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Biomedical subjects

M W Kreuter

Publications and source records attributed to M W Kreuter.

At least 19 recordsLinked to original sources
PubMed2006

Differential strength of association of child injury prevention attitudes and beliefs on practices: a case for audience segmentation.

OBJECTIVE: Many injuries to children cannot be prevented without some degree of active behavior on the part of parents. A better understanding of social and cognitive determinants of parents' injury prevention behavior and the identification of potential subgroups for targeted message delivery could advance the effectiveness of educational and behavioral interventions. This study assessed the degree to which parents' injury prevention behavior is associated with theoretical determinants and examined whether this relation differs by age or birth order of child. DESIGN: Cross sectional observational study. SETTING: Three Midwestern pediatric clinics. SUBJECTS: 594 parents of children ages 0-4 attending routine well child visits. MEASURES: Injury prevention attitudes, beliefs, and practices. RESULTS: Overall, only modest relations were observed between injury beliefs and attitudes and injury prevention behaviors. However, these relations differed substantially by child age and birth order, with stronger associations observed for parents of older first born children. Outcome expectations and social norms were more strongly related to injury prevention behavior among parents of preschool children than among parents of infants and toddlers, while attitudes were more predictive for parents of first born children than parents of later born children. CONCLUSIONS: These findings highlight the complexity of relations between theorized determinants and behavior, and suggest the potential utility of using audience segmentation strategies in behavioral interventions addressing injury prevention.

Accident Prevention↗
PubMed2001

Development and validation of brief scales to measure collectivism, religiosity, racial pride, and time orientation in urban African American women.

This article describes the development and pilot-testing of brief scales to measure four cultural constructs prevalent in urban African American women. Internal consistency and temporal stability were assessed in two convenience samples (n=47 and n=25) of primarily lower-income African American women. All scales performed well: collectivism alpha=.93, r=.85, p<.001); religiosity (alpha=.88, r=.89, p<.001); racial pride (alpha=.84, r=.52, p<.001); present time orientation (alpha=.73, r=.52, p<.01) and future time orientation (alpha=.72, r=.54, p=.07).

Adolescent↗
PubMed2001

Disseminating effective health promotion programs from prevention research to community organizations.

Promising programs developed through health promotion and disease prevention research are not always disseminated to the agencies, organizations, and individuals that can benefit from them most. Systematic and practical approaches to dissemination are needed to ensure that effective programs more often reach end users in communities. This article describes six steps used in translation and dissemination of the ABC Immunization Calendar program to public health centers in St. Louis, Missouri. The authors discuss how one health center successfully adopted this program and provide recommendations for other researchers seeking to disseminate innovative, effective health promotion programs.

Community Health Services↗
PubMed2000

How does physician advice influence patient behavior? Evidence for a priming effect.

OBJECTIVE: To explore a potential "priming effect" of physician advice on patient responses to behavioral change interventions. DESIGN: Randomized controlled trial with a 3-month follow-up. SETTING: Four community-based group family medicine clinics in southeastern Missouri. PARTICIPANTS: Adult patients (N = 915). INTERVENTIONS: Printed educational materials designed to encourage patients to quit smoking, eat less fat, and increase physical activity. MAIN OUTCOME MEASURES: Recall, rating, and use of the educational materials; changes in smoking behavior, dietary fat consumption, and physical activity. RESULTS: Patients who received physician advice to quit smoking, eat less fat, or get more exercise prior to receiving intervention materials on the same topic were more likely to remember the materials, show them to others, and perceive the materials as applying to them specifically. They were also more likely to report trying to quit smoking (odds ratio [OR] = 1.54, 95% confidence interval [CI] = 0.95-2.40), quitting for at least 24 hours (OR = 1.85, 95% CI = 1.02-3.34), and making some changes in diet (OR = 1.35, 95% CI = 1.00-1.84) and physical activity (OR = 1.51, 95% CI = 0.95-2.40). CONCLUSIONS: Findings support an integrated model of disease prevention in which physician advice is a catalyst for change and is supported by a coordinated system of information and activities that can provide the depth of detail and individualization necessary for sustained behavioral change.

Adult↗
PubMed2000

Are tailored health education materials always more effective than non-tailored materials?

