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Biomedical subjects

S G Brink

Publications and source records attributed to S G Brink.

17 recordsLinked to original sources

Diffusion of an effective tobacco prevention program. Part I: Evaluation of the dissemination phase.

As health promotion methods are proven effective, the diffusion and widespread implementation of successful programs can significantly reduce behaviors that pose risks to health within a targeted population. The Smart Choices Diffusion Project developed and evaluated a dissemination intervention program that targeted 128 school districts in east Texas. The project employed a theory-based model to disseminate information about a proven tobacco prevention program to opinion leaders in each district. These opinion leaders were asked to personally communicate the program information within their district using a videotape and printed materials, and advocate for program adoption. In addition to personal communication, a newsletter linked school districts. Opinion leaders in 52% of the districts showed the videotape, which modeled program adoption. A quasi-experimental design was used to evaluate the impact of the dissemination phase on teachers' and administrators' readiness to adopt a tobacco prevention program. Evaluation of the dissemination phase revealed no differences between the intervention and comparison districts in a district's readiness to adopt a tobacco prevention program. However, in intervention districts where school administrators viewed the videotape, the administrators were more likely to perceive the innovative program as having a relative advantage and to perceive their district's organizational and social environment as supportive of adopting the program.

Administrative Personnel↗

Increasing teacher receptivity toward use of tobacco prevention education programs.

An empirical examination of teacher receptivity to and practice of tobacco prevention education provides the foundation for comprehensive staff development to increase diffusion of drug prevention education curricula. Randomly-selected first grade Texas teachers (n = 313) were asked to complete a questionnaire during the first and second years of the Smoke-Free Class of 2000 (SFC2000) project. Initially 64 percent of recipients used materials. However, two of every five first-year users did not maintain use one year later, and many who intended use never implemented. Principal components analysis of fourteen items pertaining to receptivity resulted in four scales with acceptable reliability scores: general receptivity to tobacco prevention education, personal support for teaching tobacco prevention education, personal involvement, and school involvement in tobacco prevention. Scales were predictive of initial and continued use and provide a teacher receptivity measure to guide staff development.

Adult↗

Correlates of coalition effectiveness: the Smoke Free Class of 2000 Program.

Fifty state and local coalitions that carry out the Smoke Free Class of 2000 program of the American Cancer Society, American Heart Association and American Lung Association were surveyed in 1990. Almost all (95%) rated themselves moderately or very active and a total of 88 900 second grade teachers were estimated to have received the materials. The availability of funds, competing priorities, lack of coordination, differences in agency service areas and personnel availability were most frequently cited as areas of concern to the coalitions. Personnel barriers and formality of coalition structure were independently related to perceived coalition effectiveness and, with the number of elementary schools, to perceived coalition activity. General recommendations, that were accepted upon completion of the assessment, included (1) formalization of agreements, mission statements, and goals and objectives, (2) attention to group formation and identification, and (3) clarification of national coalition expectations.

Data Collection↗

Dreams of anorexic and bulimic women. A research study.

The research paradigms used in this study fit with the content analysis paradigms of Hall and Van de Castle (1966) and Dippel et al. (1987), but differ in the use of descriptive scenarios specific to eating disorders. Anorexic and bulimic patients are often able to share their dreams with their therapists, and this process is sometimes the start of building an analytical relationship. This study compared the dreams of twelve eating-disordered women with eleven 'normal' women. A total of 275 dreams was collected over a four-week period and rated on a 91-item scale (Brink 1991) by eight raters. Significant differences were found between the two groups, with eating-disordered women having more dream scenarios depicting themes of: impending doom at the end of the dream, attitudes of 'whatever I do I won't succeed', and images of the dreamer being attacked, and being watched. Significant differences were also found in dream content portraying the psychological traits of: ineffectiveness, self-hate, negative emotions, an inability to self-nourish, obsession with weight, and anger. The discussion centres around the role of 'inordinate oral rage', the nature of ego defences, how these defences manifest themselves in dream images and in daily living, and how they severely impair positive transformative processes. The implications for clinical practice are that dreams are an amenable way of working with eating-disordered women, and that the therapist is more likely to promote positive transformation through focusing on their dreams than trying to change their behaviour.

