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PubMed2004

Motivating parents to prevent caries in their young children: one-year findings.

BACKGROUND: The authors conducted a study to compare the effect of a motivational interviewing counseling treatment with that of traditional health education on parents of young children at high risk of developing dental caries. OVERVIEW: The authors enrolled in the study parents of 240 infants aged 6 to 18 months and randomly assigned them to either a motivational interviewing, or MI, group or a traditional health education (control) group. Parents in the control group received a pamphlet and watched a video. Parents in the MI group also received the pamphlet and watched the video; in addition, they received a personalized MI counseling session and six follow-up telephone calls. RESULTS: After one year, children in the MI group had .71 new carious lesions (standard deviation, or SD, = 2.8), while those in the control group had 1.91 (SD = 4.8) new carious lesions (t[238] = 2.37, one-tailed, P < .01). CONCLUSIONS: MI is a promising approach that should receive further attention. CLINICAL IMPLICATIONS: MI may lead parents and others to better accept dental recommendations about preventing caries in their children.

Asia, Southeastern↗
PubMed1998

A community-based randomized trial encouraging sun protection for children.

OBJECTIVE: We evaluated the impact of an intervention promoting sun protection behavior among children 2 to 11 years of age through schools and day care centers, primary care practices, and recreation areas. METHODS: Ten towns in New Hampshire were paired, then assigned randomly to intervention or control status. The multicomponent SunSafe intervention was provided to children and caregivers through primary care practices, day care centers, schools, and beach recreation areas. Training support and materials were provided by the SunSafe project, but project staff had no direct contact with children or parents in providing the intervention. All intervention components promoted the same message: avoid the sun between 11 AM and 3 PM, cover up using hats and protective clothing, use sun block with a sun protection factor >/=15, and encourage sun protection among family and friends. The impact of the intervention was determined by observing children's sun protection behavior at the beach during baseline compared with 1 year later. The primary outcomes of interest were changes in the proportion of children per town using at least some sun protection and changes in the proportion of children fully protected. Children were clustered by town, with the town thus being the unit of analysis. The primary care practice component included one practice meeting for clinicians and staff at which project staff presented background on skin cancer and how to promote its prevention; a sun protection office system manual based on our previous work, which provided specific direction on how to share responsibility among office staff and clinicians in carrying out routines that promote sun protection; and educational posters, pamphlets, and self-adhesive reminder notes designed to enhance sun protection counseling. SunSafe removable tattoos and stickers were offered to children at well-child and illness visits during the summer months. Schools each received three project staff visits: a brief visit with the principal to describe the intervention and to answer questions; an in-service program to educate teachers about skin cancer and to introduce curricular materials; and help with one parent outreach program. Larger day care centers each received one project staff visit. An additional six smaller day care centers received curricular materials through the mail but no visits. Two similar sets of curricular materials were used, one for grade schools and the other for preschools and day care centers. Both emphasized the importance of sun protection rather than the danger of skin cancer. Materials emphasized dynamic activities modeled after the "Slip, Slop, Slap" and "SunSmart" programs and included new material developed to suit regional needs. Both manuals offered structured plans but also provided a variety of activities from which teachers could choose. Teachers agreed to devote a minimum of two class periods to these materials. For recreation areas, lifeguards in each of the intervention communities attended an in-service meeting, during which background about skin cancer prevention was presented by project staff. The project also provided displays about the ultraviolet (UV) light index and about sun protection to be posted at each beach. Subsequently, project staff called beach staff in each community each morning with the predicted UV index for the day to post on the display. Educational pamphlets about the UV index and free sun-block samples were available to beachgoers through the lifeguards. One brief follow-up visit by project staff was made to each beach area to provide reinforcement. RESULTS: We observed 1930 children. Use of some sunscreen on at least one body area increased in all 5 intervention towns compared with paired control towns. In intervention towns, this mean proportion increased from 0.56 of those observed at baseline to 0.76 of those observed postintervention, with a minimal increase among control town children. (ABSTRACT TRUNCATED

Child↗
PubMed2000

Firearm safety counseling in primary care pediatrics: a randomized, controlled trial.