While promising, the evidence in support of tailored health communication has not been overwhelming. One explanation is that tailored materials may be far superior to non-tailored materials in some cases, but only slightly better, no different or less effective in others. In this study, 198 overweight adults were randomly assigned to receive either tailored or non-tailored weight loss materials. Participants' cognitive, affective and behavioral responses to the materials were measured at an immediate and 1 month follow-up. Analyses compared those who received tailored materials to those who received non-tailored materials that were--by chance alone--either a good fit, moderate fit or poor fit, based on the match between behavioral characteristics of the participant and content of the non-tailored materials. Findings showed that good-fitting non-tailored materials performed as well or better than tailored materials for several cognitive, affective and behavioral outcomes. However, moderate- and poor-fitting non-tailored materials were consistently inferior to both approaches. The art and science of creating tailored health communication programs is still evolving. Data from this study suggest present approaches to tailoring are more effective than non-tailored materials in most, but not all cases. Specific recommendations are made describing ways to refine tailoring methods to maximize the effectiveness of this approach.

Adult↗
PubMed2000

Does locus of control moderate the effects of tailored health education materials?

Research in health communication has shown that individually tailored health education materials are more effective than traditional or generic materials in producing changes in health-related behaviors. However, tailored materials have not been equally effective for all individuals. Because locus of control affects behavioral outcomes in other self-change interventions, its effect on individuals' responses to tailored messages is of particular interest. The present study examined differences in cognitive responses to tailored and non-tailored weight loss materials among 198 overweight individuals. Weight locus of control significantly interacted with study group (who received either tailored or non-tailored materials), suggesting that externals may respond to tailored health education materials with counter-arguments. Implications for the development and application of tailored health communication materials are discussed.

Adult↗
PubMed1999

One size does not fit all: the case for tailoring print materials.

Printed health education materials frequently consist of mass-produced brochures, booklets, or pamphlets designed for a general population audience. Although this one-size-fits-all approach might be appropriate under certain circumstances and even produce small changes at relatively modest costs, it cannot address the unique needs, interests, and concerns of different individuals. With the advent and dissemination of new communication technologies, our ability to collect information from individuals and provide feedback tailored to the specific information collected is not only possible, but practical. The purpose of this article is to: (a) distinguish between tailored print communication and other common communication-based approaches to health education and behavior change; (b) present a theoretical and public health rationale for tailoring health information; and (c) describe the steps involved in creating and delivering tailored print communication programs. Studies suggest computer tailoring is a promising strategy for health education and behavior change. Practitioners and researchers should understand the approach and consider the possibilities it presents for enhancing their work in disease prevention.

Algorithms↗
PubMed1999

Effects of tailored, personalized and general health messages on physical activity.

Physical inactivity is a major public health problem. Patient education programs and materials that are customized to address the unique needs and concerns of specific patients have shown promise in changing a range of health related behavior, although findings to date for physical activity have been equivocal. In this study a randomized controlled trial was conducted among 272 adult primary care patients to compare the effectiveness of tailored, personalized and general health messages, and usual medical care in promoting leisure time physical activity (LTA) and physical activities of daily living (PADLs). Patients in the tailored group were more likely to increase PADLs than were patients in the personalized, general and control groups (65% vs. 46% vs. 56% vs. 54%) and less likely to being doing fewer PADLs at follow-up (18% vs. 38% vs. 38% vs. 38%; chi 2 = 12.2, df = 6, p = 0.056). There were no significant differences for LTAs. To help maximize the effectiveness of future tailored interventions on physical activity, studies should seek to identify the social, psychological and environmental variables that are most important to include in tailored materials.

Activities of Daily Living↗
PubMed1999

Understanding how people process health information: a comparison of tailored and nontailored weight-loss materials.

Health information tailored to meet individuals' unique needs has been shown to be more effective than generic information in promoting risk-reducing behavior changes. To explore mechanisms underlying tailoring's effectiveness, this study randomly assigned 198 overweight adults to receive weight-loss materials that were (a) tailored to the individual, (b) in an American Heart Association (AHA) brochure, or (c) AHA-content formatted to look like tailored materials. Participants who received tailored materials had more positive thoughts about the materials, positive personal connections to the materials, positive self-assessment thoughts, and positive thoughts indicating behavioral intention than those who received either of the untailored materials. The tailoring of health information can significantly improve the chances the information will be thoughtfully considered and can stimulate prebehavioral changes such as self-assessment and intention.

Adolescent↗
PubMed1999

Dealing with competing and conflicting risks in cancer communication.

Applied research on cancer risk communication is sparse, and even less is known about effective communication under conditions of multiple risks. This paper briefly describes the need and rationale for cancer risk communication, then describes what is known and needs to be known about communication addressing multiple risks. Its focus is on two specific communication issues: 1) comparing different risks and 2) prioritizing between multiple risks. There is considerable unmet need in cancer risk communication for new knowledge and recommendations for best practices. Those professionals choosing to pursue this work can make a significant contribution to the field.

