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Biomedical subjects

G Kok

Publications and source records attributed to G Kok.

At least 55 records · Page 3Linked to original sources
PubMed1994

Results of the Dutch community project "Healthy Bergeyk".

BACKGROUND: This article reports on the results of a community health project that was implemented in the Dutch municipality of Bergeyk. The major goal was to reduce four cancer-related risk behaviors: smoking, high fat consumption, excessive alcohol use, and exposure to artificial sunlight. A control community received no new intervention. Intervention methods included mass media messages, self-help materials, small group activities, lectures, and structural activities. Community organization principles such as a social network approach, community participation, and intersectoral cooperation were applied in the project. METHODS: Data were collected from both communities among cohort research samples on three occasions using telephone interviews. RESULTS: The results indicate a significant reduction in fat intake in the experimental community. No other significant behavioral effects were found. Further analysis among respondents in the experimental condition showed that those personally exposed to the project as indicated by familiarity with and discussion about the project, had a greater decrease in fat consumption between baseline survey and second post-test than those who were not. Also, the percentage of smokers who quit between baseline survey and second post-test was greater among those who knew about the project than among those who did not. Finally, discriminant analysis was used to further examine the determinants of project exposure. Community involvement, marital status, education, and sex were related to project exposure. CONCLUSIONS: It is concluded that with the time limitations of the project in mind, the findings are encouraging.

Adult↗
PubMed1994

Service attributes and the choice for STD health services in persons seeking a medical examination for an STD.

This article examines choice for STD health services among patients suspecting a STD. A total of 825 patients who sought medical treatment at an STD clinic, a Family Planning Clinic or a General Practitioner participated in this study. Special STD clinics are not well known among patients visiting their GP or a Family Planning Clinic. Both perceived unprofessionality and embarrassment were reasons for not asking a GP for medical treatment and for not being loyal to their GP after a first visit. Most respondents evaluate the 16 service attributes as important and/or annoying. Differences in beliefs and evaluations about the separate service attributes existed between the three choice behavior groups. The results of this study may be useful in making persuasive arguments for the existence of special STD clinics, especially when competing for limited resources. However, attitudes to service attributes and social norms explained only 24% of the variance in scores between the three choice behavior groups. This means that other factors (have to) play a role in actual choice behavior. Future research should take into account factors, such as: personality traits, perceived behavioral control and confidentiality.

Adolescent↗
PubMed1994

Focus group interviews with risk-taking gay men: appraisal of AIDS prevention activities, explanations for sexual risk-taking, and needs for support.

Recently, several findings demonstrated an increase in high-risk sexual behaviour among gay men. This study conducted focus groups with gay men who engaged in risk-taking behaviour with casual partners. Three issues were addressed: appraisal of current AIDS prevention activities, explanations for sexual risk-taking, and needs for support. The results show that participants criticize current prevention efforts. The explanations for risk-taking behaviour contribute to a better understanding of the underlying processes related to sexual risk-taking. Participants' needs include unequivocal information on HIV and AIDS, more insight into the rationality behind safe sex directives, and more opportunities to discuss their difficulties regarding safe sex behaviour with peers.

Adult↗
PubMed1994

Public reactions towards people with AIDS: an attributional analysis.

This article addresses the issue of stigmatization and discrimination towards people with AIDS (PWAs) using Weiner's attributional theory of motivation and emotion. In a field experiment, subjects responded to vignettes describing patients with AIDS, syphilis, lung cancer or tuberculosis. In these vignettes, the onset of the diseases was either described as personally controllable or as uncontrollable. Results show that although attributional variables do account for a significant amount of variance in helping behavior and emotions towards PWAs, other variables such as the incurability of the disease, the risk of infection and associations with (homo)sexuality, may be more useful in explaining reactions to PWAs. Implications for education tailored at the prevention of the stigmatization of PWAs are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Effectiveness of a multidisciplinary education protocol in children with asthma (0-4 years) in primary health care.

