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G S Parcel

Publications and source records attributed to G S Parcel.

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

Design of process evaluation within the Child and Adolescent Trial for Cardiovascular Health (CATCH).

Process evaluation complements outcome evaluation by providing data to describe how a program was implemented, how well the activities delivered fit the original design, to whom services were delivered, the extent to which the target population was reached, and factors external to the program that may compete with the program effects. The process evaluation system used in the Child and Adolescent Trial for Cardiovascular Health (CATCH) is presented in this paper. The conceptual model underlying the CATCH process evaluation system is described, and process measures and data collection protocols are reviewed. Functions of process evaluation data in the trial include: (1) describing the implementation of the program, (2) quality control and monitoring, and (3) explaining program effects. The importance of incorporating process evaluation into final outcome analyses and assessments of program impact is emphasized.

Adolescent↗
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

Lipid and lipoprotein distributions in children by ethnic group, gender, and geographic location--preliminary findings of the Child and Adolescent Trial for Cardiovascular Health (CATCH).

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health is a school-based study designed to test the effectiveness of dietary, physical activity, and educational interventions for reducing cardiovascular disease risk and teaching healthful behaviors to children. METHODS: As part of a pilot phase in 1989, lipid, lipoprotein, and anthropometric measures were taken in black (n = 90), Hispanic (n = 68), and white (n = 265) 8- to 10-year-old schoolchildren in California, Louisiana, Minnesota, and Texas. RESULTS: There were no significant differences in mean lipoprotein cholesterol values between fasting and nonfasting children. Therefore data from fasting and nonfasting children were pooled. Males and females within the same ethnic groups had similar mean levels of total cholesterol, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol. However, levels of high-density lipoprotein cholesterol were higher among white and black males than among females from the same ethnic groups. Black males had higher total cholesterol than white males and higher high-density lipoprotein cholesterol than white males and Hispanic males. Similarly, black females had higher high-density lipoprotein cholesterol than white and Hispanic females. In all children combined high-density lipoprotein cholesterol was inversely correlated and low-density lipoprotein cholesterol was positively correlated with subscapular and tricep skinfold thickness, weight, and body mass index. There were significant differences in mean lipoprotein cholesterol levels between geographic sites. Total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were highest in children from California followed by children from Texas, Minnesota, and Louisiana. CONCLUSION: Our results suggest that body fatness total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol differ in children by gender, ethnicity, and geographic location.

Analysis of Variance↗
PubMed1993

Performance objectives for the self-management of cystic fibrosis.

Performance objectives for the self-management of cystic fibrosis (CF) were developed and subjected to a two-stage content validation. A multidisciplinary team of health care professionals generated a list of 149 medical and adjustment performance objectives. Behaviors included monitoring symptoms and judging their significance, treating symptoms and communicating with health care providers about symptoms and treatment plans. In the first stage a panel of experts in the medical and behavioral aspects of CF rated each behavior. In general, the eleven panelists rated the 149 behaviors as somewhat important or important (mean 2.6, S.D. 0.17, on a 3-point scale). In the second stage, 84 of 155 CF center directors rated all behaviors as somewhat important or important (mean 2.9, S.D. 0.23). Specific behaviors related to medical regimens were more consistently rated as important than were those related to psychosocial adjustment. The performance objectives provide a framework for developing and evaluating health education programs for the self-management of CF in order to promote optimum health and adjustment.

Cystic Fibrosis↗
PubMed1993

The linkage approach applied to a school-based smoking prevention program in The Netherlands.

Effective diffusion strategies are necessary to enhance use of innovative health promotion programs. One strategy uses the linkage approach to innovation-development and diffusion planning. The linkage approach enhances collaboration among three systems: resource system (university-based researchers), linkage system (district health educators), and user system (teachers). This article illustrates how the linkage approach was applied in a smoking prevention research project. Identification of the linkage system and the collaborative process between the resource system and linkage system are described. Results from a process evaluation indicated the linkage approach was feasible in a school-based smoking prevention project.

Child↗
PubMed1993

Measuring self-efficacy expectations for the self-management of cystic fibrosis.

This research developed and determined the psychometric characteristics of a measure of self-efficacy expectations (a social cognitive theory construct) for the self-management of cystic fibrosis (CF). Items for the original instrument were sampled from 150 self-management performance objectives for CF that represented behaviors in eight domains of CF care, including aspects of medical care, coping, and communication. The instrument was administered to 199 parents of children and adolescents with CF from two CF centers. The findings support a multidimensional structure for self-efficacy consistent with the multiple types of behavior required for the management of a chronic illness such as CF. An alpha-factor analysis yielded solutions clearly reflecting five theorized aspects of self-management: medical judgment and communication, coping, family communication, compliance, and acceptance. The first factor of the caretaker's scale most closely represents the underlying conceptualization of self-management as requiring self-monitoring of health status and collaboration with the health care provider in making judgments about treatment. The unit weighted factors exhibited high internal consistencies (Cronbach's alpha-factors ranging from 0.73 to 0.88).

