Search PubMed⌕ Search

Biomedical subjects

K Glanz

Publications and source records attributed to K Glanz.

At least 73 records · Page 4Linked to original sources
PubMed1988

An ecological perspective on health promotion programs.

During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal, organizational, community, and public policy, factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social environment will produce changes in individuals, and that the support of individuals in the population is essential for implementing environmental changes.

Community Health Services↗
PubMed1988

Environmental interventions to promote healthy eating: a review of models, programs, and evidence.

Environmental interventions are an important part of efforts to improve health in populations. With respect to strategies to encourage positive nutrition behavior, environmental approaches help create opportunities for action by removing barriers to following a healthy diet. This article reviews the rationale, conceptual models, program examples, and recent empirical evidence regarding the extent and effects of environmental interventions to promote healthy eating. The state of the art is described for five types of interventions: (1) changes in the food supply; (2) point of choice nutrition information; (3) collaboration with private sector food vendors; (4) worksite nutrition policies and incentives; and (5) changes in the structure of health and medical care related to nutrition. Environmental approaches to dietary behavior change can reach large segments of the population through increased availability of nutritious foods, provision of quality nutrition services in workplace and health care settings, and accessible information about healthful food choices. Nutrition intervention can also serve as a model for other types of health promotion initiatives using multidimensional environmental and educational technologies.

Food Supply↗
PubMed1986

A randomized trial of special packaging of antihypertensive medications.

This article reports a randomized controlled trial designed to test the effects of special packaging of antihypertensive medication on compliance and blood pressure control. One hundred eighty subjects who had exhibited elevated blood pressure greater than 90 mmHg in the two years prior to the study were recruited from patients receiving care at a community hospital-based family medicine practice. After completing preenrollment interviews and blood pressure measurements, subjects were randomly assigned to receive their antihypertensive medications either in the usual vials or in special unit dose-reminder packaging. Follow-up interviews, pill counts, and blood pressure measurements were performed at three-month intervals. There were no statistically significant differences between the control and experimental groups with regard to age, sex, race, employment, education, marital status, insurance coverage, or blood pressure regimens. Prior to the intervention, the experimental group had slightly lower diastolic blood pressure and reported better compliance than the control group. Analyses performed on 165 subjects completing the first follow-up visit revealed no significant improvements in blood pressure control or compliance for patients receiving special medication packaging. While some patients found it easy to remember to take pills packaged using this format, they also found the packages somewhat more difficult and inconvenient to use. In contrast to previously reported work, this study did not demonstrate any significant improvement in compliance with special packaging of antihypertensive medications.

Adult↗
PubMed1985

Nutrition education for risk factor reduction and patient education: a review.

Studies of adult nutrition education and counseling for weight reduction, diabetes, cancer, low-fat diets, sodium-restricted diets, and renal diets are reviewed and synthesized. Nutrition education consists of three phases: assessment or problem diagnosis, intervention, and evaluation and monitoring. This article examines the importance of accurate problem diagnosis, the use of behavioral and biological measures of nutrition education effectiveness, and the types and effects of reported strategies. In addition, the issues of maintaining behavioral changes, nutrition education providers and their training, and settings for nutrition education are discussed. Implications and suggestions for advances in practice, theory, and research in patient nutrition education are presented.

Body Weight↗
PubMed1984

Compliance with an experimental drug regimen for treatment of asthma: its magnitude, importance, and correlates.

This paper reports on data from a double-blind, randomized controlled study of out-patient use of corticosteroids following an acute asthma attack. Issues related to compliance are examined, including: (1) the extent of non-compliance; (2) impact of non-compliance on interpreting the drug trial results; and (3) correlates of non-compliance. Of the 102 cases enrolled in the study, 25.5% were excluded from analysis because they were lost to follow-up (10.8%) or non-compliers (14.7%). Based on data for compliers, the drugs were found to reduce relapse rates and asthma symptomatology; when non-compliers were included in the analysis, the steroid drug appeared ineffective for reducing relapses and less effective for improving overall illness status. Examination of 24 potential correlates of compliance yielded a few significant associations, and only the "usual habit of compliance" correlation suggests an avenue for future action. The implications of the study findings for design and interpretation of clinical trials, as well as for improved management of chronic diseases, are discussed.

Adolescent↗
PubMed1983

Efficacy of short-term corticosteroid therapy in outpatient treatment of acute bronchial asthma.

A group of adults with 76 episodes of acute asthma needing emergency therapy, but not requiring hospitalization, were discharged from an emergency department following standardized therapy with bronchodilators. Upon discharge, the patients were treated with a controlled regimen of oral theophylline, and were randomly assigned in double-blind manner to either a placebo treatment (42 patient episodes) or a corticosteroid treatment group (34 patient episodes). The latter were given an intravenous bolus of methylprednisolone followed by an eight-day tapering course of oral methylprednisolone, starting at 32 mg twice a day. Follow-up was carried out seven or 10 days after treatment in the emergency department. Relapse could not be predicted on the basis of peak expiratory flow rates measured during care in the emergency department. Those patients who received corticosteroids had a decrease in the need for repeated emergency care (5.9 percent versus 21 percent for placebo) and fewer respiratory symptoms (15.6 percent versus 36.4 percent for placebo). It is concluded that a short course of high-dose corticosteroids in outpatients reduces the relapse rate and symptoms following an acute asthmatic attack.

Acute Disease↗
PubMed1982

Intervention strategies to improve adherence among hypertensives: review and recommendations.

