Biomedical subjects

Richard B Warnecke

Publications and source records attributed to Richard B Warnecke.

7 recordsLinked to original sources

PubMed2006

A national survey of tobacco cessation programs for youths.

OBJECTIVES: We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics. METHODS: We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified. RESULTS: We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was 2000 dollars. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment. CONCLUSIONS: There is considerable homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths' smoking prevalence.

Adolescent↗

PubMed2006

Cultural variability in the effects of question design features on respondent comprehension of health surveys.

PURPOSE: The aim is to identify the characteristics of common health survey questions that may be associated with cross-cultural variability in question comprehension. METHODS: Interviews with respondents representing four cultural subgroups in the United States were analyzed through behavior coding to identify survey question characteristics that may be associated with cross-cultural variability in comprehension. Using survey responses as the unit of analysis, nested within survey respondents and survey questions, hierarchical linear modeling was used to examine the effects of four questionnaire design features on cultural variations in comprehension difficulties. RESULTS: Respondent culture was found to moderate the effects of response format, question length, and reading levels. CONCLUSIONS: Several question design strategies that reduce overall comprehension difficulty appear to also increase cross-cultural disparities.

Cognitive Science↗

PubMed2006

Understanding African Americans' views of the trustworthiness of physicians.

BACKGROUND: Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. OBJECTIVE: To better understand what trust and distrust in physicians means to African Americans. DESIGN: Focus-group study, using an open-ended discussion guide. SETTING: Large public hospital and community organization in Chicago, IL. PATIENTS: Convenience sample of African-American adult men and women. MEASUREMENTS: Each focus group was systematically coded using grounded theory analysis. The research team then identified themes that commonly arose across the 9 focus groups. RESULTS: Participants indicated that trust is determined by the interpersonal and technical competence of physicians. Contributing factors to distrust in physicians include a lack of interpersonal and technical competence, perceived quest for profit and expectations of racism and experimentation during routine provision of health care. Trust appears to facilitate care-seeking behavior and promotes patient honesty and adherence. Distrust inhibits care-seeking, can result in a change in physician and may lead to nonadherence. CONCLUSIONS: Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans.

Adult↗

PubMed2005

An investigation of the effects of social desirability on the validity of self-reports of cancer screening behaviors.

We evaluated 4 approaches to improving the reporting of disease prevention and screening behaviors. The conditions evaluated include (1) the mode in which data are collected, (2) asking the interview subject about her intention to obtain the procedure before asking whether the behavior occurred, (3) asking the interview subject about barriers that might keep respondents from getting the procedure before asking about whether she has received it, and (4) asking the interview subject about exceptions to the regularity with which she might report getting the examination. Data were collected in 2001 from a sample of women aged 50 and older in Champaign-Urbana, Illinois. After completing a telephone or audio computer-assisted self-interview (ACASI), respondents gave permission to abstract their medical records to validate self-reports of Papanicolaou tests, mammograms, and clinical-gynecologic examinations received during the past 3 years. Interviews and matching medical records were available for 588 respondents. Results indicated that first asking about future intentions may be an important design feature that warrants additional consideration. In addition, the use of ACASI may lead to lower quality reporting among women with little computer experience. This study represents the only research to date that reports experimental attempts to address the social desirability biases commonly found in the reporting of cancer screening behaviors.

Aged↗

PubMed2004

Some methodologic lessons learned from cancer screening research.

Credible and useful methodologic evaluations are essential for increasing the uptake of effective cancer screening tests. In the current article, the authors discuss selected issues that are related to conducting behavior change interventions in cancer screening research and that may assist researchers in better designing future evaluations to increase the credibility and usefulness of such interventions. Selection and measurement of the primary outcome variable (i.e., cancer screening behavior) are discussed in detail. The report also addresses other aspects of study design and execution, including alternatives to the randomized controlled trial, indicators of study quality, and external validity. The authors conclude that the uptake of screening should be the main outcome when evaluating cancer screening strategies; that researchers should agree on definitions and measures of cancer screening behaviors and assess the reliability and validity of these definitions and measures in different populations and settings; and that the development of methods for increasing the external validity of randomized designs and reducing bias in nonrandomized studies is needed.

Biomedical Research↗

PubMed2002

Evaluation of the effects of a smoking cessation intervention using the multilevel thresholds of change model.

The multilevel thresholds of change model is used to analyze the effect of a smoking cessation intervention on stage of readiness to quit across a 2-year follow-up period. The intervention, targeted to females with high school or less education, consisted of a televised component and a written manual. Any exposure to the intervention had a significant effect on stages that precede quitting but not on quitting; participation in the intervention had significant effects at all levels of change, including quitting. The written component had a stronger independent effect than the televised component. Intervention effects were strongest within women who were initially precontemplative.

Adult↗

PubMedDate not supplied

The role of the national practitioner data bank in the credentialing process.

Federal law requires hospitals and permits other entities to seek information from the National Practitioner Data Bank (NPDB) but places no requirements on how that information should be used. Our survey of NPDB users demonstrates that although the NPDB has generated substantial controversy and its information is nominally available from other sources, it still plays an important role in the credentialing process. Most institutions make timely NPDB inquiries that facilitate widespread use of the information in credentialing activities (4-5 individuals or committees). However, in 3% to 7% of cases, a decision was reached before the institution had the NPDB report. Between 5% and 30% of privileging and licensure applications involving an NPDB report were not granted "as requested," suggesting the NPDB data are important to the process. Unfortunately, underreporting was also evident: 60% to 75% of reportable actions were not reported, limiting the information to which health care entities have access.

Credentialing↗