Biomedical subjects

T M Lasater

Publications and source records attributed to T M Lasater.

66 records · Page 4Linked to original sources

PubMedDate not supplied

Correlates of expected success at health habit change and its role as a predictor in health behavior research.

Perceived ability to change health habits successfully is undoubtedly an important factor underlying personal health behavior. This report examines expected success in changing future habits, using a sample of community-resident adults 18-65 years of age (n = 1,367). One set of analyses used expected success as a dependent variable, whereas another set used it as an independent variable for health behavior and knowledge indices. In the dependent variable analysis, results showed that reported past success at health habit change was the strongest predictor of success expected in the future. Optimism about future success was also associated with variables that already placed individuals at an advantage to change behavior (e.g., not smoking, regular exercise, lower Body Mass Index, support in the family). When used as a predictor variable, expected future success was not associated with five health-related, self-report indices of behavior, knowledge, and perceived risk. Further examination showed, however, that in three instances the association between expected success and the outcome indices seemed to plateau in the most optimistic group. Extreme optimism (that admits no chance of failure) may be a belief characteristic that deserves further investigation, one that will present a challenge to research and practice. Men tended to report greater expected future success than women, although women had more favorable reports on three of the five health-related behavior/knowledge indices.

Adolescent↗

PubMedDate not supplied

Health practice correlates in three adult age groups: results from two community surveys.

Independently done surveys of a target population can make an important contribution to knowledge about the determinants of personal health behavior by highlighting variables that consistently emerge as significant predictors. This investigation examined the correlates of four health practice and knowledge indices related to cardiovascular disease (CVD) in two baseline community surveys of the Pawtucket Heart Health Program (N = 2,413; N = 2,808). An additional dimension was the use of three adult age groups (18-29, 30-49, 50-64) in conducting the analyses. Results of both surveys showed that sex was the strongest correlate of the four indices--knowledge of CVD, encouraging health practice changes in others, dietary intake, and exercise. The four indices related to CVD were also associated with years of education, primary language, and whether or not a recent cholesterol measurement had been obtained, although these relationships were not as consistent as the results for sex. Overall, about half of each survey's significant associations were also found in the other survey (survey 1, 30 of 62; survey 2, 30 of 56). Consistency of significant results between surveys was best for the group ages 30-49. In either survey, it was rare for an association between a predictor and behavioral index to appear in each of the three age groups. This study supports the importance of the subjects' sex in research on personal health practices, suggests the potential for independence even among health-related indices pertinent to a single type of illness, and emphasizes the usefulness of utilizing independent samples to identify important correlates of health behavior.

Adolescent↗

PubMedDate not supplied

The role of churches in disease prevention research studies.

The design of a large-scale research project (The Health and Religion Project) in which church volunteers deliver behavior change programming on major cardiovascular risk factors (smoking, elevated blood pressure, elevated serum cholesterol, excess weight, and physical inactivity) is described. A total of 20 churches (Roman Catholic, Baptist, and Episcopal) were recruited throughout Rhode Island and randomly assigned to five experimental conditions. These conditions were designed to test the necessity of training special task forces to coordinate efforts within each church and to test the relative efficacy of high or low levels of professional (paid staff) involvement. Churches have many characteristics that are compatible with behavior change programming for primary prevention of chronic diseases. However, there have been very few research studies of churches engaging in primary prevention activities. Thus, the first step was to test the churches' receptivity to participation in this type of project. To do this, all churches in Rhode Island were surveyed by mail and phone. Those that met several eligibility criteria were randomly selected for recruitment into the study. The high receptivity of the churches was demonstrated by a response rate of 65 percent (20 of 31). This readiness is bolstered by the fact that all of the 20 churches that originally began the study have remained involved for at least 2 1/2 years.

Adolescent↗

PubMedDate not supplied

Impact of public education and continuing medical education on physician attitudes and behavior concerning cholesterol.

Current physician attitudes and behavior concerning elevated blood cholesterol, recent changes, and reasons for change were measured in a survey of physicians in two cities. Those in a community with both continuing medical and public education programs reported changing their practice significantly over the past two years, more so than those in a comparison community. The physicians did not identify specific elements of a continuing medical education program as important in these differences. Physicians in Pawtucket, Rhode Island, identified requests from the public as important and statistically significant factors in their changed behavior, suggesting that the public education program has become an important influence on physician behavior.