Adolescent↗
PubMed1992

Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual risk behavior.

Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.

Adolescent↗
PubMed1991

Acquired immunodeficiency syndrome and adolescents. Knowledge, attitudes, and behaviors of runaway and homeless youths.

OBJECTIVE: To describe the knowledge, attitudes, and behaviors of runaway and homeless youths regarding infection with the human immunodeficiency virus (HIV). DESIGN: Cross-sectional, descriptive. SETTING: A crisis shelter for runaway and homeless youths. PARTICIPANTS: One hundred one residents, aged 13 to 20 years, of a shelter for homeless and runaway youths in Houston, Tex. INTERVENTION: None. MEASUREMENTS/MAIN RESULTS: A self-administered questionnaire was used to examine the knowledge, attitudes, and behaviors of these youths regarding infection with HIV. Nearly one fourth had injected illegal drugs; one fifth had shared needles for other purposes. Sixteen percent had had anal intercourse, 19% had engaged in prostitution, and 67% of all subjects reported having four or more sexual partners. One fifth reported that they always use condoms. While quite knowledgeable about means of transmission, they held prevalent misconceptions about casual contact and risk reduction. Youths perceive few barriers to condom use, have fairly high intentions to practice preventive behavior, and have high self-efficacy to do so. Most believe they are at little or no risk for acquiring HIV. These findings support the need for medical, educational, and social service programs to reduce the risk of HIV among these youths. CONCLUSION: Runaway and homeless youths practice behaviors that place them at high risk for acquisition of HIV infection. Risk reduction is imperative and will require programs that address the educational, psychological, social, and medical needs of these youths.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Development of a health education program to promote the self-management of cystic fibrosis.

The creative challenge of health education for chronic illnesses is the translation of theory-based intervention methods into practical strategies that can be organized into a logical series of learning activities to influence changes in environmental, cognitive, or behavioral factors. A case example describing the development and implementation of a comprehensive health-education intervention for the self-management of cystic fibrosis (CF) is presented. The design of intervention strategies began with an assessment of the educational needs for self-management of CF, followed by specification and validation of particular self-management behaviors. Behavioral and learning objectives then were formulated for each of the self-management behaviors. Constructs from social learning theory considered to be important influences on specified self-management behaviors in CF were identified. Taking into consideration the learning needs of the target population and the practical constraints of the system for providing health care, various intervention methods then were devised based on social learning theory. Lastly, the intervention methods chosen were translated into strategies organized into a series of practical learning activities for CF patients and their families. The process described here should prove useful to others who are planning and developing comprehensive health education programs for self-management of chronic illnesses.

Adaptation, Psychological↗
PubMed1991

Promoting physical activity and a healthful diet among children: results of a school-based intervention study.

BACKGROUND: National health objectives call for improved diet and more regular physical activity among children. We tested the effects of a school-based program to improve students' diet and physical activity behavior at school. METHODS: Two of the four elementary schools in one Texas school district were assigned to intervention and two to control conditions. The three intervention components were classroom health education, vigorous physical education, and lower fat, lower sodium school lunches. Nutrients from school lunches and the total day and the amount of physical activity students obtained during physical education were assessed as outcome. RESULTS: Analysis of school lunches showed declines from base line to posttest in the two intervention schools of 15.5% and 10.4% for total fat, 31.7% and 18.8% for saturated fat, and 40.2% and 53.6% for sodium; posttest values were lower in the intervention schools. Observation of physical activity during physical education classes indicated an increase in the intervention schools from baseline to posttest in the percent of time children engaged in moderate-to-vigorous physical activity from less than 10% of class time at baseline to about 40% of class time at posttest; posttest values were higher in the intervention schools than in the control schools. CONCLUSIONS: This efficacy study demonstrates the feasibility of substantially modifying school lunches and school physical education to improve children's diet and physical activity behavior at school.

Child↗
PubMed1990

Children's frequency of participation in moderate to vigorous physical activities.

