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Biomedical subjects

N Owen

Publications and source records attributed to N Owen.

At least 127 records · Page 7Linked to original sources

Why the tobacco industry fears the passive smoking issue.

The tobacco industry has identified the passive smoking issue as the single most important problem confronting its economic future. During the 1980s, the industry has been engaged in an elaborate and expensive international campaign seeking to refute the evidence against passive smoking's effects on health and to position the issue as one essentially concerned with civil liberties and smokers' "rights." There are three main reasons for the industry's concern: first, the passive smoking issue allows a widening of the definition of smoking beyond its discussion as a personal habit, legitimizing it as a social problem; second, successful cases of litigation against employers by workers with histories of chronic exposure to environmental tobacco smoke have created an industrial climate of concern leading to workplace smoking restrictions and bans, and third, the proliferation of smoking restrictions reduces smoking opportunities and thus reduces total cigarette consumption and hence financial returns to the industry. Based on the results of a large Australian study of a workplace smoking ban, an estimated 654.88 million cigarettes with a retail value of $A6,549 thousand would be forgone annually in Australia alone if 50 percent of white-collar worksites were to ban smoking. Finally, the passive smoking issue can be considered a Trojan horse to its less discussed effects: the reduced morbidity and mortality likely to result in smokers from the significant reductions in smoking frequency that occur with the proliferation of smoking restrictions introduced in the name of concern for the health of nonsmokers.

Commerce↗

Evaluations of health promotion: combining realism with rigour.

Large-scale, publicly-funded programs to reduce the risk of cardiovascular disease, cancer, AIDS and other health problems are now common in Australia. There is a need to objectively evaluate the effects of these programs, but there should be realistic expectations of such evaluations. Decisions about the appropriateness of conducting evaluation studies in the field settings need to be made with an awareness of whether new methods are being tested or whether already-tested procedures and principles are being used. The limitations on research and evaluation in field settings should also be acknowledged and the changes which are expected should be identified. Planners and administrators should have an explicit rationale for the goals, intervention methods and expected outcomes of health promotion programs. But they should be realistic about the limitations of program evaluations and avoid the traps of either attempting to adhere to inappropriately high standards of scientific rigour or of abandoning any attempts at evaluation. Some guidelines are suggested to assist planners and administrators make decisions about the extent and the appropriateness of conducting health-promotion evaluations.

Australia↗

Sex of physician: patients' preferences and stereotypes.

Patients' preferences for physicians of a particular sex tend to skew sex distributions of clinical populations in training and practice settings. A study was developed to explore these preferences and potential reasons for them. Of 185 adult patients surveyed at four family practice residency clinics, 45% expressed a preference for sex of physician; 43% of women and 12% of men preferred a female physician, while 31% of men and 9% of women preferred a male physician. Patients who stated no overall preference often expressed one in specific clinical situations, eg, anal or genital examinations. Patients who preferred female physicians reported humane behaviors as more characteristic of female physicians, and those who preferred male physicians reported humane behaviors as more characteristic of men; patients who had no overall sex preference did not sex stereotype physicians on these behaviors (F = 59.34, P less than .01). Patients who preferred male physicians reported technical competence behaviors as more characteristic of male physicians; others did not sex stereotype physicians on these behaviors (F = 15.4, P less than .01). Patients rated humaneness and comprehensiveness as being of high priority, but no relationship was found between priorities for aspects of care and preferences for sex of physician. Areas for future investigation include assessing preferences in other populations and exploring sex differences in physician behavior during office encounters and correlating these differences with patient satisfaction.

Adult↗

Staff members' acceptance of the introduction of workplace smoking bans in the Australian public service.

