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Can iron status be improved in each of the three trimesters? A community-based study.

OBJECTIVE: Intervention with iron supplementation, deworming, and information, education and communication (IEC) to improve the haematological status among each of the three trimesters of pregnant women in a rural community. DESIGN: A community-based study was carried out using a two-group pre-post experimental design in a rural community. SETTING: Two rural blocks in Vellore district were selected for the study. KV Kuppam block with a population of 120,000 and the adjacent Gudiyatham block with a population of 132,000 served as study and control areas for the study. SUBJECTS: Using a multistage sampling, initially 50% of the panchayats, the local village administrative units, were randomly selected and all pregnant women were the subjects. In the pre-intervention survey 458 and 387 pregnant women had haemoglobin tested and the post-intervention survey covered 403 and 425 pregnant women in the study and control areas, respectively. Similarly serum ferritin was tested in a randomly selected sub-sample with 254 and 191 pregnant women before intervention and in 216 and 223 pregnant women after intervention in both study and control areas, respectively. INTERVENTION: Iron supplementation and deworming were provided to all pregnant women in the study area from the fourth month of their pregnancy. An intensive information, education and communication was carried out with facts on anaemia and diet modification to each pregnant woman, using a one-to-one approach in the community, and a group method in the mobile clinics. This was carried out for a period of 18 months. RESULTS: A significant decrease in the prevalence of anaemia was found, from 56.1% to 25.07% (P<0.001), 73. 4% to 49.2% (P<0.001) and 68.8% to 56.8% (P<0.01) among women in the first, second and third trimesters, respectively, in the intervention area. Significant (P<0.001) increases in the mean haemoglobin of 0.85 g/dl (95% CI 10.18-10.84, 11.09-11.63), 0.59 g/dl (95% CI 9.98-10.34, 10.55-10.95) and 0.36 g/dl (95% CI 9.93-10. 33, 10.25-10.73) were also observed in each of the groups. CONCLUSION: A comprehensive community-based intervention with iron supplementation, helminthic treatment and increase in knowledge using IEC through effective strategies can improve the haematological status of pregnant women in each trimester.

Anemia↗

National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved?

OBJECTIVES: The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre-post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali. DESIGN: Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs. SUBJECTS AND SETTING: We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared. RESULTS: In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1-9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12-66-month-old children (95% CI 68.27-85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1-5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25-71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events. CONCLUSIONS: The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.

Anthropometry↗

Progressive resistance exercise for people with multiple sclerosis.

PURPOSE: This study aimed to determine if participation in a progressive resistance exercise (PRE) programme can: (1) increase the ability to generate maximal muscle force, (2) increase muscle endurance, (3) increase functional activity, and (4) improve overall psychological function of people with multiple sclerosis (MS). METHODS: A pre-post single group research design with a 4-week baseline familiarisation phase was used. Nine people (mean age 45.6 years, SD 10.7) with MS attended a gymnasium three times over 4 weeks for familiarization. Participants then completed a twice-weekly 10-week PRE programme, with two sets of 10 - 12 repetitions of each exercise. Outcome measures of muscle strength (1RM for arms and legs), muscle endurance (repetitions at half 1RM), walking speed, the 2-min walk test (2MWT), a timed stairs test, and the impact of MS on physical and psychological function were taken at weeks 2, 4, and 14. RESULTS: Participants attended 94.3% (SD 8.2%) of the training sessions, with no adverse events. After accounting for baseline stability, significant improvements (P < 0.05) were found in arm strength (14.4%), leg endurance (170.9%), fast walking speed (6.1%), and there was a trend for increased distance in the 2MWT (P = 0.06). The perceived impact of MS on physical function was reduced (P = 0.02). CONCLUSIONS: Adults with MS benefited from a PRE programme by improving muscle performance and physical activities, without adverse events. These findings suggest that PRE may be a feasible and useful fitness alternative for people with mild to moderate disability due to MS.

Adult↗

Evaluation of the Be Poison Smart! poison prevention intervention.

