Biomedical subjects

T Koepsell

Publications and source records attributed to T Koepsell.

39 records · Page 3Linked to original sources

PubMedDate not supplied

A community-based approach to preventing alcohol use among adolescents on an American Indian reservation.

This paper examines the effectiveness of a 5-year community-based health promotion program to reduce the rate of substance use, particularly alcohol, by adolescents on a Plains State American Indian reservation. The program was part of the Kaiser Family Foundation Community Health Promotion Grants Program. Since a reservation control group was not available, adolescents serving as control groups for other Community Health Promotion Grants Program communities, including a small sample of rural American Indians, were used as a basis for comparison. School-based surveys of 9th and 12th graders were carried out on the reservation and in five relevant California control communities--two suburban, three rural--in 1988, 1990, and 1992. The results showed that the use of both alcohol and marijuana declined substantially among American Indian adolescents living on the reservation. Binge drinking (five or more drinks on an occasion) declined from 46 percent to 30 percent, and marijuana use (in the past month) declined from 46 percent to 29 percent over the 4-year period. However, there were similar, if smaller, declines in alcohol use in the comparison groups. Since there was no evidence of a relative increase in exposure to alcohol and drug programs on the reservation, the authors are cautious in attributing the significant and heartening declines in substance use among adolescents on the reservation to the community-based program.

Adolescent↗

PubMedDate not supplied

Relationship between socioeconomic status, health status, and lifestyle practices of American Indians: evidence from a Plains reservation population.

This paper presents information on the prevalence of a variety of health behaviors and health conditions on an American Indian reservation in the Plains region of the western United States. In addition, data from two non-Indian comparison groups were used to examine the extent to which differences in health status and health behaviors between Indians and non-Indians could be explained by differences in socioeconomic status. The American Indian data were from a survey conducted in 1988 during an evaluation of a local community-based health promotion program, part of the Kaiser Family Foundation's Community Health Promotion Grants Program. The comparison groups were 12 communities in California surveyed in evaluating the Community Health Promotion Grants Program and three Plains States participating in the Behavioral Risk Factor Surveillance Survey. The results show that the higher prevalences of risk-taking behavior among Indians and their poorer self-reported health status remained after adjustment for socioeconomic status. Also, among Indians, higher levels of income and education were not associated with improved self-reported health status and lower prevalence of tobacco use, as was the case with the comparison groups. The higher prevalences of risk-taking behaviors and ill health among American Indians residing on one reservation, even among those with higher socioeconomic status, suggests a need for the investigation of other social and environmental influences.

Adolescent↗

PubMedDate not supplied

Assessment of community-level influences on individuals' attitudes about cigarette smoking, alcohol use, and consumption of dietary fat.

A basic premise of community-based health promotion is that enduring changes in health behaviors are facilitated by changing community norms or the standards of acceptable behavior in the community. We examine whether community-level influences on individuals' normative attitudes can be related to cigarette smoking, alcohol consumption, and dietary fat intake. We conducted a random-digit dialing survey of 8,849 adults in 15 communities in the western United States as part of the evaluation of the Henry J. Kaiser Family Foundation Community Health Promotion Grant Program. We found independent associations among attitudes for tobacco, alcohol, and diet and both individual-level and community-level characteristics. A significant community effect on attitudes remained even when we controlled for individual demographics and health behaviors, as well as for the overall prevalence of the target health behavior in the community. The specific community characteristics that account for this effect were not clear in our analyses, suggesting that influential characteristics vary from community to community.

Adult↗