PURPOSE: This study examined the use of the stages of change model to design an exercise intervention for community volunteers. DESIGN: The "Imagine Action" campaign was a community-wide event incorporating the involvement of local worksites and community agencies. Community members registering for the campaign were enrolled in a six-week intervention program designed to encourage participation in physical activity. SUBJECTS: Six hundred and ten adults aged 18 to 82 years old enrolled in the program. Seventy-seven percent of the participants were female and the average age was 41.8 years (SD = 13.8). SETTING: The campaign was conducted in a city with a population of approximately 72,000 and was promoted throughout community worksites, area schools, organizations, and local media channels. MEASURES: One question designed to assess current stage of exercise adoption was included on the campaign registration form as were questions about subject name, address, telephone number, birthdate, and gender. INTERVENTION: The intervention included written materials designed to encourage participants to initiate or increase physical activity, a resource manual describing activity options in the community, and weekly "fun walks" and "activity nights." RESULTS: A Stuart-Maxwell test for correlated proportions revealed that subjects were significantly more active after the six-week intervention. Sixty-two percent of participants in Contemplation became more active while 61% in Preparation became more active. CONCLUSIONS: Most participants increased their stage of exercise adoption during the six-week intervention. This study provides preliminary support for use of the stages of change model in designing exercise interventions.

Adolescent↗

PubMedDate not supplied

The FPbase microcomputer system for managing community health screening and intervention data bases.

Health promotion and intervention projects at State and community levels need computerized data bases to assist in making policy decisions and in operating the projects. Computer data base systems are used in entering, storing, retrieving, and analyzing information about health project activities and their participants in a timely and cost-effective manner. Computer support is essential for such labor-intensive tasks as post-screening followup of participants, identifying subpopulations, and evaluating recruitment efforts and behavior change programs. The Pawtucket Heart Health Program developed a microcomputer software package, FPbase, for community health project data base management. FPbase is described and is available for use by other organizations. FPbase incorporates formative and process interactive data base activities and is suitable for use in operating intervention and screening programs at State and local levels. The system accommodates management of data for social marketing, evaluation, followup, and promotional activities.

Aftercare↗

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Correlates of expected success at health habit change and its role as a predictor in health behavior research.

Perceived ability to change health habits successfully is undoubtedly an important factor underlying personal health behavior. This report examines expected success in changing future habits, using a sample of community-resident adults 18-65 years of age (n = 1,367). One set of analyses used expected success as a dependent variable, whereas another set used it as an independent variable for health behavior and knowledge indices. In the dependent variable analysis, results showed that reported past success at health habit change was the strongest predictor of success expected in the future. Optimism about future success was also associated with variables that already placed individuals at an advantage to change behavior (e.g., not smoking, regular exercise, lower Body Mass Index, support in the family). When used as a predictor variable, expected future success was not associated with five health-related, self-report indices of behavior, knowledge, and perceived risk. Further examination showed, however, that in three instances the association between expected success and the outcome indices seemed to plateau in the most optimistic group. Extreme optimism (that admits no chance of failure) may be a belief characteristic that deserves further investigation, one that will present a challenge to research and practice. Men tended to report greater expected future success than women, although women had more favorable reports on three of the five health-related behavior/knowledge indices.

Adolescent↗

PubMedDate not supplied

Health practice correlates in three adult age groups: results from two community surveys.

Independently done surveys of a target population can make an important contribution to knowledge about the determinants of personal health behavior by highlighting variables that consistently emerge as significant predictors. This investigation examined the correlates of four health practice and knowledge indices related to cardiovascular disease (CVD) in two baseline community surveys of the Pawtucket Heart Health Program (N = 2,413; N = 2,808). An additional dimension was the use of three adult age groups (18-29, 30-49, 50-64) in conducting the analyses. Results of both surveys showed that sex was the strongest correlate of the four indices--knowledge of CVD, encouraging health practice changes in others, dietary intake, and exercise. The four indices related to CVD were also associated with years of education, primary language, and whether or not a recent cholesterol measurement had been obtained, although these relationships were not as consistent as the results for sex. Overall, about half of each survey's significant associations were also found in the other survey (survey 1, 30 of 62; survey 2, 30 of 56). Consistency of significant results between surveys was best for the group ages 30-49. In either survey, it was rare for an association between a predictor and behavioral index to appear in each of the three age groups. This study supports the importance of the subjects' sex in research on personal health practices, suggests the potential for independence even among health-related indices pertinent to a single type of illness, and emphasizes the usefulness of utilizing independent samples to identify important correlates of health behavior.

Adolescent↗

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Training health professionals and lay volunteers to deliver cholesterol screening and education programs.

