Biomedical subjects

T M Lasater

Publications and source records attributed to T M Lasater.

At least 55 records · Page 3Linked to original sources

PubMed1986

Organizational and community approaches to community-wide prevention of heart disease: the first two years of the Pawtucket Heart Health Program.

The Pawtucket Heart Health program (PHHP) is a federally funded research and demonstration project for the primary prevention of coronary heart disease (CHD) in a community. This article presents a discussion of the first 26 months of this intervention, divided into its three phases. PHHP staff initially approached the intervention city through local organizations to accomplish risk-factor behavior change in the population. After 11 months, PHHP complemented its programs in organizations with activities open to all city residents, in order to accelerate participation by the population. Seven months into this phase, it was decided that community activities should be the major focus of the intervention approach to assure a level of participation adequate to make a measurable impact. The third has shown the greatest percentage of public participation, demonstrating the complementary nature of organization and community interventions and of the translation of social learning theory into principles for primary prevention in a community.

Advertising↗

PubMed1986

Community intervention to lower blood cholesterol: the "Know Your Cholesterol" campaign in Pawtucket, Rhode Island.

Sufficient data exist to support approaches to lowering cardiovascular disease risk which target population-wide reductions in elevated blood cholesterol levels. Within the context of a multifactorial cardiovascular disease prevention program, a 2-month cholesterol education campaign was launched to encourage citizens to "Know Your Cholesterol" by attending screening, counseling, and referral events (SCOREs) held throughout the community. These events featured assessment of dietary fat and cholesterol, rapid blood cholesterol analyses with a fingerstick procedure and the Kodak Ektachem DT60, and immediate dietary counseling by trained volunteers. A total of 1439 persons attended 39 SCOREs: nearly 60% were found to have blood cholesterol levels that exceeded recommended goal levels. At a 2-month follow-up of 1040 of these same individuals, 600 had lowered their blood cholesterol level by an average of 29.1 mg/dl. This experience suggests that similarly modeled campaigns may have a significant impact on the distribution of blood cholesterol levels in the entire U.S. population.

Cholesterol↗

PubMed1985

Multivariate evaluation of health attitudes and behaviors: development and validation of a method for health promotion research.

Many self-reported measures of health status, attitudes, and knowledge used by clinicians and researchers suffer from a variety of shortcomings, including limited empirical justification, excessive complexity, assessments of nonmodifiable historic or hereditary factors, and limited utility for public health program planning. The Health Attitudes and Behavior Scale is an instrument designed to overcome many of these shortcomings and direct public health professionals toward more efficacious interventions. One hundred sixty-four subjects responded to true-false and Likert scale items related to health beliefs, attitudes, and behavioral practices. A principal component analysis of the Likert items yielded six components, tentatively labeled (a) Lack of Social Support, (b) Hurdles to Health, (c) Health Attitudes/Weight Concerns, (d) Positive Environment, (e) Disease Concerns, and (f) Time and Work Pressure. Analyses of these scales using coefficient alpha indicated adequate internal consistency for each of them. These scales were then related to demographic variables of age, educational level, sex, and marital status. Next, these scales were correlated with individual true-false items reflecting self-reported behavioral practices or health histories. A component analysis of the true-false items yielded four principal components labeled (a) Organizational Health Concerns, (b) Smoking and Exercise Concerns, (c) Coronary and Weight Concerns, and (d) Blood Pressure and Risk Factor Programs. Finally, a cluster analysis yielded six typical profiles reflecting different levels of the original six components. Of interest is the fact that the Lack of Social Support and Time and Work Pressure scales had a very limited integration into the overall patterns. The assumption that organizational and environmental factors can have an important impact on health was supported. The need for further research in this area is also discussed.

Adolescent↗

PubMed1985

A simple, valid step test for estimating maximal oxygen uptake in epidemiologic studies.

The authors' modification of the Astrand-Rhyming Cycle Ergometer Test is of short duration, has low initial and peak work rates and was in an earlier study applied for population fitness testing (N = 587) at a survey center after other cardiovascular risk factor measures were obtained in the home. To add fitness testing in the home, the authors have designed a safe, brief 10 inch (25.4 cm) high step test for estimating maximal oxygen uptake (VO2max). Measured maximal oxygen uptake for step tests has been shown to be approximately 10% higher than that reported for cycle tests. All test instructions and stepping rates were included on a cassette tape; heart rates were monitored by a digital tachograph during the last 30 seconds of stepping. Maximal oxygen uptake was measured directly on a bicycle, estimated by the step test, and measured by the authors' bike test in 48 men and women aged 19-70 years who took part in a community fitness program in Pawtucket, Rhode Island in January-February 1983. No significant differences in maximal oxygen uptake were found between the bicycle protocols. The step test estimate of maximal oxygen uptake (VO2max) was significantly higher (12%) than directly measured VO2max, reflecting the expected difference between stepping and cycling. The correlation between direct and both estimates was 0.92. The cross-validation correlation between the estimates was 0.98. The authors' protocol provides accurate estimates of maximal oxygen uptake and is safe and suitable for in-the-home assessment of fitness of people aged 19-70 years for epidemiologic studies.

