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T M Lasater

Publications and source records attributed to T M Lasater.

At least 37 records · Page 2Linked to original sources

Community-based approach to weight loss: the Pawtucket "weigh-in".

The Pawtucket Heart Health Program (PHHP), in its attempt to treat obesity in the community, has delivered many traditional group and self-help weight loss programs. However, in order to reach a sufficient number of people to produce a public health impact in Pawtucket, PHHP devised a monthly city-wide "weigh-in." This program, designed to be delivered by volunteers, allowed individuals to set a weight loss goal and pledge a monetary incentive toward this goal. Self-help materials and the opportunity to join weight loss groups were provided. In the pilot study, 129 (61%) of 213 enrollees completed the 10-week program with a mean weight loss of 8.2 lb (p less than .001). A large decrease in total serum cholesterol was also observed. Nonpersonnel costs, including the total costs of the cholesterol measurement, were $1.30 per pound lost. Moreover, success is also evident by continued availability of the program and the increasing number of new participants "referred" to the weigh-in by members.

Adult↗

Enhancing adherence to referral advice given at blood cholesterol screenings: impact on participant follow-up and physician behavior.

Adherence to referral recommendations given to participants at blood cholesterol screening programs is a critical aspect of these efforts to help detect and control high blood cholesterol in the US adult population. In this study, 386 participants who had received two consecutive blood cholesterol measurements above 240 mg/dl (6.21 mmol/l) were interviewed by telephone 3 months after their second measurement (May 1987 - May 1988). Approximately 40% of respondents had seen a physician by the time of the interview; another 30% reported having scheduled an appointment. There was no significant difference in adherence behavior between participants who received a letter reiterating the referral and those who did not. However, participants who received the letter reported greater physician attention to the evaluation and treatment of their high blood cholesterol, primarily because these participants stated that they visited their physician for their high blood cholesterol. Significantly higher rates of further blood tests, cholesterol education material distribution, cholesterol-lowering medication prescription and patient-physician discussions about cholesterol were the result. These findings suggest that consumers can be effective in stimulating and reinforcing physician practice behaviors related to cholesterol control. However, strategies must be crafted so that consumers are aware of, and appreciate, the necessity of seeking physician care when they become aware of a high blood cholesterol level.

Adult↗

Use of population-based data to assess risk factor profiles of blue and white collar workers.

In light of increasing interest in the workplace as a site for primary prevention of chronic disease, more information concerning the current health status of workers is needed. This report compares "blue collar" (n = 2118) and "white collar" (n = 1900) respondents from a population-based random sample survey conducted in two southeastern New England communities. The specific responses were to a household interview and physiological measures emphasizing the risk factors for cardiovascular disease. These risk factors were elevated blood cholesterol, elevated blood pressure, smoking, being overweight and physical inactivity. Designation as blue or white collar was based upon the Standard Occupational Classification Manual. Gender specific comparisons of physiological status and self-reported knowledge attitudes and behaviors related to cardiovascular disease revealed that blue collar workers are at higher risk only for certain controllable risk factors, namely smoking and body mass index (women only). Contrary to other reports in the literature we have not found any significant difference in blood pressure or total cholesterol between the two groups. Even when people in high risk categories (systolic blood pressure greater than or equal to 140 mm/Hg, diastolic blood pressure greater than or equal to 90 mm/Hg cholesterol greater than or equal to 240 mg/dL) were studied the distributions were equally similar in both blue and white collar workers among each gender group. These findings indicate that educational interventions should target all segments of the population regardless of the nature of their occupation. More emphasis should be placed on offering programs to increase knowledge and improve health-related attitudes of blue collar workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗

The Pawtucket Heart Health Program. Influencing adolescent eating patterns.

The Pawtucket Heart Health Program, a research effort testing a process of community activation for cardiovascular risk factor behavior change, risk factor change, and coronary heart disease event rate change, utilizes risk factor behavior change programs for the entire population of a northeastern city. A diversity of nutrition programs designed to teach new skills and to alter the nutrition environment have been delivered. These include group programs, highlighting restaurant menus, labeling grocery shelf items, screening for blood cholesterol levels accompanied by nutritional counseling, and provision of programs in schools. In addition to standard curricula, the Heart Healthy Cook-Off for both junior high school and high school students has been developed. Students select recipes, make substitutions to lower fat, saturated fat, and cholesterol content, analyze original and substitution recipe nutrient content using a microcomputer and nutrient analysis software, and prepare the food. A panel of judges assesses presentation, taste, and health-promoting characteristics. In one junior high school class, cholesterol measure before and after the cook-off decreased by 10.7% among those with elevated cholesterol. The Heart Healthy Cook-Off is an education program that influences the culinary practices of children in an enjoyable, challenging format.

