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Biomedical subjects

S B Fawcett

Publications and source records attributed to S B Fawcett.

At least 19 recordsLinked to original sources
PubMed2000

Promising community-level indicators for evaluating cardiovascular health-promotion programs.

Rigorous evaluation of community-based programs can be costly, particularly when a representative sample of all members of the community are surveyed in order to assess the impact of a program on individual health behavior. Community-level indicators (CLIs), which are based on observations of aspects of the community other than those associated with individuals, may serve to supplement individual-level measures in the evaluation of community-based programs or in some cases provide a lower-cost alternative to individual-level measures. Because they are often based on observations of the community environment, CLIs also provide a way of measuring environmental changes--often an intermediate goal of community-based programs. The Centers for Disease Control and Prevention convened a panel of experts knowledgeable about community-based program evaluation and cardiovascular disease (CVD) prevention to develop a list of CLIs, and rate their feasibility, reliability and validity. The indicators developed by the panel covered tobacco use, physical activity, diet and a fourth group that were considered 'cross-cutting' because they related to all three behaviors. The indicators were subdivided into policy and regulation, information, environmental change, and behavioral outcome. For example, policy and regulation indicators included laws and ordinances on tobacco use, policies on physical education, and guidelines for menu and food preparation. These indicators provide a good starting point for communities interested in tracking CVD-related outcomes at the community level.

Cardiovascular Diseases↗
PubMed2000

A review of collaborative partnerships as a strategy for improving community health.

Collaborative partnerships (people and organizations from multiple sectors working together in common purpose) are a prominent strategy for community health improvement. This review examines evidence about the effects of collaborative partnerships on (a) community and systems change (environmental changes), (b) community-wide behavior change, and (c) more distant population-level health outcomes. We also consider the conditions and factors that may determine whether collaborative partnerships are effective. The review concludes with specific recommendations designed to enhance research and practice and to set conditions for promoting community health.

Community Health Planning↗
PubMed1997

Evaluating a statewide partnership for reducing risks for chronic diseases.

We describe a case study evaluation of Kansas LEAN, a statewide partnership with the mission of reducing risks for chronic diseases through dietary and exercise modification. We used a case study design to examine five primary questions related to process and outcome: (a) were the goals of the partnership important to constituents? (process), (b) were constituents satisfied with the partnership (process), (c) were community or systems changes (new or modified programs, policies, or practices) facilitated by partnership efforts (outcome)?, (d) were these changes important to the partnership's mission (outcome)?, and (e) what critical events helped facilitate community changes (outcome)? several measurement instruments--a monitoring and feedback system, constituent surveys, and semistructured interviews--were used to address key evaluation questions. Kansas LEAN is a strong statewide partnership with involvement from key representatives throughout Kansas. It is an ongoing, comprehensive health promotion program that plans and implements multiple components, in a variety of settings, to create awareness, behavior change, and a supportive environment. Kansas LEAN has facilitated several important community or systems changes related to its mission. We conclude with a discussion of the challenges of evaluating partnerships that seek to reduce risks for chronic diseases.

Acute Disease↗
PubMed1997

Developing capacities of youth as lay health advisors: a case study with high school students.

Youth lay health advising, a form of support or helping, is an important potential resource for preventive intervention. This article describes a case study of a youth lay health advising program designed to provide high school students with support and guidance to handle challenges and concerns related to their health and quality of life. First, the planning, program development, and implementation of the approach are described. Second, a rapid formative evaluation presents quantitative and qualitative information on adolescent issues faced, the types and content of interactions, and peer helper satisfaction with the program. Third, the strengths and challenges of the peer helping program and the role of youth as lay health advisors are discussed. The article concludes with a discussion of the implications for practitioners on this approach to building the capacity of adolescents as lay advisors for community health.

Adolescent↗
PubMed1997

Evaluating community coalitions for prevention of substance abuse: the case of Project Freedom.

In the United States alone, there are more than 2,000 community coalitions to address local concerns about abuse of alcohol, tobacco, and other drugs. This article describes an evaluation system used to examine the process, outcome, and impact of coalitions for the prevention of substance abuse. The evaluation addresses five key questions: (a) Was the community mobilized to address substance abuse (Process)? (b) What changes in the community resulted from the coalition (Outcome)? (c) Is there a change in reported use of alcohol and other substances by youths (Outcome)? (d) Does the coalition have a community-level impact on substance abuse (Impact)? and (e) Is community-level impact related to changes facilitated by the coalition (Impact)? To address these and other questions, using eight core measurement instruments, the evaluation system collects 15 distinct measures. This evaluation system is illustrated with a multiyear study of Project Freedom, a substance abuse coalition in a large midwestern city.