The acceptability to employees of workplace smoking bans is an important factor in their introduction and in subsequent compliance. This study describes the acceptance by affected staff members before the ban on smoking in Australian public-service premises. Four thousand, two hundred and fifteen (79% of those who were approached) public servants were surveyed from areas of six departments across three states. Twenty-five per cent of the sample were current smokers. Support for the bans was strong, with 76% of the sample approving over all. Approval among smokers was less, with 40% of smokers approving, compared with 82% of ex-smokers and 90% of "never" smokers. Thus, the results show a generally favourable attitudinal milieu among employees who were facing an impending ban on smoking, and far-from-unanimous opposition from smokers. Among smokers, acceptance of the bans was predictable from the attitudes towards smoking acceptance of the bans was predictable from the attitudes towards smoking in general, and from the perceived impact of the bans on smokers. The existence of restrictions on smoking at the time of the survey was associated with slightly higher levels of approval of the impending total ban, especially when the restrictions were not seen as being imposed on the respondents by others.

Attitude↗

Smoking cessation by mail: a comparison of standard and personalized correspondence course formats.

Self-Instructional behavior-change programs for reducing risks to health are potentially widely available, acceptable and cost-effective. This paper reports outcomes of a smoking cessation program administered by mail. Two hundred and eight smokers were allocated systematically to a quit kit control condition (n = 40), to a standard correspondence course (n = 86) and to a personalized correspondence course prepared with the aid of a microcomputer (n = 82). There were significantly higher rates of abstinence after the course for correspondence course participants compared to controls, but these differences did not persist at three-month and nine-month follow-ups. There were no differences between the personalized and standard courses on abstinence rates, number of cigarettes smoked per day, or return of feedback forms on each lesson. There were associations between self-efficacy strength and reduced rates of smoking, and active participation in the course was associated with lower smoking rates.

Behavior Therapy↗

Development of behaviorally-based policy guidelines for the promotion of exercise.

We describe the results of a project to develop policy guidelines to promote increased levels of participation in regular physical activity in Australia. Theories of behavior change, and research findings concerning factors influencing the adoption and maintenance of exercising, were used as an information base for policy development. This information was presented and organized in the form of eleven behaviorally-based principles designed to be of use to practitioners, administrators and policy makers. Nine policy recommendations were developed from these principles, and from the contributions of people with practical administrative and political expertise in the field. Specific, focused campaigns, the provision of pleasant and convenient facilities, and an awareness of the process of behavior change and of the limitations imposed by environmental and social factors were emphases of the final recommendations. These may have relevance for similar work in North America and other developed countries. Some comments on the process involved in moving from an interpretation of behavior-change theories and basic research to the development of usable recommendations are offered. The project illustrates an approach to using a behavioral-science knowledge base for the development of public health principles and policies which have the potential to be of practical use.

Australia↗

Community exercise programs: follow-up difficulty and outcome.

The use of follow-up assessments to determine maintenance following behavior change programs is widely recognized as essential. It is often difficult to contact all previous participants, and evidence from alcohol abuse programs suggests that data from those people most readily contacted are not representative of overall outcomes. This study examines the relationship between the difficulty of follow-up and the reported maintenance of regular physical activity 6 months after the completion of a community-based fitness program. Ninety percent of 372 participants were contacted, and those easier to contact reported a significantly greater amount of current exercise. It is concluded that as large a percentage of former participants as possible must be contacted in order to conduct meaningful follow-up studies.

Adult↗

Facilitating transfer and maintenance of fluency in stuttering therapy.

The present state of stuttering therapy programs enables the clinician to render many stuttering virtually stutter-free in the clinic. A major clinical problem, however, is the transfer of fluency to nonclinical situations and its maintenance over time. Concepts and techniques extrapolated from the literature on behavior change are applied to assessment, treatment objectives, treatment techniques, and to a number of procedures designed to facilitate transfer and maintenance during therapy. When fluency has been established, self-control techniques based on speech practice, self-monitoring, and the deliberate use of self-administered and social contingencies are stressed. Guidelines for termination of therapy and follow-up are given. For many of these techniques, specific examples are offered from clinical work with stutterers. Other techniques are presented because of their potential relevance and their demonstrated effectiveness with a variety of clinical problems.

Behavior Therapy↗