This paper describes the results of an asthma self-management protocol delivered to parents of children aged 0-4 years. The protocol was delivered by general practitioners (GPs), community nurses, asthma nurses, and doctors to child health centers. It consisted of 16 educational modules developed after an initial needs assessment of parents and a task analysis of primary care practitioners. The program was evaluated by means of an experimental design. Parents participating in the program had significantly more knowledge, a more favorable attitude toward asthma, and a higher self-efficacy score with respect to performing asthma self-management behaviors. Also, they reported performing self-management behaviors more frequently than parents in the control group. One-year follow-up results, which were collected for parents in the treatment group only, showed that the described changes were sustained. Further, the treatment group was found to have decreased its emergency and nonemergency use of the physician's office and to have a reduction in (reported) asthma severity. Process evaluation indicated that most modules were provided by the GPs to nearly all parents. After parents had read the modules at home, almost all the information was discussed in the next contact. GPs seldom referred patients to the community nurses, although this was suggested in the protocol.

Asthma↗
PubMed1993

The determinants of four cancer-related risk behaviours.

This paper reports research into the determinants of four cancer-related risk behaviours: smoking, excessive alcohol consumption, high fat consumption and exposure to artificial sunlight. The results indicate that the four types of risk behaviour are determined by several factors: the perceived behaviour of the social environment, individual's attitudes towards the risk behaviour and self-efficacy perceptions on changing the risk behaviour. High fat consumption differs from the other risk behaviours in that people tend not to be aware of their high fat consumption. No significant relationships were found among the risk behaviours apart from small correlations between smoking and heavy alcohol consumption, and between high fat consumption and heavy alcohol consumption. The implications of these results for the development of behaviour change programs are discussed.

Adult↗
PubMed1993

Why do homosexual men relapse into unsafe sex? Predictors of resumption of unprotected anogenital intercourse with casual partners.

OBJECTIVE: To assess predictors of relapse into unprotected anogenital intercourse with casual partners among homosexual men in Amsterdam, The Netherlands. DESIGN: A prospective study ongoing since October 1984. METHODS: Self-reported data on sexual behaviour were obtained at 12 semi-annual intervals. Participants who reported unprotected anogenital intercourse with casual partners at wave 12 but not at wave 11 were considered to have relapsed into unsafe sex (n = 47). Men who did not report unprotected anogenital intercourse at wave 11 or at wave 12 were considered to have maintained behaviour change (n = 197). RESULTS: Relapse into unsafe sex with casual partners occurred more frequently among men with a less positive attitude towards condom use, lower personal efficacy with respect to using condoms with casual partners, a weaker intention to avoid anogenital intercourse with casual partners and those who were not involved in a primary relationship. Intention to avoid anogenital intercourse with casual partners was related to an individual's attitude, normative beliefs and personal efficacy with respect to avoiding anogenital intercourse. CONCLUSIONS: In order to improve motivation it is important to support homosexual men in their personal decision-making process, which may be more resolute when the outcome is in accordance with individual preferences. Therefore, health education should be community-based and sensitive to individual needs.

Adult↗
PubMed1993

Reactions among Dutch youth toward people with AIDS.

AIDS education emphasizing personal responsibility toward AIDS-inducing behavior might enhance negative reactions to people with AIDS. This study, based on Weiner's attributional theory of motivation and emotion, addressed this dilemma by reporting data from a sample of 1,018 Dutch secondary school students. Results support the reasoning that emphasizing personal responsibility, and consequently personal controllability, increases negative reactions to people with AIDS. In addition to causal attributions, however, AIDS knowledge and attitudes toward homosexuality also related significantly to reactions to people with AIDS. To prevent negative reactions to people with AIDS, the subject of homosexuality should be dealt with before AIDS education is provided. AIDS education should address the impossibility of HIV infection by daily interactions, and the meaning and consequences of being seropositive.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Worry: a particular determinant of consultation illuminated.

In this study, exploring the worry experienced by patients in the GP waiting room and the reasons for being worried, 791 patients completed a structured questionnaire just before they consulted their GP, and afterwards. The perceptions of the patients concerning the complaint and the need for more information about the complaint played an important role in the degree of worry. Patients who wanted more information about the complaint were more worried than the patients who did not feel they needed more information. Not surprisingly, the more serious the patients perceived the complaint to be and the greater the perceived chance of serious disease, the more worried they were. General health status and frequency of consultations per year were related to the degree of general worry. According to the patient self-reports, worry was almost never due to information from the mass media or from other persons, or to a concern for the consultation itself. Patients generally evaluated the consultation as positive with respect to the way their worry was discussed. The decrease in worry after consulting the GP, in patients who were positive about the consultation was significantly higher than that in patients who were less positive. The theoretical and practical implications of this study are discussed.

