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PubMedDate not supplied

Evaluation of an 8-week mailed healthy-weight intervention.

BACKGROUND: This study investigated the impact of a low-intensity, healthy-weight intervention among adult volunteers in a low-income, inner-city neighborhood. The intervention, which comprised 18 pamphlets mailed to participants' homes over 8 weeks, focused on increasing awareness of healthy weight ranges, increasing self-acceptance and satisfaction with weight, and improving eating habits, while downplaying dieting and weight loss. METHODS: Subjects were recruited from households randomly selected from residential telephone subscriber lists. The 188 volunteers (23.0% of 816 persons contacted) were randomly assigned to intervention or control status. Psychosocial and behavioral measures were administered by telephone 1 week before and 2 weeks after the intervention. RESULTS: After exposure to the pamphlets, intervention subjects were more likely than controls to know how to control their weight. They were more satisfied with their weight and less likely to report they were too heavy. They reported less high-fat/junk food consumption, more improvements in their eating habits, and more frequent exercise. CONCLUSION: This inexpensive, low-intensity intervention was effective in supporting change processes among volunteers who wanted to learn about weight control, to improve eating habits, and to improve health.

Adult↗
PubMed1994

Readability of HIV/AIDS educational materials: the role of the medium of communication, target audience, and producer characteristics.

The reading difficulty of many HIV/AIDS brochures and pamphlets limits their effectiveness. This analysis addresses correlates of readability in 136 HIV/AIDS educational items. Readability is measured using the SMOG Index. The medium of communication is significantly related to readability: comic books and brochures are, on average, more readable than books and pamphlets (10.9 versus 11.9). The target audience also differentiates readability. Materials for HIV antibody test seekers, the general community, and sexually active adults have a more difficult reading grade, averaging 12.1, whereas materials for ethnic minorities average a more readable 9.2. The producer organization's type and location are unrelated to readability, but an AIDS-specific organizational focus correlates with better readability (grade 10.8 vs. 11.8). These findings remain significant in multivariate analysis. The results indicate that brochures and comics are more likely to be comprehended by low-literacy populations, that an understanding of the literacy of target audiences is needed to produce materials with appropriate reading levels, and that policies to influence producer organizations may result in the creation of more readable materials.

Adolescent↗
PubMed2004

Increasing mammography screening among women over age 50 with a videotape intervention.

BACKGROUND: A randomized trial was conducted to test the effectiveness of a videotape for increasing mammography screening among a multiethnic sample of older women. METHODS: A multiethnic sample of Caucasian, African-American, and Hispanic women between the ages of 50 and 70 was recruited from Resident Lists compiled by the State of Massachusetts. After completing a baseline questionnaire, women were randomized to receive either a videotape or pamphlet about mammography and recontacted at 2 and 12 months after baseline to assess attitudes, beliefs, and mammography screening. A total of 581 women completed questionnaires at all three time points. RESULTS: At baseline, approximately 75% of women reported having a mammogram in the past year and 90% reported having one in the past 2 years. Rates did not differ between groups. At the 12-month follow-up, mammography rates, adjusted for baseline screening, were 80.4% in the video and 74.8% in the pamphlet group. Logistic regression analysis of mammography at 12 months (within past year vs. >1 year ago) controlling for baseline mammogram produced an odds ratio of 1.48 for the video group that was not significantly different from unity (95% CI = 0.95-2.28). CONCLUSIONS: The videotape had a small effect on increasing mammography screening. Although the effect was smaller than more intensive interventions, the video is a convenient, low cost, and easily implemented method to increase mammography screening.

Black or African American↗
PubMed1994

The use of ephemera with particular reference to blood and organ donation: a review of sources.

Emphasis has been placed upon a study of the use made of ephemera such as leaflets, pamphlets and booklets by non-professional staff working in British statutory organizations such as health authorities, community health councils and family health services authorities as well as voluntary organizations such as charities, citizens' advice bureaux and patient participation groups. Publicity methods and the use made of ephemeral materials by those statutory and voluntary organizations involved in recruiting and retaining blood and organ donors is highlighted. Research findings confirm that patients, carers and others, wish to receive comprehendable and appropriate health information. Ephemera provided in support of this need are not comprehensive in subject coverage and lack any standardization of format. In particular, great care needs to be taken with the design of leaflets, pamphlets and booklets. Ephemeral materials are difficult to locate and obtain, and no bibliographical centre exists to coordinate and support existing activity by identifying, acquiring, storing, advertising and distributing such health care material. Marketing and publicity skills, and much time and effort are required to rectify this deficiency, and thus to satisfy the needs of consumers.

Blood Donors↗
PubMed2003

Assessing the readability of skin care and pressure ulcer patient education materials.