Hypertension is a leading public health problem, which significantly increases the risks of death and disability from cardiovascular and cerebrovascular diseases. Medical treatment is effective for reducing hypertension and the associated risks, but nonadherence to recommendations for treatment has limited the realization of benefits of advances in medical care. This paper reviews recent attempts to improve adherence to medical regimens for the control of high blood pressure. Adherence to antihypertension regimens is defined as a behavioral problem, which includes a series of steps: participation in screening, entering treatment, continuing treatment, and adhering to the prescribed regimen. In the past decade, a wide range of structural and educational interventions attempting to increase adherence have had varying degrees of success. The interventions, their efficacy, study designs, and populations studied are reviewed, and recommendations for future testing and adoption of strategies for improving management of hypertension are advance.

Appointments and Schedules↗
PubMed1981

Linking research and practice in patient education for hypertension: patient responses to four educational interventions.

Data from a longitudinal study of 432 hypertensive patients under the care of private practitioners are used to answer two questions: How do patients react to educational interventions, and how are their responses related to changes in their adherence behaviors? The four educational interventions, introduced sequentially and tested in a factorial design, were written messages, nurse's phone call, self-monitoring and social support. Patients' reactions to the interventions were assessed, using data from questions asked at post-intervention interviews and information recorded during the interventions. Cognitive, attitudinal and behavioral data are examined. Findings indicate that respondents were cognizant of the interventions and viewed them positively; also, some predictions about intervention features were supported. However, actions which respondents attributed to the interventions were not found to be related to increased adherence, according to the test used in this study.

Attitude to Health↗
PubMed1979

Dietitians' effectiveness and patient compliance with dietary regimens. A pilot study.

Demonstration of dietitians' effectiveness is a necessary prerequisite in documenting the cost-effectiveness of untritional care. In this report, a framework for the study of dietitians' effectiveness and patient compliance with dietary regimens is developed, and the results of a pilot study are presented. Personal, attitudinal, and situational variables that affect adherence to diets were investigated. Findings suggest that (a) disclosure of patient non-compliance varies, depending on the type of question asked and the sequence of questions in an interview; and (b) dietitians with higher "Orientations to Social Influence" use more influence strategies, involve patients in counseling sessions more, and tend to have patients with more appropriate health attitudes and behaviors.

Adolescent↗
PubMed1979

Strategies for nutritional counseling. Dietitians' attitudes and practice.

Responses to a questionnaire distributed to forty-four Midwest dietitians during the development of a program to train dietitians in patient counseling strategies are summarized. Dietitians rated forty-five strategies, divided into five broad categories: Instructional, motivational, behavioral, educational diagnosis, and assessment of compliance. Questions about each strategy included reported use, perceived benefits, and perceived barriers to implementation. Six nutritional consultants rated the relative innovativeness of the strategies. The results provide evidence that strategies currently being developed for training dietitians are compatible with dietetic practice, are often viewed favorably by practitioners, and are "teachable" to nutritionists.

Attitude of Health Personnel↗
PubMedDate not supplied

Worksite cancer screening and nutrition intervention for high-risk auto workers: design and baseline findings of the Next Step Trial.

BACKGROUND: This article describes the design and baseline findings of The Next Step Trial, a health promotion intervention targeting automobile industry employees at increased colorectal cancer risk. The intervention encouraged colorectal cancer screening participation and adoption of low-fat, high-fiber diets. METHODS: Twenty-eight worksites (n = 5,042) were randomized to control (a company-sponsored screening program) or intervention (an enhanced screening program including a personalized educational booklet and motivational telephone call and diet-change program including nutrition classes, self-help materials, and computer-generated personalized feedback). Outcomes included screening compliance and fat and fiber intake. RESULTS: Pretrial data indicated targeted employees were predominantly older, well educated, married, Caucasian men. Sixty-one percent (SE = 2) participated in the screening program in the preceding 2 years, and 24% (SE = 1) reported a history of colorectal polyps or cancer. Fifty-eight percent of the cohort responded to the baseline questionnaire; respondents were older and more educated; more were married, retired, and Caucasian than nonrespondents. Mean dietary intakes were 36.9% energy from fat (SE = 0.21), 8.8 g fiber/1000 kcal (SE = 0.07), and 3.4 servings of fruits and vegetables per day (SE = 0.04). CONCLUSIONS: Baseline data show moderate screening participation and dietary intakes that did not meet guidelines; hence intervention efforts were warranted. Data from this trial will support a rigorous test of whether this high-risk employee population is responsive to targeted health promotion, early cancer detection, and prevention interventions.

Automobiles↗
PubMedDate not supplied

Behavioral research contributions and needs in cancer prevention and control: dietary change.

This paper summarizes key behavioral research contributions to the promotion of healthful diets and identifies the outstanding behavioral research needs that could lead to positive dietary changes in the United States. Nutrition plays an important role in the initiation, promotion, and progression of cancer. Dietary guidelines for health promotion and cancer prevention recommend diets that are lower in fat and higher in fiber, fruits, and vegetables. Behavioral research on dietary change has become more rigorous and sophisticated in the past decade, with noteworthy contributions in four areas: behavioral research within clinical trials, self-help or minimal contact intervention strategies, school nutrition programs and services, and advances in the development of measures. Work in progress includes large-scale randomized intervention trials, with the majority of funding for studies to increase fruit and vegetable consumption. There are many needs for further research. Six priority areas for behavioral research are identified and discussed: (1) determinants of dietary behavior and change processes; (2) policy, environmental, and organizational interventions; (3) studies of dietary change and exercise and interventions with persons at high risk for diet-related cancers; (4) methodological research; (5) research on diffusion and dissemination; and (6) systematic behavioral research on dietary change in clinical trials. A concerted research effort in the area of dietary change has great potential benefits for cancer prevention and control and for public health in general.

Diet, Fat-Restricted↗