Adolescent↗

Heart healthy cook-offs in home economics classes: an evaluation with junior high school students.

The Pawtucket Heart Health program works closely with the 23 parochial and public schools in Pawtucket, R.I., to educate students and teachers about heart health promotion. As part of that partnership, the PHHP developed a program to teach junior high school home economics students about nutrition, food purchasing techniques, and heart healthy cooking methods. In this Heart Healthy Cook-off program, the PHHP distributes recipe guidelines to home economics teachers who instruct students in recipe modification, food preparation, and presentation. Students choose recipes and make heart healthy substitutions to lower fat and sodium content. Recipes are analyzed for nutrient content by the PHHP and returned to the students with suggestions for lowering fat and sodium if necessary. Final recipes are judged for heart healthiness by a nutritionist and for taste by a panel of judges. Prizes are awarded to students with winning recipes. Before and after the Cook-offs, classes host a blood cholesterol SCORE (screening, counseling, and referral event) where students learn about their blood cholesterol level and its relationship to dietary intake. In 1988-1989, 105 junior high school students participated in the Cook-off/SCORE program. Forty percent had elevated blood cholesterol levels of 170 mg/dl or above. A statistically significant decrease in blood cholesterol levels was observed during a 12-week time period. The Cook-off is a fun, effective program for teaching secondary school students about heart healthy eating habits.

Adolescent↗

Characteristics of volunteers who deliver health education and promotion: a comparison with organization members and program participants.

The use of volunteers in this culture for community health endeavors is an understudied area. Yet, there may be many potential benefits for utilizing volunteers in the delivery of community health education and promotion. Volunteers may have more immediate access to their peers, credibility, and familiarity with the cultural environment and organization elements. An assumption of volunteer use is that persons drawn from a targeted organization (or community subgroup) will be like other members. Such an assumption, however, should be confirmed or disproved. This article compares a sample of volunteers to a sample of members from organizations from which the volunteers were recruited. The paper also compares the volunteers to a sample of program participants. The participants were persons to whom the volunteers delivered CVD prevention programming and, in most cases, were also organization members. Collectively using the variables under investigation, multivariate analyses of variance found that the volunteers were different from the organization members, and different from program participants. To assess differences between the samples on each individual variable, univariate tests were conducted stratifying the samples by age. Statistically significant differences were found regarding organization activity, formal education level, success with past health habit change, health self-assessment, occupation, gender, and marital status.

Adult↗

Information-seeking about health in a community sample of adults: correlates and associations with other health-related practices.

Action by individuals to acquire information about their health has been an element incorporated throughout theory, research, and programs related to health promotion. This report describes an attempt to determine if an information-seeking dimension could be empirically identified in a general community-resident sample, and if so, to examine some of its characteristics. A total of 281 adults aged 18-75 were contacted by telephone using random digit dialing and were interviewed about a variety of personal health practices. Factor analysis identified a five-item cluster representing a tendency to seek out information about health. Women were more likely than men to report seeking information. In addition, more frequent information-seeking was associated with favorable responses to several other health-related practices. Formal health service use was the only type of health practice not associated with information-seeking, perhaps because regularity of contact is influenced strongly by health professionals (e.g., reminder cards and having staff call to schedule annual exams). Overall, results of the investigation support the importance of information-seeking as a component of a personal health practice repertoire. Additional attention might be directed toward elaborating its role as a "process" variable in health education programs and social marketing efforts, particularly in areas such as response to recruitment messages, dropout vs. maintenance, and differential gains on outcome measures of program effectiveness.

Adolescent↗

Pawtucket Heart Health Program: the process of stimulating community change.

The Pawtucket Heart Health Program (PHHP) is a community-based research and demonstration project in cardiovascular disease (CVD) prevention located in the United States. Targeted risk factors include high blood pressure, elevated blood cholesterol, cigarette smoking, obesity and sedentary living. Evaluation methods included biennial household risk factor surveys in the education and comparison communities, morbidity and mortality surveillance in hospitals serving each community, and both formative evaluation and process tracking. Intervention methods are theoretically derived from social learning theory and seek to motivate, enable and maintain individual behavior change; modify social networks; and introduce environmental change in organizations and normative shifts in the community in ways that reduce the prevalence of CVD risk factors. The intervention strategy began as an organization-based model, and has evolved into a community-wide effort in which marketing research tools and techniques are employed. In the past 4 years, over 40,000 individual contacts have been made with PHHP programs, including 1,260 persons who have volunteered their time to deliver risk factor programs.