OBJECTIVE: The purpose of this study was to evaluate the readability of written patient education materials used to teach patients about the prevention and care of skin and pressure ulcers. Other design characteristics of the materials including organization, writing style, appearance, and appeal also were assessed. DESIGN: This study used a nonexperimental, descriptive design. Setting and Stimulus Materials: Ten pamphlets and brochures commonly used in urban hospitals, home care agencies, and public clinics in the Midwest were evaluated. INSTRUMENTS: The study used 2 instruments: The Area Health Education Center (AHEC) checklist and the Simple Measure of Gobbledygook (SMOG) readability formula. METHODS: The investigator used the SMOG readability formula to analyze patient education materials. The AHEC checklist was used to evaluate the design characteristics of the materials, including organization, writing style, appeal, and appearance. RESULTS: The overall readability level of the written materials was 10th grade. At least half of the materials were written at 8th-grade level or below, which is considered acceptable for the general public. Some pamphlets used words such as "seborrheic keratosis" or "actinic keratosis," making the materials difficult to read. An incidental finding was that none of the materials addressed skin care or pressure ulcer experiences of different cultural groups. CONCLUSION: None of the materials was determined to be appropriate teaching tools for low-literacy patients, as measured by the AHEC checklist. Although half the materials were written at the 8th-grade level and below, that level may be too high for many patients.

Educational Status↗
PubMed1990

Readability of the public education literature on cancer prevention and detection.

This paper presents an analysis of the readability level of the educational literature on cancer prevention and early detection. Cancer education brochures and pamphlets were obtained from the American Cancer Society, the National Cancer Institute, private companies, public nonprofit agencies, and state health departments. A total of 183 brochures and pamphlets were examined and reading level (SMOG) scores were computed for 159 of them. The average reading level of the printed cancer education materials was found to be between 10th and 11th grade, with little overall variation by publishing agency, topic, cancer site, focus, or target population. In general, the results suggest that much of the cancer education literature may be of limited value in providing information to the low-income, low-education population.

Female↗
PubMed1999

Relationships among educational material readability, client literacy, perceived beneficence, and perceived quality.

Illiteracy remains a pervasive problem that compromises quality health care, limits understanding of health information, and potentially leads to poor health outcomes. This study demonstrated that participants' measured reading level was significantly lower than both their stated years of education and readability of an educational pamphlet. A positive relationship was identified between measured reading level and pamphlet helpfulness (client-perceived beneficence). Participants perceived care quality as good to very good. Quality client education requires use of either educational materials appropriate for the measured reading level of clients or alternatives to written material.

Adult↗
PubMedDate not supplied

Computerized training in breast self-examination: a test in a community health center.

Fifty-eight women recruited from a community health center completed either a brief interactive multimedia training program on breast self-examination using a breast model and computer guided feedback on accuracy of lump detection or read a National Cancer Institute pamphlet on breast self-examination and breast lumps. Women using the computer program as compared to the pamphlet group reported a higher sense of self-efficacy for being able to perform a breast self-examination immediately after their educational session and 1 month later. However, the increase in self-efficacy for the computer group diminished over 4 weeks, underscoring the importance of an environment that reminds and reinforces learning for women about the performance of regular breast self-examination. The increase in sense of self-efficacy to perform breast self-examination with roughly 20 minutes of computer-based training and the partial maintenance of that self-efficacy 30 days later suggests the utility of incorporating short, focused interventions in busy primary healthcare settings.

Adult↗
PubMed1992

Multiple sclerosis: will it come between us? Sexual concerns of clients and their partners.

Multiple sclerosis (MS), an unpredictable neurologic disease, is sometimes called the crippler of young adults. This crippling effect often involves sexual functioning. Sexuality is an issue that is frequently difficult for clients, their partners and health care providers to discuss. To address this difficulty, a teaching pamphlet entitled, MS ... Will it Come Between Us? was produced. Open communication and creativity are helpful in dealing with problems frequently encountered by clients with MS: fatigue, impotence, decreased vaginal lubrication, bladder and bowel dysfunction. The pamphlet helps clients with these issues as well as the basics of sexuality as a whole.

Adaptation, Psychological↗
PubMedDate not supplied

A randomized controlled trial of a decision aid for women at increased risk of ovarian cancer.

