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Biomedical subjects

Sally L Lusk

Publications and source records attributed to Sally L Lusk.

15 recordsLinked to original sources

Comparison of the original and revised structures of the Health Promotion Model in predicting construction workers' use of hearing protection.

Pender's health promotion model (HPM) has been revised, including substantial changes in its structure. The purpose of this study was to compare the fit and predictive usefulness of the original and revised structures of the HPM as applied to the use of hearing protection devices by 703 construction workers. Structural equation modeling was used to evaluate the two alternative forms of the model. Both forms of the model fit well, with the revised structure having a better fit and explaining more of the variance in use of hearing protection (28% vs. 18%). Results support the revised structure of the health promotion model (HPM) over the original form, and indicate it may be useful in understanding and predicting use of hearing protection.

Adult↗

Selecting control interventions for clinical outcome studies.

In the current research environment the design and management of control groups is becoming more complex. The selection of a control group design is dependent on study goals, presence and quality of existing interventions, urgency of the problem or issue being addressed by the intervention, and factors related to the study site. The purpose of the presentation is to identify various approaches to the design of control groups in experimental studies and to identify their strengths, limitations, and applications. A case study exemplifies the issues associated with control group selection and design.

Clinical Nursing Research↗

Ethnic differences in predictors of hearing protection behavior between Black and White workers.

The purpose of the study is to determine whether there are ethnic differences in predictors of hearing protection behavior between Black and White workers. The Predictors of Use of Hearing Protection Model (PUHPM) derived from Pender's Health Promotion Model (Pender, 1987) was used as a conceptual model. A total of 2,119 (297 Blacks, 1,822 Whites) were included in the analysis. Internal consistency of instrument items was assessed using theta reliability estimates. Significant predictors of the use of hearing protective devices (HPDs) for Black and White workers and differences in predictors between the two groups were examined using multiple regression with interaction terms. Ethnic differences in scale or individual item scores were assessed using chi-square and t-test analyses. Different factors influenced hearing protection behavior among Black and White workers. The model was much less predictive of Blacks' hearing protection behavior than Whites' (R2 = .12 vs. .36). Since the PUHPM was not as effective in predicting hearing protection behavior for Blacks as for Whites, future studies are needed to expand the PUHPM through qualitative study and to develop culturally appropriate models to identify factors that better predict hearing protection behavior as a basis for developing effective interventions.

Adult↗

Relationship of work schedules to gastrointestinal diagnoses, symptoms, and medication use in auto factory workers.

BACKGROUND: Gastrointestinal (GI) complaints are common in shift workers. This study examines the relationship between work schedules and GI symptoms, medications, and diagnoses. METHODS: In a cross-sectional survey of 343 US auto factory workers, four work schedule variables were examined: assigned shift, number of hours worked, number of night hours, and schedule variability. Multiple regression tested the relationship between GI outcomes and work schedule variables while controlling for covariates. RESULTS: The evening shift was associated with more GI symptoms and GI diagnoses. Unexpectedly, more consistent work times were associated with having a GI diagnosis. As schedule variability increased the probability of GI medication use increased in low noise exposure. CONCLUSION: Findings suggest that evening shift and widely varying work start and end times may increase risks for GI disturbances.

Adult↗

Acute effects of noise on blood pressure and heart rate.

The authors assessed the acute effects of exposure to noise on systolic and diastolic blood pressure, and heart rate, among 46 workers in a midwestern auto assembly plant. Workers wore ambulatory blood pressure monitors and personal noise dosimeters during one work shift. After adjustment for covariates of cardiovascular function, systolic and diastolic blood pressure, along with heart rate, were shown to be significantly positively associated with noise exposure. Although the long-term effect of these associations is not known, results from other studies suggest that they may be harmful. Replication of this study with a larger number of subjects, monitored for several days and in a variety of work settings, is recommended to verify these findings. The results of this and other studies imply that reducing acute noise exposure reduces cardiovascular stress.

Adult↗

Impacting health through the worksite.

The achievement of the Healthy People 2010 objectives will require community involvement of health care providers. The worksite remains the best place to access the adult population for health promotion and disease prevention. In addition, it is essential that non-worksite primary care services be attuned to the effects of work on health and illness. Given the frequency and duration of exposure, the significance of a worksite health history for the primary care provider cannot be overstated. To effectively serve clients, health histories should include assessment for the presence of hazardous worksite exposures and consideration of organizational climate. Further, when considering the provision of health promotion programs in the community, offering programs at the worksites within the community can be particularly effective. There should be increased efforts by health care providers to promote lifestyle modification through client and community interventions. The worksite offers an excellent setting as well as an opportunity to collaborate with employers to facilitate health promotion programs. Recognizing the significance of the occupational environment, an increasing number of worksite intervention studies have been reported. However, continued growth in this area is still needed. Research on worksite health promotion and disease prevention intervention is still in its infancy. Nurses can make a unique contribution to research on worksite lifestyle modification programs, and in enhancing the health status of the nation.