Adult↗

An evaluation of the effectiveness of a planned diffusion process: the Smoke-Free Class of 2000 project in Texas.

The first year of the Texas Triagency Coalition Smoke-Free Class of 2000 project (SFC2000) in Texas was evaluated using a descriptive model developed from diffusion theory. Tobacco-prevention education (TPE) materials were to be made available to all first grade teachers within the state. A random sample survey of 213 teachers indicated that 96 (44.7%) had received the materials. Adoption and implementation were high. By May of 1989, 64.2% of those teachers receiving materials had adopted and already implemented the program, and 25.3% had adopted and intended to use the materials. Almost all (96.8%) of those teachers who received the kit indicated that they would maintain the first grade program in the coming school year. Of respondents to a 1 year follow-up survey, 41.1% used it the first year only, 27.3% used it both years, 12.5% used it only in year 2 and 18.2% did not use it either year. Of those receiving the kits, 48% indicated that they had not previously taught TPE and thus were introduced to the concept of TPE through the SFC2000 kits. Receptivity was highest (over 90% agreement) for including TPE in elementary school curricula, with fewer teachers strongly agreeing with items tapping personal involvement with TPE. This evaluation of a statewide component of a national initiative reinforces the need to consider the dissemination and implementation of materials when planning large-scale interventions and evaluating their impact.

Adult↗

A hospital-based infant safety seat program for low-income families: assessment of population needs and provider practices.

Evaluation of a hospital-based car safety seat education and loan program for low-income families included hospital interviews with new mothers (N = 94), a survey of pediatricians (N = 28), and a task analysis of the program coordinator's time. Mothers who entered the hospital with safety seats were more likely than those without safety seats to (1) be White or Mexican-American than Black; (2) not be dependent on public transportation; (3) have an older child who always rides in a car seat; and (4) wear seat belts themselves. Mothers with seats did not differ from mothers without seats in knowledge or beliefs about the importance of, or intent to use, car seats. Of mothers without seats, 86.3% were aware of the hospital's car seat rental program, but only 12 of 51 rented a seat from the program. 61% of pediatricians surveyed believed that mothers' lack knowledge and skills to acquire and use car seats regularly, but only 31% always included education about the importance of using car seats and only 21% always referred mothers without seats to the rental program. Car seat loan programs addressing low-income populations should place greater emphasis on education of medical providers to provide education and referrals, encourage organizational policy that requires a safe first ride home and address issues of social support and perceived norms and ease of acquisition.

Black or African American↗

An ecological approach to the prevention of injuries due to drinking and driving.

Among the many alcohol-related public health concerns, motor vehicle crashes account for nearly one-third of all deaths attributable to alcohol. Adolescents and young adults, particularly males, are important target populations for intervention efforts. Taking an ecological perspective of individuals within their social and physical environments, a diagnostic framework is employed in reviewing the literature on factors associated with drinking and driving injuries and on interventions to prevent injuries due to drinking and driving. Intervention planning is conceptualized according to a multilevel intervention framework, which consists of four phases: (1) health goals selection, (2) intervention planning, (3) intervention, and (4) evaluation. Possible intervention objectives, targets of the intervention actions, intervention approaches, and evaluation criteria are identified and discussed for three societal levels and four practice settings.

Accidents, Traffic↗

Developing comprehensive smoking control programs in schools.

During the school years, students encounter peer influences and role models who encourage smoking initiation. To counteract these influences, schools can provide comprehensive programs that include smoking prevention and cessation education and a supportive nonsmoking environment. In the past several years, programs and information have become available to help schools establish curricula to address smoking and to create nonsmoking environments. In addition, state and local governments have acted to legally restrict smoking in schools or to require smoking content in curricula. Efforts can be categorized into three avenues of intervention: student education, school and school system policy, and governmental regulation. Resources are suggested for each category to assist in developing a comprehensive intervention to foster nonsmoking by children and adolescents in the school setting.