Adolescent↗
PubMed1996

Evaluating the effects of a community coalition's efforts to reduce illegal sales of alcohol and tobacco products to minors.

Minors' access to alcohol and tobacco is a major public health concern because of the many deaths and disabilities associated with use and the ease with which minors purchase these products. We evaluated the effects of a community-based substance abuse coalition's efforts to reduce alcohol and tobacco products to minors. The intervention--implemented entirely by coalition members--consisted of adults and minors issuing citations to clerks in supermarkets, convenience stores and liquor stores, who were willing to sell alcohol and tobacco products to minors and issuing commendations to clerks who refused to sell. For those liquor stores receiving the citizen's surveillance, there was a marked decrease in alcohol sales to minors, from 83% to 33%; and in those liquor stores not experiencing the intervention, there was a smaller decrease in alcohol sales, from 45% to 36%. This study's findings suggest that citizen surveillance and feedback may be effective in reducing alcohol sales to minors when the intervention is fully implemented, but may be ineffective, at least in these doses, with tobacco sales.

Adolescent↗
PubMed1996

Health marketing in the supermarket: using prompting, product sampling, and price reduction to increase customer purchases of lower-fat items.

Reducing purchase and consumption of higher-fat foods is an important health objective for the nation since these behaviors are associated with cardiovascular disease and some cancers. Public health agents attempt to promote health-related behaviors, such as purchases of lower-fat foods, by changing key features of relevant environments. This study examined the effects of a marketing intervention in a supermarket on customer purchases of lower-fat products. Customers of one store of a major supermarket chain participated in this study. Direct observations of customer purchases of lower-fat milk, salad dressings, and frozen desserts were conducted. The supermarket intervention consisted of prompting, product sampling, and price reduction (store coupons). Using an interrupted time series design with switching replications, we found low to moderate increases for the lower-fat counterparts of milk, frozen desserts, and salad dressing. The greatest increase in purchases was found with frozen desserts. Findings from this study suggest that prompting, product sampling, and price reduction can increase customer purchases of some lower-fat products. Implications of these findings for the development and evaluation of health marketing interventions are discussed.

Advertising↗
PubMed1995

Promoting the use of advance directives. An empirical study.

OBJECTIVE: To examine the effects of a practical method to increase patient completion and filing of advance directives. METHODS: Randomized controlled trial to examine the effects of structured discussions, information, and mailed reminders on completion of advance directives by internal medicine outpatients. MAIN OUTCOME MEASURE: Presence of advance directives in patients' medical files. Secondary analyses include (1) participant satisfaction with procedures, (2) data on delayed effects of discussion, and (3) data on discrepancies in patients' completion of forms. RESULTS: Six months following the intervention, 23% of patients in the experimental group and 3% of patients in the control group had directives on file. The findings were statistically significant. Patients, nurses, and physicians were satisfied with intervention procedures. Chart reviews at 6 weeks and 6 months indicated that intervention effects were delayed. CONCLUSIONS: Structured discussions and follow-up mailings substantially increased use of advance directives and were time effective and cost-effective.

Adult↗
PubMed1995

Using empowerment theory in collaborative partnerships for community health and development.

Models of community empowerment help us understand the process of gaining influence over conditions that matter to people who share neighborhoods, workplaces, experiences, or concerns. Such frameworks can help improve collaborative partnerships for community health and development. First, we outline an interactive model of community empowerment that describes reciprocal influences between personal or group factors and environmental factors in an empowerment process. Second, we describe an iterative framework for the process of empowerment in community partnerships that includes collaborative planning, community action, community change, capacity building, and outcomes, and adaptation, renewal, and institutionalization. Third, we outline activities that are used by community leadership and support organizations to facilitate the process of community empowerment. Fourth, we present case stories of collaborative partnerships for prevention of substance abuse among adolescents to illustrate selected enabling activities. We conclude with a discussion of the challenges and opportunities of facilitating empowerment with collaborative partnerships for community health and development.

Adolescent↗
PubMed1995

Home access modifications: effects on community visits by people with physical disabilities.