PURPOSE: To carry out a randomized controlled trial of a decision aid for women at increased risk of developing ovarian cancer to facilitate decision making regarding risk management options. METHODS: This randomized trial, conducted through 6 familial cancer centers, compared the efficacy of tailored decision aid to that of a general educational pamphlet in preparing women for decision making. PARTICIPANTS: 131 women with a family history of breast and/or ovarian cancer or of hereditary nonpolyposis colorectal cancer. OUTCOME MEASURES: Decisional conflict, knowledge about ovarian cancer risk management options, and psychological adjustment were reassessed at 3 time points. RESULTS: Compared to those who received the pamphlet (control), women who received the decision aid (intervention) were significantly more likely to report a high degree of acceptability of the educational material at both follow-up assessment time points. Findings indicate neither group experienced significant increases in psychological distress at either follow-up assessment time points relative to baseline. Two weeks postintervention, the intervention group demonstrated a significant decrease in decisional conflict compared to the control group (t = 2.4, P < 0.025) and a trend for a greater increase in knowledge about risk management options (t = 2.1, P = 0.037). No significant differences were found 6 months postintervention. CONCLUSION: This form of educational material is successful in increasing knowledge about risk management options and in reducing decisional conflict in the shorter term. The decision aid is an effective and acceptable strategy for patient education to facilitate an inclusive and informed decision-making process about managing ovarian cancer risk.

Anxiety↗
PubMed2004

Effectiveness of nurse counselling in discouraging the use of the infant walkers.

Infant walkers are widely used by caregivers in Singapore despite being recognized as a household hazard. The study determined the effectiveness of nurse counselling in dissuading caregivers from using the walker. Caregivers of children 4 months of age were recruited and divided into the intervention group (nurse's advice and illustrated pamphlets), a conventional group (questionnaire alone) and a control group (without any intervention in separate polyclinic). The percentage of the caregivers, who used the walkers in each group when their child was 9 months old, was taken as a surrogate indicator of effectiveness of nurse's intervention. The study analyzed 708 caregivers. Fewer caregivers (62.7% intervention vs. 80.4% questionnaire alone vs. 83.0% control) used the walker after nurse's advice with illustrated pamphlets. 8% of the users reported walker-related injuries (n=43). Nurses' counselling could be a simple yet effective method to discourage the use of walkers.

Accident Prevention↗
PubMed2006

Evaluation of a decision aid for prenatal testing of fetal abnormalities: a cluster randomised trial [ISRCTN22532458].

BACKGROUND: By providing information on the relative merits and potential harms of the options available and a framework to clarify preferences, decision aids can improve knowledge and realistic expectations and decrease decisional conflict in individuals facing decisions between alternative forms of action. Decision-making about prenatal testing for fetal abnormalities is often confusing and difficult for women and the effectiveness of decision aids in this field has not been established. This study aims to test whether a decision aid for prenatal testing of fetal abnormalities, when compared to a pamphlet, improves women's informed decision-making and decreases decisional conflict. METHODS/DESIGN: A cluster designed randomised controlled trial is being conducted in Victoria, Australia. Fifty General Practitioners (GPs) have been randomised to one of two arms: providing women with either a decision aid or a pamphlet. The two primary outcomes will be measured by comparing the difference in percentages of women identified as making an informed choice and the difference in mean decisional conflict scores between the two groups. Data will be collected from women using questionnaires at 14 weeks and 24 weeks gestation. The sample size of 159 women in both arms of the trial has been calculated to detect a difference of 18% (50 to 68%) in informed choice between the two groups. The required numbers have been adjusted to accommodate the cluster design, miscarriage and participant lost--to--follow up. Baseline characteristics of women will be summarised for both arms of the trial. Similarly, characteristics of GPs will be compared between arms. Differences in the primary outcomes will be analysed using 'intention-to-treat' principles. Appropriate regression techniques will adjust for the effects of clustering and include covariates to adjust for the stratifying variable and major potential confounding factors. DISCUSSION: The findings from this trial will make a significant contribution to improving women's experience of prenatal testing and will have application to a variety of maternity care settings. The evaluation of a tailored decision aid will also have implications for pregnancy care providers by identifying whether or not such a resource will support their role in providing prenatal testing information.

Cluster Analysis↗
PubMedDate not supplied

Developing and testing lay literature about breast cancer screening for African American women.

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening. The authors chose a food theme for the cover of the pamphlet written at a third-grade level and suggested a photographic version. In the motivational book, two women address barriers to screening and replace myths and fears with facts and actions. Data from 162 women showed that they learned from both the photographic and illustrated versions. Women in the photographic group found significantly more lumps in the silicone models, so the authors chose that version to use in final testing. Finally, nurses pretested a group of patients before they reviewed the materials and post-tested another group after they reviewed them. The group who had reviewed the materials had greater knowledge of and intent to follow the guidelines and received higher scores on BSE techniques.

Adult↗
PubMed2005

Participatory development of a cervical health brochure for Apsáalooke women.