CONTEXT: Physicians have been encouraged to counsel families about risks associated with gun ownership, but the effectiveness of physician counseling regarding gun safety is unknown. OBJECTIVE: To determine the effectiveness of gun safety counseling during well-child care visits. DESIGN: Group randomized, controlled trial. Physicians, nurse practitioners, and physician assistants were randomized to either the intervention group or a control group. SETTING: Group Health Cooperative, a staff-model health maintenance organization. Patients. Consecutive sample of families (n = 1295) seen for a scheduled appointment for well-child care for a child <18 years of age. Of the families originally scheduled for a visit, 80. 3% were seen and completed the outcomes surveys. INTERVENTION: Each family in the intervention group was given a 60-second message by their practitioner that depended on the presence of guns in the home. Families without guns were informed of the health risks associated with gun ownership and given a standard information pamphlet. Families with guns were given the same information about risks and were told that if they chose to keep a gun, they should store it locked and unloaded. They were given instructions on storage and a folder with material, including the same pamphlet, a letter from the police department, written storage guidelines, and discount coupons for gun storage devices. MAIN OUTCOME MEASURE: Changes in the following self-reported events: 1) acquisition of a safe storage device; 2) removal of firearms from the home; and 3) acquisition of firearms. Results. There were no important differences between intervention and control groups in the rate of acquisition of new guns (intervention: 1.3% vs control:.9%) after the intervention. Among households with guns at baseline, there were also no differences between groups in the removal of guns (intervention: 6.7% vs control: 5.7%), but there was a fairly large nonsignificant difference in the proportion who purchased trigger locks (intervention: 8.0% vs control: 2.5%). CONCLUSIONS: A single firearm safety-counseling session during well-child care, combined with economic incentives to purchase safe storage devices, did not lead to changes in household gun ownership and did not lead to statistically significant overall changes in storage patterns.

Adolescent↗
PubMed1996

Kenya cardinal burns condoms.

Kenya's top Roman Catholic church official burned condoms and safe sex literature in a ceremony organized by a group opposed to contraception and sex education. About 250 people watched as Cardinal Maurice Otunga and two gynecologists prayed and sang before setting fire to several boxes of condoms and 100 copies of pamphlets promoting safe sex. The pamphlets encouraged condom use to fight the spread of HIV. The World Health Organization has estimated that 1 million of Kenya's 26 million people are infected with HIV or AIDS.

Africa↗
PubMed2002

Breast health educational interventions. Changes in beliefs and practices of working women.

Health education programs supported by women's groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the women's decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.

Adult↗
PubMedDate not supplied

Are chiropractors interested in participating in immunization awareness and promotion activities?

BACKGROUND: Chiropractors have expressed both pro- and anti-vaccination opinions. PURPOSE: We explored the interest of Alberta chiropractors in participating in immunization awareness and promoting activities. METHODS: Data were collected in a cross-sectional postal survey (response rate: 78.2%, 503 respondents) in 2002. Participants indicated their interests in a close-ended checklist of seven immunization awareness/promoting activities on 5-point scales. Analyses included frequencies and cross tabulations with demographic characteristics of respondents. RESULTS: More than 60% expressed at least some interest in participating in one or more activities. The three most popular activities were: call Public Health/doctor/nurses for information to answer questions on immunization (40%); refer parents to Public Health/doctors for information on immunization (39%); and display/give out pamphlets provided by Public Health on vaccines/immunization in office (29%). CONCLUSION: Public health practitioners might consider providing chiropractors with contact information for questions on immunization as well as pamphlets on vaccines and immunization for office display.

Alberta↗
PubMedDate not supplied

A pilot study on inducement of smoking cessation by a simple 5A (asking, advice, assess, assist, and arrange) approach at outpatient clinics.