Attitude of Health Personnel↗

PubMedDate not supplied

Training volunteers to conduct heart health programs in churches.

With cardiovascular disease the leading cause of death and disability in the United States, economically feasible and effective methods of prevention are needed. The Health and Religion Project (HARP) uses volunteers to provide cardiovascular risk-factor change programs to individuals in their church communities. The rationale for the use of volunteers in this setting is described, along with the design and initial response to the HARP volunteer training program. Two hundred twenty-two volunteers were certified across 16 study churches to conduct risk-factor change programs. Their certification exam performance demonstrated that they had mastered the knowledge and skills deemed necessary for their jobs. Overall, the trainees were very enthusiastic about their new roles. Based on this initial response, our partnership with churches for health promotion is worthy of further development.

Cardiovascular Diseases↗

PubMedDate not supplied

Rapid measurement of blood cholesterol: evaluation of a new instrument.

Rapid and reliable techniques for the measurement of blood cholesterol are a necessary first step in implementing effective mass screening efforts to reduce the risks of cardiovascular disease. This paper reports preliminary data gathered on the Kodak Ektachem DT60, one of the first of a new generation of dry chemistry analyzers to appear on the market. The results of the first study demonstrated high reproducibility of the methodology (r = .98, p less than .0001) but showed an average 25 mg/dL underestimate of total blood cholesterol as compared with a standardized lipid laboratory. Changes in the manufacturer's calibration protocol in the second study with two other DT60s reduced this bias on serum samples to -18 mg/dL. A third study using fresh blood samples found a difference of 3-11 mg/dL between the two DT60s and the laboratory. A significant difference between the two analyzers was also found. Alternatives are available to enable those who use this instrument to correct for the observed bias. Despite some problems, several other advantages of the technology lend support for its expanded use in public health interventions.

Adult↗

PubMedDate not supplied

The use of volunteers in mass screening for high blood pressure.

This paper describes the effectiveness of an incentive-based approach to screening for hypertension by comparing it to two more typical on-site screenings. In the "bounty system," adolescents were trained and certified in blood pressure assessment to enable them to conduct door-to-door blood pressure screenings. The youths received incentives for various phases of their training and the screenings. The two other screenings were conducted in a worksite and a public "community" setting. It was evident that incentives played a major role in recruiting adolescents to volunteer as screeners. The final results, however, revealed that this contact did not result in an increase in the number of persons screened as had been predicted. This was due in part to the reluctance of residents to admit teenagers into their homes and related problems.

Adolescent↗

PubMedDate not supplied

Cross-sectional relationship between diet and physical activity in two southeastern New England communities.

The hypothesis that health promotive diets associated with higher levels of habitual physical activity confound the relationship between regular physical activity and health has not been well explored in epidemiologic studies. We evaluated self-reported physical activity, Willett Food Frequency dietary data, sociodemographic and physiologic factors cross-sectionally for 2,004 household survey participants in two southeastern New England communities. We compared the dietary habits of sedentary participants (n = 964) to those of moderately active (n = 600) and very active (n = 440) participants after adjusting for age, gender, education, smoking status, year of survey, and total calories. Our results showed that moderately active and very active participants consumed more fiber, less total fat, and less saturated fat than sedentary participants (P < .01). They also consumed more vitamins (A, C, D, E), beta carotene, and calcium, (P < .01), and ate more fruits and vegetables (P < .001) than sedentary participants. We found these relationships in both New England communities studied. This association between regular physical activity and diet suggests that the relationship of habitual physical activity and chronic disease may be confounded by diet.

Adult↗

PubMedDate not supplied

Effects of intervention on compliance to referral and lifestyle recommendations given at cholesterol screening programs.