Adult↗

Preventing noise-induced hearing loss.

Noise-induced hearing loss is a significant, irreversible impairment, but one that is preventable. The numbers of persons, including children, exposed to high noise is increasing, necessitating the use of hearing protection if the noise cannot be reduced to a safe level. The effectiveness of interventions has been tested with select worker groups, but use of hearing protection continues to be less than necessary when in workers are exposed to high noise. Clinicians have an essential role in educating clients of all ages about this problem and in assisting them in protecting their hearing.

Adult↗

Occupational health nursing research. An overview from January 1990 to December 1999.

Occupational health nursing research contributes to the scientific knowledge base, shapes practice guidelines, lends credibility to the profession, and ultimately benefits worker health and work settings. This descriptive study reviewed occupational health nursing research published from January 1990 through December 1999 in the AAOHN Journal. A single investigator reviewed all articles published during the 10 year period to determine if they qualified for inclusion by applying the inclusion and exclusion criteria. During the 10 year period, a total of 577 articles were published in the AAOHN Journal (the official journal of the American Association for Occupational Health Nurses) with 146 (25.3%) considered to be reports of research. Cumulatively, 261 RNs were authors of the research articles. Of the 146 research articles, 88% addressed the National Occupational Research Agenda (NORA) priorities, 60% addressed the 1989 AAOHN priorities, and 65% addressed the 2000 AAOHN priorities. Occupational health nursing research is performed primarily by graduate and postgraduate level nurses working either alone or with nurse co-investigators. The occupational health nursing research articles addressed NORA priorities often. However, the outcomes focused priorities of AAOHN were addressed less often. Much has been accomplished in the field of occupational health nursing research and more remains to be performed to ensure a strong research base for occupational health nursing practice.

Clinical Nursing Research↗

Incorporating health services research into nursing doctoral programs.

Despite the successes of the US health care system, problems associated with access, affordability, and quality of care remain to be solved. Health services research (HSR) has the potential to aid nurses in addressing these issues; yet the importance of its inclusion in the academic preparation of nurse researchers has not been consistently recognized. This article discusses the relevance of HSR to nursing, provides a brief review of the history of HSR and its imperatives, and presents rationale for nursing's involvement in HSR. Problems identified by the Re-envisioning PhD project conducted by the University of Washington are assessed for relevance to HSR and nursing doctoral preparation. Recommendations are included for integrating HSR into nursing doctoral programs and meeting HSR capacity building needs for the future.

Curriculum↗

Chronic effects of workplace noise on blood pressure and heart rate.

Environmental noise levels in the United States are increasing, yet there are few studies in which the nonauditory effects of workplace noise are assessed. In the current study, the authors examined chronic effects of noise on blood pressure and heart rate in 374 workers at an automobile plant. Data were collected from subjects prior to the start of their workshift. Participants completed questionnaires about diet, alcohol use, lifestyle, noise annoyance, use of hearing protection, noise exposure outside of the work environment, personal and family health histories, and demographic information. Resting blood pressure, heart rate, and body mass index were obtained. Noise exposure levels were extracted retrospectively from company records for each participant for the past 5 yr. Summary statistics were generated for each variable, and the authors performed bivariate correlations to identify any unadjusted associations. The authors then completed statistical modeling to investigate the effects of noise on blood pressure and heart rate, after they controlled for other variables (e.g., gender, race, age). The authors controlled for confounding variables, after which use of hearing protection in high-noise areas was a significant predictor of a decrease in both systolic and diastolic blood pressures. The results suggested that the reduction of noise exposure by means of engineering controls or by consistent use of hearing protection by workers may positively affect health outcomes.

Adult↗

Factors influencing use of hearing protection among farmers: a test of the pender health promotion model.

BACKGROUND: Most farmers are exposed to potentially hazardous noise levels through many of their work activities, such as operating tractors, grain dryers, and chain saws. Rates of noise-induced hearing loss in this group are high. Although this condition is preventable through the use of hearing protection, rates of protective device use are low. Understanding factors influencing the use of hearing protection devices will provide direction for programs to increase their use and decrease risk of noise-induced hearing loss. OBJECTIVES: A study was designed using the Pender Health Promotion Model to identify factors affecting farmers' use of hearing protection devices. METHOD: Model testing was conducted with a convenience sample of 139 farmers. Prior to model testing, existing instruments designed to measure concepts from the Health Promotion Model were modified for use with farmers through interviews, validity testing with an expert panel, and reliability testing with first a small (n = 36) then a second larger (n = 139) convenience sample of farmers. Instruments measuring cognitive and affective factors related to hearing protection device use were administered to farmers at a regional farm show in the Midwest. RESULTS: A logistic regression analysis identified interpersonal support, barriers, and situational influences as statistically significant predictors of this health behavior, correctly predicting 78% of the cases. Results of model testing were consistent with results of previous studies of Health Promotion Model variables with other worker groups' use of hearing protection. CONCLUSIONS: Information from this study can be used to design and evaluate interventions to promote hearing protection device use among farmers and reduce the level of noise-induced hearing loss in this high-risk and underserved worker group.

