

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Impact of a physician intervention program to increase breast cancer screening.

In order to improve compliance with the National Cancer Institute's breast cancer screening guidelines, we developed a multifaceted intervention designed to alter physician screening practice. A pre-post test, two-community design was used. Primary care physicians in one community served as the control. Data were collected by two mailed surveys (1987 and 1990). Response rates were 61% and 64%, respectively. The physician intervention program consisted of a hospital-based continuing medical education program and an outreach component which focused on implementing a reminder system. Outcome measures were self-reported attitudinal, knowledge, and screening practices changes. In spite of an impressive change in comparison community physicians' practice, the difference in change over time in the intervention community physicians' ordering of annual mammography compared to the change in the comparison community physicians' ordering was significant (P = 0.04). The adjusted odds ratio is nearly 8. We conclude that our in-service continuing medical education program was successful in improving breast cancer screening practices among primary care physicians.

Education, Medical, Continuing↗

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Racial and gender differences in use of procedures for black and white hospitalized adults.

A number of studies have found that blacks and females with coronary heart disease are less likely to undergo major diagnostic and therapeutic procedures than whites and males, even after controlling for severity of illness and other indicators of physical condition. This investigation examined 78 conditions treated in acute care hospitals to identify possible variations in medical treatment by race and gender among blacks and whites. The study is unique in examining such a wide range of conditions and in using an all-payer national sample. The study examines over 1.7 million inpatient discharge abstracts from the Hospital Cost and Utilization Project, a national sample of about 500 hospitals in the United States. Logistic regression modeling was used to describe the influence of race and gender among blacks and whites on the likelihood of having a major therapeutic or major diagnostic procedure, controlling for patient age, disease severity, health insurance and hospital-level characteristics. The study found that blacks were less likely than whites to receive major therapeutic procedures in 37 of 77 (48%) conditions, and females were less likely than males to receive major therapeutic procedures for 32 of 62 (52%) conditions. The proportion of conditions in which blacks and females were less likely to receive a major diagnostic procedure (without a major therapeutic procedure) was 21% and 26%, respectively. This study identified a number of conditions with apparent variations in medical treatment by race or gender among blacks and whites that should be targeted for more detailed investigations.

Adult↗