We examined the effects of access modifications to home entrances of people with physical disabilities on their reported community outings. An interrupted time-series design was used, in which the introduction of ramps was staggered across the homes of 6 people with moderate to severe mobility impairments. Four participants reported increases in weekly outings following installation of ramps at their entrances, and 2 reported a small decrease. These findings suggest that reducing the response requirements of access to and from the residence of people with mobility impairments may increase community visits, but may be insufficient given other environmental barriers in the community.

Architectural Accessibility↗
PubMed1994

An experimental evaluation of an incentive program to reduce serum cholesterol levels among health fair participants.

OBJECTIVE: To evaluate the impact of a health fair and incentive program on the reduction of serum cholesterol levels among participants. DESIGN: Pretest-posttest control group design, with a 6-month delay between pretest and posttest screenings. SETTING: Health fair program for employees of a large midwestern school district. PARTICIPANTS: Volunteer sample among persons with serum cholesterol levels above 5.17 mmol/L (200 mg/dL). Participants were randomly assigned to experimental (N = 29) and comparison groups (N = 34). INTERVENTION: The intervention consisted of four components: a health fair, health risk information, announcement of follow-up screening, and an incentive program. The incentive program consisted of five $100 cash prizes for reducing serum cholesterol levels by 20% or below 5.17 mmol/L (200 mg/dL). The comparison group received only the first three components. MAIN OUTCOME MEASURE: Serum cholesterol levels were measured by a venipuncture, nonfasting, chemical analysis process. RESULTS: The experimental group showed a 13.2% reduction in serum cholesterol levels, and the comparison group exhibited an 11.3% reduction (P < .05). CONCLUSIONS: A health fair, consisting of information on the level of risk and how to reduce risk, and announcement of follow-up screening and incentives can reduce the risk for cardiovascular disease.

Adult↗
PubMed1994

A contextual-behavioral model of empowerment: case studies involving people with physical disabilities.

When people with disabilities, ethnic minorities, older adults, women, and others lack power, they usually experience adverse conditions disproportionate to other members of society. Empowerment--the process by which people gain some control over valued events, outcomes, and resources--is an important construct for understanding and improving the lives of people of marginal status. This manuscript presents a contextual-behavioral model of empowerment and its application in collaborative research with people with physical disabilities. The eight case studies illustrate 18 tactics for promoting empowerment that flow from the model. The case studies show the use of different combinations of empowerment tactics in a variety of contexts: (a) setting improvement agendas from the perspective of people with disabilities, (b) enforcing ordinances that preserve access to parking spaces designated for people with disabilities, (c) enabling access to homes through housing modifications, (d) enhancing support available through mutual-aid groups, (e) developing skills for recruiting mentors, (f) promoting self-directed behavior change with personal and health concerns, (g) enhancing skills for personal self-advocacy, and (h) building the capacities of groups of people with disabilities for systems advocacy. Finally, we discuss issues that may contribute to research and action related to empowerment.

Activities of Daily Living↗
PubMed1994

Courteous service: Its assessment and modification in a human service organization.

We evaluated strategies to increase behaviors associated with courteous provision of service by 3 staff members of a human service agency. Training included written instructions, practice, and performance feedback. A lottery procedure was introduced to maintain courteous service after training. The results of a multiple baseline design across the 3 participants showed marked increases in courteous behaviors following training. These effects were maintained at 3-, 5-, and 8-month follow-ups. Consumers' satisfaction with service also increased. These findings suggest that simple training and reinforcement procedures can enhance courtesy afforded those who receive service from public and nonprofit organizations.

Journal Article↗
PubMed1993

A methodology for monitoring and evaluating community health coalitions.

Community coalitions are prominent mechanisms for building local capacities to address health and social concerns. Although there are case studies and descriptive reports on coalitions, there is little empirical information about coalition process and outcome. This paper describes a case study using a methodology for monitoring and evaluating community health coalitions. Data are fed back to coalition leaders and members, funding agents, and other relevant audiences as part of the development process. The monitoring system provides data on eight key measures of coalition process and outcome: the number of members, planning products, financial resources generated, dollars obtained, volunteers recruited, services provided, community actions and community changes. Illustrative data are presented for two different community health coalitions. Finally, challenges and opportunities in evaluating community coalitions are discussed.

Community Health Services↗