Asking smokers about their smoking status, followed by advice to quit smoking, assessing the intention to quit, assistance with cessation, and arrange of follow-up (5A) is recommended for induction of smoking cessation. To obtain preliminary data on effects of "5A" , we investigated the smoking cessation rate with two modes in the phase I: 1) self-administered questionnaire and 2) doctor's interview at respiratory disease clinics of three general hospitals in Japan, and another mode in phase II: 3) doctor's interview with an additional pamphlet at one of the three hospitals. The interviews for smokers were conducted by doctors in charge of treatment. Subject smoking habits were followed up by postal surveys three months after the enrollment. In phase I, 359 outpatients were recruited and 189 smokers responded, among whom 27 patients (7.5% of 359 outpatients) had quit smoking at the three months after the enrollment. The cessation rate of the self-administered questionnaire group (8.4% of 238 smokers) did not differ significantly from that of doctors' interview group (5.8% of 121 smokers). Age and intention to quit at enrollment were found to be independent predictors of smoking cessation. Patients aged 50 years or older (odds ratio=5.05, 95% confidence interval 1.89-13.54), and participants with an intention to quit (odds ratio=6.78, 95% confidence interval 2.66-17.30) were more likely to be successful in quitting. In phase II, another 212 smokers of one hospital were interviewed by doctors in charge and provided with an additional pamphlet describing how to practice to dislike smoking. No significant difference in the cessation rate was observed between phase I and phase II (5.8% vs. 8.0%). In conclusion, there were no differences among the three modes of "5A", but 7.7% of the 571 outpatients visiting respiratory divisions quit smoking with this simple "5A". The findings may indicate that this simple practice at clinics is useful for smoking cessation strategy, although randomized trials are now required.

Adult↗
PubMed2006

[Contribution of medical technologists in team medical care of diabetics].

For the effective treatment of diabetic mellitus (DM), patients are encouraged to self-manage their disease according to the doctor's instructions and advice from certified diabetes educators (CDE) and other comedical staff. Therefore, the cooperation of medical staff consisting of a doctor, CDE, nurse, pharmacist, dietitian, and medical technologist is important for DM education. Medical technologists licensed for CDE (MT-CDE) have been participating in the DM education team in Kobe University Hospital since 2000. MT-CDE are in charge of classes for medical tests, guidance for self-monitoring of blood glucose and teaching how to read the fluctuation graph of the blood glucose level in the education program for hospitalized DM patients. MT-CDEs teach at the bedside how to read the results of medical tests during the first few days of hospitalization using pamphlets for medical tests. The pamphlets are made comprehensible for patients by using graphics and photographs as much as possible. It is important to create a friendly atmosphere and answer frank questions from patients, since they often feel stress when having medical tests at the early stage of hospitalization. This process of questions and answers promotes their understanding of medical tests, and seems to reduce their anxiety about having tests. We repeatedly evaluate their level of understanding during hospitalization. By showing them the fluctuation graph of the glucose level, patients can easily understand the status of their DM. When prescriptions are written on the graph, their therapeutic effects are more comprehensible for the patients. The items written on the graph are chosen to meet the level of understanding of each patient to promote their motivation. In summary, the introduction of MT-CDE has been successful in the education program for DM patients in our hospital. We plan to utilize the skills and knowledge of MT-CDE more in our program so that our DM education program will help patients cope with life with DM.

Blood Glucose Self-Monitoring↗
PubMed1991

[Use and misuse of an outpatient casualty department].

During periods of five weeks before and five weeks after distribution of a pamphlet entitled "Before you go to your doctor or to the casualty department" which was distributed to all households, the patterns of attendance at a casualty department were investigated with subdivision into degrees of indication for attendance. A significant decrease in the number of attendances was observed after distribution of the pamphlet. Patients with lesser indications remained away. It was estimated that at least 56% of the cases could have been treated in the primary sector. 37% of the attendances outside normal working hours were considered as being postponable until daytime.

Adolescent↗
PubMed1987

Registry of unrelated bone marrow donors.

Reports of successful transplantation of bone marrow obtained from unrelated donors who were histocompatibility leukocyte antigen (HLA) identical prompted the Canadian Red Cross Blood Transfusion Service in Ottawa to assess the possibility of developing a bone marrow donor registry in Canada. We sent a pamphlet that explained the program to 1568 people who had undergone apheresis and asked them to reply, stating their interest. At the same time the pamphlets and a poster were placed in the blood donor clinic. We received 1232 replies (78.6%) from the apheresis donors, 838 (68.0%) of which indicated a willingness to attend information sessions. Of the 7158 people who gave blood during the 3-month study period, 225 (3.1%) were interested. At the time this paper was written 47 information sessions had been held, and 721 people had attended, 624 (86.5%) of whom had signed a consent form. This indicates a clear interest in a bone marrow donation program. We believe that the ethical issues are overcome by requesting the donation before identification of any patient. From our experience a national registry of unrelated donors seems feasible, and steps are being taken to implement such a program.