The National Heart, Lung, and Blood Institute of the National Institutes of Health launched the National Cholesterol Education Program (NCEP) in 1985. With the goal of reducing the prevalence of elevated blood cholesterol in the United States, the NCEP aims to raise awareness and understanding in both health professionals and the general public of high blood cholesterol levels as a risk factor for coronary heart disease. Public interest in blood cholesterol measurement has created an enormous market for cholesterol screening and education programs. The importance of quality screening and educational services was recognized by the NCEP, which has urged the training of all personnel involved in public cholesterol screenings. This paper presents models for training lay volunteers and health professionals to deliver quality public screening programs for high blood cholesterol that are consistent with NCEP recommendations. Blood cholesterol screening, counseling, and referral (SCORE) programs are key intervention strategies of the Pawtucket Heart Health Program (PHHP), a cardiovascular disease prevention research program in Pawtucket, RI. This paper describes the PHHP volunteer training and certification program for cholesterol SCOREs and the demographics of screening volunteers. With the goal of improving the quality of cholesterol screening and education programs nationally, the Cholesterol Training Center (CTC) was established in 1988. Using models established by PHHP, the center developed training workshops to help health professionals initiate, update, expand, or enhance training for cholesterol screening and education programs. CTC training protocols and the characteristics of workshop participants are described, and the workshops' effects on participants' knowledge and self-sufficiency are discussed.

Allied Health Personnel↗

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Performance characteristics of a blood cholesterol measuring instrument used in screening programs.

Four experiments were conducted to assess the precision and accuracy of the Boehringer Mannheim Diagnostics Reflotron, an instrument that is being adopted by many public health groups to conduct blood cholesterol screening programs. Our study is one of the first to evaluate and document the instrument's performance characteristics. Successive generations of reagent tabs supplied by the manufacturer were tested against a reference laboratory method standardized by the Centers for Disease Control. Three of the experiments also compared two or more Reflotrons to assess intermachine reliability. The Reflotron analyzer provided precise blood cholesterol measurements both in repeated tests and among instruments. The accuracy of the method varied across reagent lots, with an average negative bias of 21.05 milligrams per deciliter (mg per dl), decreasing steadily to a negative bias of 4.07 mg per dl. Reliability between and within analyzers was high. The data provide support for the use of the instrument in blood cholesterol screening efforts, yet signal the need for attention to quality control procedures, both by the manufacturer and operators, to ensure the validity and accuracy of the results.

Cholesterol↗

PubMedDate not supplied

The role of churches in disease prevention research studies.

The design of a large-scale research project (The Health and Religion Project) in which church volunteers deliver behavior change programming on major cardiovascular risk factors (smoking, elevated blood pressure, elevated serum cholesterol, excess weight, and physical inactivity) is described. A total of 20 churches (Roman Catholic, Baptist, and Episcopal) were recruited throughout Rhode Island and randomly assigned to five experimental conditions. These conditions were designed to test the necessity of training special task forces to coordinate efforts within each church and to test the relative efficacy of high or low levels of professional (paid staff) involvement. Churches have many characteristics that are compatible with behavior change programming for primary prevention of chronic diseases. However, there have been very few research studies of churches engaging in primary prevention activities. Thus, the first step was to test the churches' receptivity to participation in this type of project. To do this, all churches in Rhode Island were surveyed by mail and phone. Those that met several eligibility criteria were randomly selected for recruitment into the study. The high receptivity of the churches was demonstrated by a response rate of 65 percent (20 of 31). This readiness is bolstered by the fact that all of the 20 churches that originally began the study have remained involved for at least 2 1/2 years.

Adolescent↗

PubMedDate not supplied

Impact of public education and continuing medical education on physician attitudes and behavior concerning cholesterol.

Current physician attitudes and behavior concerning elevated blood cholesterol, recent changes, and reasons for change were measured in a survey of physicians in two cities. Those in a community with both continuing medical and public education programs reported changing their practice significantly over the past two years, more so than those in a comparison community. The physicians did not identify specific elements of a continuing medical education program as important in these differences. Physicians in Pawtucket, Rhode Island, identified requests from the public as important and statistically significant factors in their changed behavior, suggesting that the public education program has become an important influence on physician behavior.

Attitude of Health Personnel↗

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Training volunteers to conduct heart health programs in churches.

With cardiovascular disease the leading cause of death and disability in the United States, economically feasible and effective methods of prevention are needed. The Health and Religion Project (HARP) uses volunteers to provide cardiovascular risk-factor change programs to individuals in their church communities. The rationale for the use of volunteers in this setting is described, along with the design and initial response to the HARP volunteer training program. Two hundred twenty-two volunteers were certified across 16 study churches to conduct risk-factor change programs. Their certification exam performance demonstrated that they had mastered the knowledge and skills deemed necessary for their jobs. Overall, the trainees were very enthusiastic about their new roles. Based on this initial response, our partnership with churches for health promotion is worthy of further development.

Cardiovascular Diseases↗

PubMedDate not supplied

Promoting the selection of healthy food through menu item description in a family-style restaurant.

We describe an attempt to influence the selection of menu items in a family-style restaurant. Three different messages, varying in content and emphasis, were used to promote one food special each intervention day. One message emphasized that the specials were particularly healthful, being relatively low in fat, sodium, and cholesterol. A second message stressed flavor and added that the choice was healthful. A third, nonspecific message made no mention of taste or health factors, but simply noted that there was a daily special. Results indicated that restaurant patrons selected healthful specials when the message noted that the choice was healthful but emphasized flavor. Patrons were apparently more open to information about the palatability of the food than its healthfulness per se. These results have implications for point-of-purchase health promotion efforts in general, especially those involving food-labeling programs in restaurants and grocery stores.

Cardiovascular Diseases↗