To enhance compliance to physician referral as well as dietary and other lifestyle recommendations given at blood cholesterol (BC) screening programs, we randomized Pawtucket Heart Health Program SCORE (screening, counseling, referral event) participants with elevated BC levels into one of four groups: usual care group; a participant intervention group (mailed reminder letter and refrigerator magnet); a physician intervention group (mailed packet to participant's physician including letter, National Cholesterol Education Program [NCEP] guidelines, and preaddressed postcard to mail to patient); and a group that received both interventions. Beginning four months after the screening, we surveyed study subjects by phone. The participant intervention increased recall of physician referral and dietary recommendations; however, neither intervention successfully improved compliance to referral or dietary and lifestyle recommendations. Overall, 58%, 67% and 34% of subjects reported complying to physician referral, dietary recommendations, and lifestyle recommendations, respectively. Referral compliance was associated with a longer time interval between screening and survey (relative risk [RR] = 1.3, 95% confidence interval [CI[ = 1.0, 1.7), possession of medical insurance that covered physician visits (RR = 2.1, 95% CI = 0.98, 4.4), and history of hypertension (RR = 2.6, 95% CI = 1.1, 5.8). Dietary compliance was positively associated with baseline BC levels > or = 240 mg/dL (RR = 3.3, 95% CI = 1.4, 7.3) and negatively associated with increasing age; each one year increase in age corresponded to a 3% decrease in compliance (RR = 0.97, 95% CI = 0.9. 1.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗

PubMedDate not supplied

Characteristics of smokers who attempt to quit and of those who recently succeeded.

Although a high percentage of smokers attempt to quit each year, success rates are low. Thus, public health strategies must not only convince some smokers to attempt cessation, but also improve the success rate among other smokers already motivated to quit. Specific cessation strategies may be required for smokers in these two groups. This study compares sociodemographic and health behavior characteristics of smokers who have and have not attempted to quit and of those who recently succeeded. To determine whether these characteristics vary for men and women, we stratified analyses on gender. Data were obtained from random sample health surveys conducted 1981-1982 and 1983-1984 in two New England communities. Analyses include data on 2,086 respondents who reported smoking cigarettes in the previous year. Men and women were equally likely both to attempt cessation and to quit. Except for an inverse association with age, attempting to quit was not associated with sociodemographic variables. In men and women, attempts were associated with encouraging others to quit and attempting to increase exercise. Successful cessation attempts were associated with not living with a smoker in women; marital status, attempted weight loss, and increased age in men; and with efforts to increase exercise in both men and women. These characteristics could be useful in targeting smokers who attempt to quit, but fail. Improving the success rate in this group could greatly reduce smoking prevalence in the community.

Adult↗

PubMedDate not supplied

Education and risk factors for coronary heart disease: results from a New England community.

This article investigates the association of education with the estimated coronary heart disease (CHD) risk and the prevalence of CHD risk factors for men and women in a New England community over a period of 10 years. Educational differentials in knowledge of cardiovascular disease prevention, body mass index (BMI), total and high-density lipoprotein (HDL) cholesterol, cigarette smoking, and hypertension were examined for 3,765 respondents 25-64 years of age from five surveys of the Pawtucket Heart Health Program. We found a clear negative association between education and composite CHD risk. A stable separation in risk level was maintained across time between the least educated (< 12 years of education) and the other two educational groups (12, > or = 13 years of education) in both men and women. Educational differentials were observed in BMI and total and HDL cholesterol of the women 25-44 years of age. For men and women 25-44 years of age, smoking was negatively associated with education. Hypertension differed by education level among the women 45-64 years of age. These findings are highly comparable with the national data from aggregate vital statistics and the results of the National Health and Nutrition Examination Survey (NHANES) cohort follow-up.

Adult↗

PubMedDate not supplied

Changing physicians' attitudes, knowledge, and self-efficacy regarding cholesterol screening and management.

The National Cholesterol Education Program (NCEP) has identified a need to convey practical approaches for the management of high blood cholesterol (BC) to physicians. Our study was a joint effort between the Pawtucket Heart Health Program and the Brown University Department of Family Medicine to improve family medicine residents' attitudes, knowledge, self-efficacy, and practices regarding cholesterol screening and management. Thirty-six resident physicians received a BC screening and management training program. This program included training in BC screening using the fingerstick method and a desktop analyzer, diet assessment and counseling, and a management protocol for evaluation and treatment of high BC based on NCEP guidelines. The training program also included evaluation of residents' BC screening activity, incentives, chart audits, and biweekly articles in the departmental newsletter. We administered a survey to residents before and one year after the training program began to assess self-reported knowledge, attitudes, self-efficacy, and practices for BC management. Survey results indicated that the residents significantly improved their reported knowledge and attitudes about BC management. In addition, they significantly increased their reported self-efficacy and practices in dietary counseling and patient education. Residents also indicated that the training program was worthwhile, necessary, and practical and that many would use the materials and protocols in their future practices.

Cholesterol↗