Communication↗
PubMed1997

Future trends affecting public health: challenges and opportunities.

Many accomplishments of public health can be cited, yet public health professionals face unprecedented challenges and opportunities in the coming decades. To assist public health practitioners, researchers, and educators in preparing for current and future changes affecting the population's health, the authors describe several important "macrolevel" trends. These trends include: the aging of the population, changing patterns in the U.S. racial/ethnic composition, changes in health care delivery systems, the explosion of information technologies, changing needs in the public health work force, the growth in health-related partnerships, and anti-government sentiment and polarization. A series of implications for each of the major trends is provided. It may be important for public health leaders and policy makers to take these trends and implications into account as they plan and prioritize future approaches to disease prevention and health promotion.

Aged↗
PubMed1996

Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial.

Health risk appraisal (HRA) remains one of the most widely used health promotion tools despite only equivocal evidence for its effectiveness. Theories of behavior change predict conventional HRA's ineffectiveness because risk information alone is seldom sufficient to change complex behaviors. In this study, a randomized trial compared the effects of feedback from an enhanced HRA with a typical HRA and a control group among adult patients from eight family medicine practices. The enhanced HRA assessed behavior-specific psychosocial factors and provided patients with computer-generated, individually-tailored behavior change information in addition to typical HRA risk feedback. Changes in seven behaviors were assessed at a 6 month follow-up. Overall, patients receiving enhanced HRA feedback were 18% more likely to change at least one risk behavior than were patients receiving typical HRA feedback or no feedback (OR = 1.18, 95% CI = 1.00, 1.39). The enhanced HRA feedback appeared to promote changes in cholesterol screening, dietary fat consumption and physical activity, but not in smoking, seat belt use, mammography and Pap smears. We conclude that the addition of theory-based, individually-tailored behavior change information may improve the effectiveness of HRA.

Adolescent↗
PubMed1995

Do cigarette smokers have unrealistic perceptions of their heart attack, cancer, and stroke risks?

This study examined whether perceived risks of heart attack, cancer, and stroke were higher among smokers than nonsmokers; whether smokers were more likely to underestimate these risks; and the demographic correlates of unrealistic risk estimation among smokers. Two thousand seven hundred eight-five patients from 12 North Carolina family practices completed a questionnaire including a health risk appraisal and questions concerning smoking behavior and perceived risks of heart attack, cancer, and stroke. While most smokers accurately perceived their health risks to be greater than nonsmokers', smokers were also more likely to underestimate their risks. This optimistic distortion of risk was associated with age, gender, and education levels. Smokers may not yet understand the magnitude of health risks posed by smoking. These data suggest the need for renewed attention to perceptions of the health risks of smoking. As long as smokers underestimate their risks, they underestimate the imperative to quit.

Adolescent↗
PubMed1995

Are patients of women physicians screened more aggressively? A prospective study of physician gender and screening.

OBJECTIVE: To determine the effects of physician gender on rates of Pap testing, mammography, and cholesterol testing when identifying and adjusting for demographic, psychosocial, and other patient variables known to influence screening rates. DESIGN: A prospective design with baseline and six-month follow-up assessments of patients' screening status. SETTING: Twelve community-based group family practice medicine offices in North Carolina. PARTICIPANTS: 1,850 adult patients, aged 18-75 years (six-month response rate, 83%), each of whom identified one of 37 physicians as being his or her regular care provider. MAIN RESULTS: Where screening was indicated at baseline, the patients of the women physicians were 47% more likely to get a Pap test [odds ratio (OR) = 1.47, 95% confidence interval (CI) = 1.05, 2.04] and 56% more likely to get a cholesterol test (OR = 1.56, 95% CI = 1.08, 2.24) during the study period than were the patients of the men physicians. For mammography, the younger patients (aged 35-39 years) of the women physicians were screened at a much higher rate than were the younger patients of the men physicians (OR = 2.69, 95% CI = 0.98, 7.34); however, at older ages, the patients of the women and the men physicians had similar rates of screening. CONCLUSIONS: In general, the patients of the women physicians were screened at a higher rate than were the patients of the men physicians, even after adjusting for important patient variables. These findings were not limited to gender-specific screening activities (e.g., Pap testing), as in some previous studies. However, the patients of the women physicians were aggressively screened for breast cancer at the youngest ages, where there is little evidence of benefit from mammography. Larger studies are needed to determine whether this pattern of effects reflects a broader phenomenon in primary care.

Adolescent↗