Adult↗

PubMed1985

Self-reported physical activity compared with maximal oxygen uptake.

Maximal oxygen uptake has been used as a measure of physical fitness. This measure increases by approximately 25% when sedentary individuals become more physically active. Oxygen uptake measurement in the laboratory or estimation in fieldwork is complex and costly with finite risk. For the present study, 36 men and 32 women completed the Paffenbarger Physical Activity Index Questionnaire, including a sweat-inducing physical activity frequency question, and had measurement of oxygen uptake during pedal ergometry. Using maximal oxygen uptake as the measure of fitness, the authors found that the Paffenbarger Physical Activity Index, although more detailed, may be less valid than the simpler sweat induction frequency question for estimating fitness. The correlations observed between the sweat question and oxygen uptake were 0.54 for males, 0.26 for females, and 0.46 for the total group. The correlations between the Physical Activity Index and oxygen uptake were 0.26 for males, 0.08 for females, and 0.29 for the total group. The regression relationship (oxygen uptake = 1.92 X (sweat days) + 23.76; standard error of estimate = 8.63 ml/kg/min) is significant for sweat versus oxygen uptake. While the confidence interval limits the practical ability to predict individual values, low cost, absence of risk, and population validity suggest that fitness can be assessed rapidly and simply for epidemiologic studies with a simple "sweat" question.

Adult↗

PubMed1985

Physical fitness and blood pressure: the role of age.

Most epidemiologic studies have shown an inverse relationship between resting blood pressure and usual levels of physical fitness or activity. The inference is that fitness lowers blood pressure. However, maximum oxygen uptake (VO2max--a widely accepted measure of fitness) and blood pressure are both correlated with age; young people usually have lower pressures and higher VO2max (ml X kg-1 X min-1). Systolic and diastolic pressures were measured and maximal oxygen uptake was estimated in 184 men and 227 women aged 18-65 years who were randomly selected as part of a cardiovascular risk factor survey conducted in two New England cities between April 1981 and March 1982. Initially, both measures of blood pressure were strongly and inversely correlated with estimated maximal oxygen uptake. However, when the effects of age were partialed out, the strength of the correlations decreased sharply for both males and females. The proportion of the variance in systolic pressure explained by maximal oxygen uptake decreased from 9.6 to 0.8% for males and 21.2 to 2.3% for females. Similar decreases were demonstrated for diastolic pressure in males (14.4 to 2.9%) and females (20.3 to 2.3%). These data indicate that the frequently observed relationship between fitness and blood pressure is strongly influenced by age. Future research to specifically examine the effects of physical activity and of physical fitness on blood pressure is needed.

Adolescent↗

PubMed1985

Applications of behavior modification to community health education: the case of heart disease prevention.

Principles of behavior modification increasingly have been applied to community health education and offer considerable promise for public health in general. Behavior modification procedures can be conceptualized in a 2 X 2 framework with desired goals being either to increase and strengthen or decrease and weaken behavior, and procedures producing essentially positive or negative consequences. Modifying specific behavioral risk factors for the prevention of heart disease may include the use of positive reinforcement, shaping, differential reinforcement, negative reinforcement, and "punishment." The use of an adequate "behavior analytic" history, highly acceptable interventions, observable effects, inexpensive materials and procedures, community-owned programs, and other practical guidelines can help optimize the effectiveness of behavior modification for health education in the community.

Behavior Therapy↗

PubMed1983

Coronary heart disease and human behavior.

Coronary heart disease due to atherosclerosis is prevalent in people whose circulating cholesterol level is high, who smoke, who have elevated blood pressure, and, perhaps, whose fitness is low and/or body weight excessive. Whereas the epidemiologic evidence is relatively strong for each of these health factors (behavioral patterns and their physiological consequences), the evidence from clinical trial interventions is still ambiguous. Each of the health factors relates to personal and societal lifestyle. Each is influenced by individual choice and by the practices of health professionals. The relatively low risks of intervention, viewed in the light of its potentially high benefits, justify the attempt to engender a more healthful lifestyle on a public health scale. The present paper provides guidelines for health professionals and lists corollary recommendations for concerned individuals for each of the five relevant health factors. Application of these prescriptions by health professionals in concert with the individual holds promise for reduced coronary artery disease at the societal level.

Arteriosclerosis↗

PubMed1982