Cardiovascular Diseases↗

Theory and delivery of health programming in the community: the Pawtucket Heart Health Program.

The Pawtucket Heart Health Program is one of the community studies examining whether population-based efforts to lower cardiovascular risk factors will reduce cardiovascular morbidity and mortality. The Pawtucket Heart Health Program intervention is based on a blend of social learning theory, community organization models, community psychology tenets, and diffusion research. This model allows for multifaceted programs that target individuals, groups, organizations, and the entire community to alter their cardiovascular risk through managing blood pressure, lowering blood cholesterol, quitting smoking, increasing fitness, and maintaining desirable weight levels. A dominant feature of the intervention is the emphasis that it places on volunteers for program delivery. The role of volunteers in providing direct services to help citizens lower their blood pressure and lose weight is highlighted to demonstrate the feasibility and effectiveness of these services. In addition, church-based programming which utilizes volunteers to manage and direct programs is also presented as an example of community-based health promotion efforts that promote collective efficacy.

Adolescent↗

Evaluation of two community-wide smoking cessation contests.

The Pawtucket (Rhode Island) Heart Health Program is designed to effect a community-wide change in heart disease morbidity and mortality by reducing smoking prevalence and other behavioral risks for this disease. The initial emphasis of the Pawtucket Heart Health Program was on the development of risk factor programs within specific churches, work sites, and other organizations in the community. At the end of 9 months of programming, however, only one organization had elected to begin a stop-smoking program. Given the community smoking prevalence of 43.4%, it was decided that larger-scale interventions would be required if a significant public health impact was to be realized. Therefore, a community-wide campaign was mounted to recruit as many participants as possible into the "Up in Smoke" cessation program. A lottery was attached to this program, with the contingency based on program attendance rather than cessation per se. One hundred three participants, including residents of neighboring communities, enrolled in three Up in Smoke lottery groups. At a 3-month follow-up, only 11 (7%) of smokers from the Up in Smoke lottery reported that they were not smoking (10% of those actually contacted). For a variety of reasons, the "Quit and Win" approach was later adopted by the Pawtucket Heart Health Program as the primary smoking intervention. One month after the end of the contest, 20% of those contacted reported not smoking. The percentage of quitters for the Up in Smoke program increased while the Quit and Win rate decreased over longer periods of follow-up. These and other data were compared with those of participants of a screening program conducted concurrently. Lotteries in general and face-to-face recruitment in large crowds were shown to be effective recruiting methods for large-scale smoking cessation programs.

Adult↗

Characteristics of participants in community health promotion programs: four-year results.

Four years of participant tracking data (N = 24,995) for community-based programs targeting cardiovascular disease risk factors are presented. Over two-thirds of contacts were female; age segment representation in these programs was comparable to the city's demography. However, the data show that programs of varying formats which target specific risk factors attract different types of participants. Implications for marketing strategy are discussed.

Adolescent↗

Primary prevention of coronary heart disease: a challenge for behavioral medicine.

Arteriosclerosis is importantly influenced by blood cholesterol level, blood pressure, and cigarette smoking. Each of these major risk factors is influenced by behavioral choices made by individuals and supported by societies. Behavioral medicine has a rich tradition of dealing with individuals and small groups. The public health perspective of disease challenges behavioral medicine to develop new strategies and tactics for behavioral modification for health promotion on a population-wide basis. Additional research is needed to test effective methods for influencing population behavior, population risk factors, and ultimately population morbid and mortal event rates. Several major community projects are now investigating the health promotion process targeting individuals, small groups, organizations, and the entire community. School, worksites, and churches are particularly conducive to health promotion programming. Each has unique advantages and disadvantages; each deserves careful experimentation to determine its efficacy for population-wide health promotion efforts. A public health dimension to behavioral change promises widespread impact, generalization to other health promotive behaviors, maintenance of new cultural behavioral norms, and significant reductions in the incidence of many chronic diseases.

Behavior Therapy↗

The use of telemarketing in the community-wide prevention of heart disease: the Pawtucket Heart Health Program.

The marketing of preventive health behaviors is typically accomplished through various broadcast, print, and other mass media channels. By making randomly-dialed telephone calls to 4,000 residents of Pawtucket, RI, volunteers of the Pawtucket Heart Health Program succeeded in registering nearly 400 individuals for risk factor reduction groups or self-help behavior change kits. Additionally, community awareness of the program was an indirect benefit of this "telemarketing." Telemarketing is an interactive and inexpensive approach to marketing preventive health behaviors.

Heart Diseases↗