Blood Component Removal↗
PubMed1987

AIDS prevention and control in Japan.

Surveillance for the acquired immunodeficiency syndrome (AIDS) in Japan started in September 1984 and in February 1987 was extended to seropositive carriers of human immunodeficiency virus (HIV) antibodies. A total of 2,000 hospitals and clinics throughout the country have actively participated in the surveillance. An educational program for health care workers, including physicians, was initiated in July 1985 by issuing a series of government memoranda and distributing pamphlets and posters. Counseling programs for people concerned about AIDS and laboratory support to provide screening services have been developed. Laboratories that can also perform confirmatory tests will be established shortly. The screening of all donated blood was established in November 1986. Education programs for the public have been conducted mainly through the production and distribution of various materials and pamphlets. Research has been focused primarily on diagnosis and treatment, with international cooperation emphasized. A new act of legislation has been proposed in the Parliament that will require mandatory reporting of cases of AIDS and HIV infection with confidentiality preserved. Further debate may be needed to reach national consensus on this issue. The proposed law will not include provisions that would affect international travelers, foreign students or immigrants.

Acquired Immunodeficiency Syndrome↗
PubMed1987

CHID: a unique health information and education database.

The public's growing interest in health information and the health professions' increasing need to locate health education materials can be answered in part by the new Combined Health Information Database (CHID). This unique database focuses on materials and programs in professional and patient education, general health education, and community risk reduction. Accessible through BRS, CHID suggests sources for procuring brochures, pamphlets, articles, and films on community services, programs at HMOs and hospitals, aspects of coping, and more. CHID is a joint project of six federally funded agencies in the Public Health Service. CHID provides citations with abstracts to major health journals, books, reports, pamphlets, hard-to-find information resources, and to health education programs under way in state and local health departments and other locations.

Bone Diseases↗
PubMed1984

Effecting change in outpatient failed appointments.

The problem of failed appointments was addressed in a family practice clinic. This study borrows an approach toward increasing clinic attendance that has had consistent and positive results in mental health settings: pretherapy induction. The previsit induction was intended to prepare the patient for entry into a medical system, altering erroneous and unrealistic expectations of the patient, which, if left unaddressed, can lead to patient frustration and subsequent noncompliance. Four hundred sixty patients were each randomly assigned to one of three groups. One group viewed a 20-minute videotape introducing the clinic, its staff, and services, and how to utilize the staff during and outside office hours. A second experimental group received the same information in pamphlet form. The control group received no information about clinic function except that which was requested by the patient. Eleven months after onset of the study all patient charts were reviewed. Compared with both the no-treatment control group and the pamphlet experimental group, significantly fewer new patients viewing the induction videotape missed subsequent scheduled appointments (P less than .025). This same group had a significantly lower number of missed appointments during the study period (P less than .05).

Appointments and Schedules↗
PubMedDate not supplied

Enhancing the effectiveness of media messages promoting regular breast self-examination: messages based on innovation adoption principles.

As public health departments have come to rely more and more on the mass media for the promotion of healthful behavior, it has become increasingly desirable to determine the motivating capability of the messages used in this promotion. A fact that is well understood is that many times any message at all is better than none. However, the effectiveness of various media health messages has not been well researched.A study was therefore undertaken of the comparative effectiveness of two different messages describing how to do a breast self-examination. An "experimental message" for the study was designed by applying the principles that facilitate innovation adoption to the message's format and presentation. This message's impact was then compared with that of the American Cancer Society's pamphlet "How To Examine Your Breasts." This pamphlet had been mailed to a sample of women similar to those receiving the experimental message, but who lived in a different geographic area. The use in each area of control groups who had received no messages afforded an opportunity to study maturation effects (other factors than the mailings that might have influenced study results).The experimental message proved more successful in persuading women to adopt breast self-examination than the comparison message. The women who reported a change in breast self-examination practice following the mailing could be characterized as having a more extensive social support system to promote breast examinations and as having a pre-experiment perception that breast self-examination was a complex practice to perform repeatedly at regular intervals.