Adolescent↗

Comprehensive health screening in elementary schools: an outcome evaluation.

A health screening program, piloted in 14 school districts in Texas from 1977 to 1979, was evaluated to determine the outcome of the screenings. Outcome measures used were the number of completed referrals, the number of conditions judged by health care providers not to exist and the number of problems of potential educational significance identified. While several problems were detected, the high rate of false positives and low referral completion reported from community health care providers leads to questions concerning the effectiveness of comprehensive health screening in the schools. However, the emphasis placed on identification during the screening of children with educationally significant problems may enable the schools to better serve these children. Referral follow-up in the community and schools to address identified problems would assure that the expenditure of funds for screening would not be futile.

Child↗

Utilization of child health services by children in single-parent and two-parent families.

With the increase in single-parent families, questions have been raised concerning the adequacy of the access to care for children residing in these families. A year of visits to primary health care sources are compared for a random sample of elementary school children residing with one of two-parent families. Contrary to expectations concerning the medical disenfranchisement of single-parent children when socioeconomic status, ethnicity, and children and youth project enrollment are controlled, no differences are found in use/nonuse of facilities or range of visits. Further studies should take into account parental employment as a separate and possibly more important factor than number of parents in the home when studying use of pediatric services.

Analysis of Variance↗

Patterns of primary care utilization in a triethnic urban population of school children.

Patterns of primary health care utilization for a random sample of urban elementary school children in three ethnic groups are described. Visit type, reasons for visit, and frequency of visits remained stable from year to year. More than 50 per cent of the children were non-visitors each year; 72 per cent of those not visiting the first year also did not visit the second year. Anglo-Americans were more likely to be non-visitors. Enrollment in a children and youth project is examined as a system factor that enabled limited-income families to seek comprehensive medical services. Analysis of the lowest two social classes indicated that significantly fewer Anglos than Mexican-Americans and blacks were enrolled in the Children and Youth Project. The proportion of Anglo non-visitors in the enrolled group was higher than the proportion of enrolled non-visitors in the Mexican-American and black population. Each year, significantly more children in the non-visitor category were in the non-enrolled group regardless of ethnicity.

Adolescent↗

Does visiting the school health room teach appropriate or inappropriate use of health services.

This study examines the school health room visiting behavior, over two school years, of a random sample (N = 671) of urban children, grades K-5. Excluding eight students who visited regularly for medication (and who alone accounted for 25 per cent of all visits), 94 per cent of the students made at least one visit. Girls visited more frequently than boys (5.1 visits/year vs 4.1 visits/year). Girls were more likely to be in the frequent visitor group (P = 0.01); to have presented five or more different complaints (P = 0.02); and to have visited for stomachache (P less than or equal to 0.001). These sex differences were observed as early as first grade. Almost 58 per cent of the variance in visiting in the second year was predicted by frequency of visiting in the first. These data raise questions about the influence of the school in either reinforcing or modifying the health services utilization behavior of individuals.

Child↗

A community view of smoking cessation counseling in the practices of physicians and dentists.

The practice norms of community physicians and dentists in the Lehigh Valley of Pennsylvania for counseling about smoking cessation were surveyed. In addition, 1,373 residents in the valley were interviewed by telephone about the smoking counseling behaviors of their dentists and physicians. These activities were conducted as part of the planning for an intervention by the Coalition for a Smoke-Free Valley, a coalition of 100 persons and organizations in the area. The survey response rate for 172 physicians was 77 percent, and for 103 dentists, it was 76 percent. More physicians than dentists advised patients to quit, counseled patients, provided materials, and helped the patient to set a quit date. However, there was a clear discrepancy between what physicians say they do and what smokers say they hear.

Counseling↗