Agricultural Workers' Diseases↗

Explaining Mexican American workers' hearing protection use with the health promotion model.

BACKGROUND: Mexican American workers are vulnerable to noise-induced hearing loss, the most common occupational disease in the United States. OBJECTIVES: The purpose was to test the applicability of the Health Promotion Model to Mexican American workers' use of hearing protection devices. METHOD: A correlational descriptive design and path analysis were used to determine the relationships between cognitive-perceptual factors, modifying factors and use of hearing protection devices. A questionnaire was completed by a total of 119 workers in three garment manufacturing plants. Interviews were conducted with the occupational health nurse or safety director in each plant to determine the policy regarding hearing protection also. RESULTS: Factors that directly influenced the use of hearing protection devices were a clinical definition of health, benefits of and barriers to use of hearing protection devices, self-efficacy in the use of hearing protection devices and perceived health status (R2 =.25, p <.01). An exploratory analysis allowing a direct relationship of modifying factors with the dependent variable explained additional variance in use of hearing protection devices through the contribution of situational factors (R2 =.55, p <.01). CONCLUSIONS: Important factors related to Mexican American workers' use of hearing protection devices were identified to provide direction for nursing interventions. Future research should further test the explanatory capabilities of the Health Promotion Model, explore the importance of situational influences on health behavior, and ensure reliable measures of all model components for this population.

Adult↗

Effectiveness of a tailored intervention to increase factory workers' use of hearing protection.

BACKGROUND: In the United States it is estimated that more than 30 million workers are exposed to harmful levels of noise on the job. When engineering or administrative controls cannot be used to reduce noise, workers should always use hearing protection devices (HPDs) when exposed to loud noise to prevent noise-induced hearing loss (NIHL). Previous research has shown that workers do not always use HPDs when required; therefore, it is essential that workers assume personal responsibility for preventing NIHL by increasing their use of HPDs. OBJECTIVES: This study tested the effectiveness of an individually tailored multimedia intervention to increase use of HPDs by factory workers. METHODS: A randomized controlled design was used to compare the effects of a tailored intervention (n= 446) with two other interventions (a nontailored predictor-based intervention (n= 447) and a control intervention (n= 432)) on workers' self-reported use of HPDs 6 to 18 months following the intervention. RESULTS: Only those workers receiving the tailored intervention significantly increased their use of HPDs from pretest to posttest. However, this increase significantly differed from the nontailored group but not from the control group. CONCLUSIONS: Individually-tailored interventions offer promise for changing behavior. In light of the similarity between the results for the tailored intervention and the control intervention groups, further research is needed to understand barriers to HPD use and how to maximize the benefits of individually tailored interventions in this setting.

Adult↗

Effects of booster interventions on factory workers' use of hearing protection.

BACKGROUND: The provision of reinforcements or boosters to interventions is seen as a logical approach to enhancing or maintaining desired behavior. Empirical studies, however, have not confirmed the effectiveness of boosters nor assessed the optimum number of boosters or the timing for their delivery. OBJECTIVES: This randomized controlled trial contrasted the effect of four booster conditions (a). 30 days; (b). 90 days; (c). 30 and at 90 days; and (d). no boosters of the intervention to increase the use of hearing protection devices (HPDs). METHODS: A total of 1325 factory workers completed a computerized questionnaire and were randomly assigned to one of three computer-based (tailored, nontailored predictor-based, or control) multimedia interventions designed to increase the use of hearing protection devices. After the intervention, colorful boosters specific to the type of training received were mailed to workers' homes. Posttest measures of use were administered at the time of their next annual audiogram 6 to 18 months after the intervention. RESULTS Repeated measures of analysis of variance (ANOVA) showed a significant main effect for the booster (after 30 days) in the group that received tailored training (F[3442] = 2.722; p =.04). However, in the assessment of the interaction between time (pretest and posttest) and boosters (four groups), the ANOVA did not find significant differences in hearing protection device use for any of the training groups. To assess for significant differences between groups, post hoc comparisons were conducted at the pretest and posttest for the total sample and for the subsample of workers who reported using hearing protection devices less than 100% of the time needed. Sheffé contrasts by intervention group, gender, ethnicity, and hearing ability found no significant changes in the mean use of hearing protection devices for the booster groups. CONCLUSIONS: Although the provision of boosters represented a considerable commitment of resources, their use was not effective in this study. However, it would be premature to eliminate boosters of interventions. Further study is needed to explore the effects of different booster types for increasing the use of hearing protection devices, and to assess carefully the effects of boosters on other health behaviors in studies with controlled designs.

Adult↗