Breast Neoplasms↗
PubMed1995

An audit of the sudden infant death syndrome prevention programme in the Auckland region.

AIM: An audit of the sudden infant death syndrome (SIDS) prevention programme in the Auckland region. METHODS: 107 health professionals working in antenatal classes, postnatal wards, domiciliary midwifery and the Plunket Society were interviewed. RESULTS: Maternal smoking and infant sleeping position were considered to be the most important risk factors for SIDS; lack of breast feeding and cosleeping were rated less important. Many other putative risk factors were also mentioned. There was no difference in the evaluation of the relative importance of risk factors for SIDS by health professionals working in south Auckland, where SIDS mortality has declined only slightly, compared with the evaluation by health professionals in the rest of Auckland, where SIDS mortality has declined considerably. The most important source of information for health professionals was the pamphlet "Cot death: you can reduce the risks", which is designed for parents. CONCLUSION: Differences in the SIDS prevention message by health professionals do not explain differences in SIDS mortality within Auckland. Health professionals were knowledgeable about risk factors for SIDS, but knowledge could be improved further by regular updates. New resource material including posters and pamphlets for families is also required.

Attitude of Health Personnel↗
PubMed1994

Understanding asthma: patient survey.

Eight hundred and two adult patients attending five randomly selected polyclinics in Singapore were interviewed to assess their understanding of asthma. Knowledge of asthma mechanism and its medications was poor with a mean score of 1.4 (median: 1) out of a total score of 6. About a third knew that asthma is due to narrowing of airways and a quarter knew the action of bronchodilators. Only 4.4% (27) knew that steroids decrease airway swelling or inflammation. The best knowledge score was associated with subjects who had the highest education, who had a family history and who had been exposed to pamphlets and books. Incorrect use of prophylaxis was also evident with only one-third (37%) using steroid inhalers regularly as prescribed. Only half (54.5%) of those with no schooling used the correct inhaler technique. Doctors were a source of information for only 49.9% (400) of the patients and it was those with the highest education who were most likely to get information from the doctors. Pamphlets were a source of information for less than one-fifth (16.2%) of the subjects. Greater emphasis should be given to patient education by doctors to help patients understand asthma and its treatment. Important target groups are the older, lesser educated and the moderate or severe patients on steroid inhalers.

Adult↗
PubMed1993

Evaluation and retraining programs for older drivers.

Although many individuals who have had strokes or other physical problems assume that they can no longer drive, they are often unaware of retraining programs. In addition to formal courses supported by sponsoring agencies, such as the AAA, there are also programs run by occupational therapists. This article addresses issues relevant to the role of occupational therapists in evaluation and retraining of older drivers and describes several cases as examples. To better inform the public about driver retraining programs for the elderly and the disabled population, the American Occupational Therapy Association has published a pamphlet entitled Able Driving Is Safe Driving that provides information on how driving skills may be affected by age or illness. This publication also will provide examples of adaptive driving equipment usage and driver training. AOTA hopes this pamphlet will inform older adults of their options in maintaining independent community mobility. Research is needed to find out if older adults have relinquished driving because of a physical disability that may have been treatable with rehabilitation. Also, there needs to be a comparison study of classroom driving instruction to actual skill performance so that older adults and insurance companies are investing in programs that will demonstrate the outcome of improved driving performance.

Aged↗
PubMed1995

Backfire: AHCPR practice guideline for acute low back pain.

The AHCPR "Guideline for Acute Low Back Problems in Adults" is a must-read for every South Carolina physician treating low back pain. The 25-page pamphlet excels as a practical guide for swiftly triaging acute low back problems into the 90 percent majority who recover within a month, from the few "red flag" and "red herring" serious back problems requiring urgent attention. But the Guideline panel overstepped its policymaking mandate by venturing into the quicksand of treatment by committee edict, rather than by on-the-spot caretakers. The rumbling backfire is that U. S. Government document, intended as practice guideline for routine acute back care, will come to haunt us as a practice standard for all back care. One-size-fits-all proposals for the majority short-change the few with more demanding healthcare resource requirements. Be sure to read the pamphlet; your patients, insurers, providers, administrators, journalists and attorneys will!

Humans↗