Third and fourth grade boys (n = 422) and girls (n = 390) in four Texas elementary schools reported their participation in moderate to vigorous physical activities (MVPAs) over a 3-day period. Students were surveyed during class on successive days. On a subsample (n = 44), the agreement between reported and observed physical activities during physical education or recess was 86.3%. Running, walking fast, games and sports, and bicycling accounted for 70% of Total MVPAs. Of Total MVPAs reported, 47.0% for boys and 44.6% for girls were 10 min or longer in duration (LMVPA). The average number of LMVPAs per day was 1.7 for both boys and girls. Students reported significantly more occurrences of LMVPAs out of school than during school. Significant interaction between grade and gender indicated that third grade boys reported more Total MVPAs and LMVPAs than third grade girls, but fourth grade boys reported fewer Total MVPAs and LMVPAs than fourth grade girls reported fewer Total MVPAs and LMVPAs than fourth grade girls. During the 3-day reporting period, 12.3% of boys and 13.3% of girls reported no LMVPAs, and 35.6% of boys and girls reported fewer than one LMVPAs per day. While the majority of children reported obtaining at least some activity daily, a substantial proportion of children in this sample reported fewer than one LMVPA daily, indicating that many children may not be obtaining adequate amounts of physical activity.

Child↗
PubMed1990

Expectations of preschool children to protect themselves from cigarette smoke: results of a smoking prevention program for preschool children.

Because preschoolers and first graders show signs of readiness to try smoking and because they are already learning about smoking through their environment, smoking prevention at the preschool level is appropriate. The large numbers of children seen in primary care practices and day care facilities are indicative of the numbers that could be exposed to smoking prevention instruction through these settings. This study assessed the future expectations of children to protect themselves from sidestream smoke after participating in a preschool smoking prevention program offered in four primary care settings. Through this program, children and their parents read stories and complete activities concerning the human body and the health risks of smoking. Using a randomized posttest-only case control design, the authors found that children who were exposed to the curriculum were more than twice as likely as others to report the intention to act to protect themselves from adult sidestream smoke.

Age Factors↗
PubMed1990

School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH).

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multisite intervention research study that builds on significant progress made in school health education research in the 1980s. The study has three phases: Phase I deals with study design, intervention, and measurement development, Phase II involves the main trial in 96 schools in four states, and Phase III focuses on analysis. The intervention program targets third-fifth grade students and focuses on multiple cardiovascular health behaviors, including eating habits, physical activity, and cigarette smoking. Classroom curricula, school environmental change, and family involvement programs are developed for each grade level and behavioral focus. This paper describes Phase II of CATCH with a rationale for cardiovascular health promotion with youth. The process of change that appears to be necessary for school-based health promotion and that will be tested in CATCH are presented as a framework to guide these efforts.

Adolescent↗
PubMed1989

Stability in a measure of children's health locus of control.

Increased interest in children's health locus of control has precipitated continued examination of the psychometric properties of scales measuring this concept. The Children's Health Locus of Control scale (CHLC) was administered to more than 1,000 urban black students in each of four years across three grade levels: Year 1 - grades four-six to Year 4 - grades seven-nine. Factor analyses revealed five factors forming scales with acceptable reliability at each year. Students' beliefs that they have control over their own health increased as a function of age. Beliefs in self-control had low, negative correlations with measures of external control. Stability of CHLC and the relatively simple procedure (16 dichotomous items) suggest that, despite problems with wording of some items, CHLC is an appropriate and efficient measure for comparing cross-sectional and longitudinal samples in this age range.

Adolescent↗
PubMed1989

School promotion of healthful diet and physical activity: impact on learning outcomes and self-reported behavior.

The Go For Health Program included classroom health education and environmental changes in school lunch and physical education to foster healthful diet and exercise among elementary school children. Interventions were based on social learning theory and implementation was based on an organizational change strategy for school innovations. Two schools were assigned to intervention and two to control conditions. Cognitive measures (behavioral capability, self-efficacy, behavioral expectations) and self-reported diet and exercise behavior were assessed at baseline and following intervention. Data were analyzed by ANOVA using the student and then the school as the unit of analysis. Statistically significant changes were observed for diet behavioral capability, self-efficacy, and behavioral expectations, use of salt, and exercise behavioral capability (fourth grade), self-efficacy (fourth grade) and frequency of participation in aerobic activity. The results provide evidence for program impact on learning outcomes and student behavior.

Behavior Therapy↗
PubMed1989

An ecological approach to the prevention of injuries due to drinking and driving.

Among the many alcohol-related public health concerns, motor vehicle crashes account for nearly one-third of all deaths attributable to alcohol. Adolescents and young adults, particularly males, are important target populations for intervention efforts. Taking an ecological perspective of individuals within their social and physical environments, a diagnostic framework is employed in reviewing the literature on factors associated with drinking and driving injuries and on interventions to prevent injuries due to drinking and driving. Intervention planning is conceptualized according to a multilevel intervention framework, which consists of four phases: (1) health goals selection, (2) intervention planning, (3) intervention, and (4) evaluation. Possible intervention objectives, targets of the intervention actions, intervention approaches, and evaluation criteria are identified and discussed for three societal levels and four practice settings.

Accidents, Traffic↗