BACKGROUND: One challenge for eliminating health disparities is increasing the cultural sensitivity of educational systems including printed educational materials. These materials can be effective in changing health knowledge, attitudes, and behaviors. Participatory community-based processes are vital in creating culturally sensitive interventions. METHODS: We held community meetings in 4 communities on the Apsáalooke Reservation. We gave women examples of cervical health pamphlets and held modified focus groups to gather information on women's preferences. RESULTS: Women provided detailed feedback and we developed an Apsáalooke-specific educational pamphlet. CONCLUSION: These results support a participatory process for overall project guidance.

Community Participation↗
PubMed2006

Motivating mothers to prevent caries: confirming the beneficial effect of counseling.

BACKGROUND: The purpose of this study was to compare the effect of a motivational interviewing (MI) counseling visit with traditional health education for mothers of young children at high risk of developing dental caries. METHODS: The authors enrolled 240 infants aged 6 to 18 months and their mothers in the study and randomly assigned them to MI or traditional health education (control) groups. Mothers in the control group received a pamphlet and watched a videotape. Those in the MI group received the pamphlet and watched the videotape, as well as received an MI counseling session and six follow-up telephone calls during the first year. There were no interventions in year 2. RESULTS: After two years, children in the MI group exhibited significantly less new caries (decayed or filled surfaces) than those in the control group (that is, a protective effect of MI) (odds ratio = 0.35, 95 percent confidence interval = 0.15 to 0.83). CONCLUSIONS: MI is a promising approach that warrants further attention in a variety of dental contexts. CLINICAL IMPLICATIONS: The results of this study show that MI has a protective effect with regard to the development of early childhood caries. One reason for this clinical effect is greater compliance with recommended fluoride varnish treatment regimens in families who received MI counseling compared with families who received traditional education.

Cariostatic Agents↗
PubMed2003

Effectiveness of an educational intervention in modifying parental attitudes about antibiotic usage in children.

OBJECTIVE: To determine the effectiveness of educational materials in improving the attitudes of parents of young children about the judicious use of antibiotics. METHODS: We conducted a randomized controlled trial by recruiting parents of children who were younger than 24 months and being seen for any reason in primary care pediatric offices. At the time of enrollment, study parents indicated their level of agreement with 16 statements, including 9 statements about antibiotic usage and 7 about injury prevention. After being randomized, parents received either a pamphlet and a videotape promoting the judicious use of antibiotics (intervention group) or brochures about effective injury prevention (control group). Six weeks after enrollment, each group received another copy of the pamphlet or brochures and a follow-up questionnaire with the identical 16 statements. Responses on both questionnaires were transformed to an ordinal scale for analysis. Scores on the follow-up questionnaire for each statement about antibiotic use and injury prevention in the 2 groups were compared using linear regression, after controlling for the score obtained for the statement at enrollment. RESULTS: We enrolled a total of 499 eligible parents in the study; 358 (72%) completed the follow-up questionnaires. At study entry, there were no significant differences between parents in the intervention and control groups regarding attitudes for 15 of the 16 statements assessed. However, 6 weeks after receiving the antibiotic educational materials, parents in the intervention group had significantly different attitude scores for 5 of the 9 statements about the antibiotic use. In each case, the scores reflected attitudes that would promote the judicious use of antibiotics. We found significant attitudinal change for statements about the use of antibiotics for specific conditions in children; there were no differences between the 2 groups for more general or theoretical statements about antibiotic use. CONCLUSIONS: A simple educational effort was successful in modifying parental attitudes about the judicious use of antibiotics. Information about specific childhood conditions may be more effective in changing attitudes than more general information about antibiotic usage.

Anti-Bacterial Agents↗
PubMedDate not supplied

Tinnitus information: a study by questionnaire.

The aim of the present study was to improve the information for patients with tinnitus. The investigation consists of three parts: a pilot study where 24 slightly informed tinnitus patients as well as 17 well-informed tinnitus patients and 9 audiological professionals suggested contents for a tinnitus information pamphlet. The second part consisted of scoring of the 74 most common suggestions by 36 of the original 50 people. The answers were graded according to importance. Three available tinnitus information folders from Sweden, Germany and the USA were also studied and taken into account in preparing recommendations on content and size for a tinnitus information pamphlet. This should probably not exceed 2500 words, and 35 items of information.

Adult↗
PubMed1977

The believability of the media as sources of information on drugs.

Based on an analysis of data gathered by a school drug survey given to junior and senior high school students in a middle-class community in the spring 1974, important differences were found to exist in the believability of various sources of drug information. Overall, comparisons indicate that friend, expert (e.g., doctor, staff member of a drug program), and ex-user drug information sources are perceived to be more credible than pamphlets, newspapers/magazines, radio, and television. Among the media, pamphlets were felt to be most believable. Examination of the believability in the media as sources of drug information by youngsters with varying substance use behavior found that the more students are involved with substances, the less credible they percieve the media to be.

Adolescent↗