Adult↗
PubMed1992

The reliability and validity of a Dutch questionnaire on fat consumption as a means to rank subjects according to individual fat intake.

In this paper a short, 25-item, telephone-administered questionnaire, designed to rank individuals according to their dietary intake of fat, is presented. Based on two studies of 52 and 639 men and women, respectively, its relative validity regarding a 7-day diet record and its reproducibility are discussed. A Pearson correlation of 0.59 was observed between fat intake estimated by 7-day diet records and fat score derived from the short questionnaire. Gross misclassification, defined as disagreement between the two fat consumption assessments beyond an adjacent tertile, was 15.4%. A Pearson correlation of 0.71 was calculated by a test-retest procedure. It is concluded that the Dutch short questionnaire on fat consumption is a rapid, simple and inexpensive method that can very well be used in nutrition education research to rank individuals according to their dietary fat intake.

Adolescent↗
PubMed1992

The utilization of qualitative and quantitative data for health education program planning, implementation, and evaluation: a spiral approach.

The process of development of a Dutch smoking prevention project is described. An essential feature of the project is the combination and interaction of qualitative and quantitative research methods. It is advocated that each method has its own contribution and can be considered as a separate methodology contributing to social science in general and health education research in particular. Combining the two approaches in a spiral approach will result in a synergistic effect, because of the interaction of both approaches. The results of both methods suggest that qualitative methods enhanced the generation of ideas and theories. Qualitative methods were used to formulate ideas for improving quantitative data gathering, analyzing and comparing ideas with respect to program development, and for testing the internal validity of a quantitative design. The quantitative method enabled testing of results in different groups and detecting detailed differences. It also provided information that one of the assumptions of the program, the development of a teacher independent program, was not completely realized. The major advantage of using both methods is that this provides feedback between assumptions and data, thus enhancing comparison of results and critical reflection during the whole project.

Health Education↗
PubMed1992

Why do patients consult the general practitioner? Determinants of their decision.

In order to obtain more information about the reasons why patients consult their general practitioner 1000 patients completed a questionnaire in the waiting rooms of eight general practices. After the consultation the patients received a second questionnaire. The aim of the study was to determine why people decide to consult their general practitioner about one complaint but not about a second complaint. Both questionnaires were based on the health belief model, augmented by three other factors: the perceptions patients have of their own abilities to cope with their condition (efficacy of self care), their knowledge about the complaint and their need for information. The results showed that two of the additional factors (efficacy of self care and need for information) as well as most of the factors of the health belief model (efficacy of general practitioner care, perceived severity of complaint and cues to consult) were important determinants of consulting the general practitioner. The results suggest that patients sometimes expect information from their general practitioner rather than medical treatment. Furthermore, as the perceived efficacy of general practitioner care is also an important determinant, unnecessary consultation or unnecessary delay in treatment could be prevented by offering patients information about the potential effectiveness of medical care or self care for specific conditions. Implications for general practitioners' daily practice and future research are discussed.

Attitude to Health↗
PubMed1991

Determinants of behavioural risk factors for burn injuries.

Systematically developed health education should be based on a thorough knowledge of the determinants of the behavioural risk factors. Compared to other health-related behaviours, safety behaviour has some specific characteristics, which complicate studying its determinants. First, there is a multitude of circumstances leading to injuries, which means that it is not possible to pinpoint one desired behaviour to be linked with the prevention of injuries. Secondly, people are often not familiar with (the advantages and disadvantages of) all the possible preventive measures. Thirdly, the usefulness of preventive measures may depend on housing situations. So far, no elegant way of coping with these problems in examining the determinants of safety behaviour seems to have been suggested in the literature. In this article an approach to the study of determinants of safety behaviour is presented. The general description of this approach is illustrated by a study on the determinants of the behavioural risk factors for burn injuries in young children, which was conducted among Dutch and Turkish parents of children aged 0-4 years. The results indicate, for instance, that parents who implemented the safety behaviour reported that safety behaviour had become habitual to them.

Accidents, Home↗