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J A Best

Publications and source records attributed to J A Best.

48 records · Page 3Linked to original sources
PubMedDate not supplied

Dispositional risk factors for smoking-stage transitions: a social influences program as an effect modifier.

A cognitive-developmental model postulates three predominant adolescent dispositions (self-definition, social compliance, and affect regulation) which may impede or facilitate transitions in stages of smoking. The purpose of the present prospective study was to build on the findings supporting this model. One hundred schools were randomly assigned to either receive or not receive a social influences smoking prevention program. A baseline survey, including smoking behavior and dispositional items, was administered in the sixth grade in 1990, interventions were delivered in the sixth and seventh grades, and a survey was administered following the seventh grade intervention. Principal component patterns, based on dispositional items, were very similar for grades 6 and 7, did not vary by gender, and the components (rebelliousness, rejection of adult authority, personal dissatisfaction, and peer approval) were correlated. All smoking-stage transitions were positively related to rebelliousness for boys. The relationship of the dispositional scores with smoking-stage transitions was more complex for girls. Receiving the program modified the effects of the dispositional risk scores, particularly for girls.

Adolescent↗
PubMedDate not supplied

Social environment and smoking initiation.

This paper reports exploratory research to predict smoking initiation prospectively as a function of both personal (peer and family) and more macro (school and community) social environment. At the macro level, older peer smoking by school system and school board by school system were significant predictors of smoking onset. At the personal level, the effect of gender varied with time. Males began to smoke earlier than females, but females had higher onset rates in the period from the end of Grade 7 to the end of Grade 9. Significant sibling and peer influences replicate the consistent findings in the smoking initiation area. Implications for the longitudinal study of the smoking onset process are given.

Adolescent↗
PubMedDate not supplied

A comparison between instructional experience and performance of teachers and nurses delivering a smoking prevention program.

This paper focuses on the implementation evaluation strategy of a smoking prevention program and examines differences in instructional experience and implementation of the grade six curriculum in relation to provider type. Arbaseline, nurses (n = 40), compared with teachers (n = 39), reported (a) less previous classroom teaching experience, (b) greater reliance on lecturing and audio/visual materials, (c) less use of small group classroom activities, and (d) less confidence using small group and role playing methods in the classroom. More nurses than teachers believed smoking to be a significant problem in the schools. Nurses had less confidence than teachers in their ability to teach the smoking prevention curriculum. Nonetheless, behavioural observation indicated that nurses implemented the curriculum more completely. However, teachers, at least those who received workshop training, showed some evidence of greater utilization of teaching styles thought to be desirable.

Adult↗
PubMedDate not supplied

A family physician smoking cessation program: an evaluation of the role of follow-up visits.

Our purpose in this randomized clinical trial was to compare a two-visit smoking cessation intervention by family physicians with the same intervention supplemented by additional follow-ups. Forty-one southern Ontario family physicians volunteered for the study and subsequently participated in a four-hour training program on smoking cessation techniques. Physicians advised patients who smoked and indicated an interest in attempting to quit with the help of their physician to stop smoking at the end of a regularly scheduled visit. Physicians instructed patients to make a specific appointment for an evaluation of their smoking habits. Six hundred forty-seven patients returned for that assessment and were than randomized into either the two-visit intervention group (with risk assessment, support, the setting of a cessation date, self-help literature, and a prescription for nicotine gum, where appropriate) or into the other intervention group (with the same maneuvers as well as the offer of four more supportive follow-up visits). We found no statistically significant difference in one-year, biochemically validated, sustained cessation rates between the group offered the long-term follow-up visits (12.5%) and the group given the brief intervention (10.2%). The 95% confidence interval on the difference between the groups was 2.8% in favor of the brief intervention group to 7.3% in favor of the group offered follow-up. The results do not support the value of long-term follow-up visits for smokers.

Adult↗
PubMedDate not supplied

Patients' perspectives of a physician-delivered smoking cessation intervention.

Forty-three patients--recipients of a highly structured, physician-delivered smoking cessation intervention--were interviewed using ethnographic (anthropological) research methods. We conducted interviews with patients after visits with the physician, then audiotaped and transcribed them. Discourse analysis of interview texts identified features and components of the physician maneuver most effective from the patients' point of view. Patients discussed two general areas of physicians' preventive activities: an interventionistic component (in which professional, diagnostic, and authoritative features were emphasized) and a personalistic component (in which physicians were experienced as equals, supportive, caring, empowering, and challenging). From the perspective of patients, the personalistic component of the physician-delivered smoking cessation maneuver appeared most effective. We conclude that, in clinical preventive medicine generally, patients (1) evaluate the kind of support they receive from their physician (e.g., degree of empathy, encouragement, and sincerity), (2) respond favorably to positive imagery in the challenge to alter their lifestyle, (3) look for a balance in the relationship established with their physician (negotiation, respect, mutual understanding, and rapport), and (4) remember the consistency and regularity of their physician's health promotion messages.

Female↗
PubMedDate not supplied

The dissemination of chronic disease prevention programs: linking science and practice.

A strong partnership between researchers and providers is crucial to advance the science of dissemination and to support dissemination of effective chronic disease prevention programs. We reflect on our experience in three recent studies, (a) COMMIT, (b) a National Survey of School Smoking Prevention Programs, and (c) an ongoing study of Training of Providers of Smoking Prevention Programs to identify specific ways in which research and provider communities might collaborate. We propose that a national working group of researchers and providers be established to support (a) dissemination of programs by creating and continuously updating an inventory of 'tested' methods and protocols for use in key community intervention channels (health care offices, worksites, etc.) and (b) dissemination research by establishing a shared set of research priorities and mechanisms to stimulate researcher-provider partnership during the research process.

Canada↗
PubMedDate not supplied

Health promotion practice and public health: challenge for the 1990s. Heart Health Think Tank Group.

The issue of practice skills arose in the course of a process evaluation of the Heart Smart North Shore (HSNS) project in British Columbia. We created a Think Tank of researchers and community practitioners to make recommendations for improvement of our skills. These recommendations differed according to different values for health and opinions on how to create health in the community. Because the site reviewers of the HSNS project were clear this was a disease prevention project and not a community development initiative, HSNS's orientation to skill development after the Think Tank moved toward the Precede/Proceed model, the Transtheoretical model and social marketing approaches. The Health Unit has now been restructured into multidisciplinary service teams which must focus on population health, evidence-based practice and the social determinants of health, and thus need to consider health promotion from a community development perspective and empowerment model. We suggest that learning and the development of staff and community volunteers should be seen as a continuous and reflective process that takes place at the individual, community and organizational level.

British Columbia↗