BACKGROUND: Most poisonings to young children are preventable if parents/caregivers receive proper education and professional guidance. The Be Poison Smart! (BPS) (http:// www.bepoisonsmart.com) train-the-trainer intervention was designed to reach healthcare, education, and social service providers who impart the BPS message to parents/caregivers of young children. METHODS: Using the "Do You Know How to Be Poison Smart!?" Evaluation Tool, service providers and parents/caregivers were assessed pre- and 6 weeks post-BPS intervention to determine changes in poison prevention knowledge and poison prevention behaviors. The dependent variables were pre-post differences in total poison prevention knowledge score and in total poison prevention behaviors score. Data were analyzed descriptively and using one-way ANCOVA. Effect sizes were also calculated. RESULTS: Post-test response rates were 28.7% for the service providers (146 out of 509) and 12.4% for parents/caregivers (68 out of 549). The mean knowledge score for service providers showed a significant increase of 13% (95% Confidence interval (CI) = 8.35%, 17%) from a pre-test mean of 9.4 (total possible = 13). Poison prevention behaviors reported by service providers significantly improved by 24% (95% CI = 15.6%, 32%) from a pre-test score of 5.7 (total possible = 11). The mean knowledge score for parents/caregivers significantly increased by 16% (95% CI = 7.2%, 24%) from 8.1, and the mean number of poison prevention behaviors reported by parents/caregivers significantly improved by 11% (95% CI = 3%, 19%) from 6.9. The effect sizes ranged from 0.48 to 0.69. CONCLUSIONS: The BPS intervention increased the self-reported knowledge and behaviors of most participants.

Adolescent↗

An evaluation of the impact of training Honduran health care providers in interpersonal communication.

OBJECTIVE: To evaluate the impact of interpersonal communication (IPC) training on practice and patient satisfaction and to determine the acceptability of this training to providers in a developing country. DESIGN: The study used a pre-post design with treatment and control groups. Data collection methods included interaction analysis of audio-taped clinical encounters, patient exit interviews, and a self-administered questionnaire for health providers. STUDY PARTICIPANTS: Interaction analysis was based on an experimental group of 24 doctors and a control group of eight with multiple observations for each provider). Exit interviews were carried out with 220 pre-test patients and 218 post-test patients. All 87 health providers who received training responded to the self-administered questionnaire. INTERVENTION: A brief in-service training programme on interpersonal communications was presented in three half-day sessions; these focused on overall socio-emotional communication, problem solving skills and counselling. MAIN OUTCOME MEASURES AND RESULTS: The IPC intervention was associated with more communication by trained providers (mean scores of 136.6 versus 94.4; P = 0.001), more positive talk (15.93 versus 7.99; P = 0.001), less negative talk (0.11 versus 0.59; P = 0.018), more emotional talk (15.7 versus 5.5; P = 0.021), and more medical counselling (17.3 versus 11.3; P = 0.026). Patients responded by communicating more (mean scores of 113.8 versus 79.6; P = 0.011) and disclosing more medical information (54.7 versus 41.7; P = 0.002). Patient satisfaction ratings were higher for providers who had received the training and providers reported training to be relevant and useful. CONCLUSIONS: Further validation of IPC skills and simplification of assessment methods are needed if IPC is to be an area for routine monitoring and quality improvement.

Ambulatory Care↗

The effect of support group on the mental health and quality of life for mothers with autistic children.

BACKGROUND: The purpose of this study was to explore the effect of support groups on the mental health and quality of life for mothers with autistic children. METHOD: A quasi-experimental pre-post control group design was used in this study. The mothers had children without chronic diseases diagnosed as autistic based on Diagnostic and Statistical Manual of Mental Disorder-Fourth Edition (DSM-IV) and were their primary caregivers. The mothers were assigned to control or intervention groups based on their willingness. The 10 weeks of the support group programme served as an intervention. There were three waves of data collection: pre-test, post-test, and after 1 month follow-up. A total of 27 mothers with autistic children were assigned into experimental and control groups. In total, there were eight mothers in the experimental group and 19 mothers served as the control group. RESULTS: The results of this study showed that mental health had not significantly improved in the intervention group compared to those in the control group at the end of the first month during follow-up. However, the subjective well-being and employment status had an effect on their mental health. Only the subjective well-being had an effect on their quality of life. CONCLUSION: According to the results of this study, recommendations included (1) regularly promulgating a caregiver support group, (2) the advancement of training skills within the group, and (3) upgrading and promoting nurses' ability to lead support groups in the future.

Adult↗

Cardiopulmonary resuscitation in elderly patients hospitalized in the 1990s: a favorable outcome.

OBJECTIVE: To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival. DESIGN: Retrospective survey of cardiac arrest database and hospital charts, plus telephone follow-up. SETTING: 450-bed acute care teaching hospital. STUDY POPULATION: Seventy-eight hospitalized patients 70 years or older and 73 hospitalized patients under 70 years of age. MEASUREMENTS: Survey of cardiac arrest data base, hospital charts, and telephonic follow-up to allow (1) comparison of clinical characteristics, survival, and long-term follow-up between two age groups and (2) univariate and multivariate analysis of predictors of mortality. MAIN RESULTS: Pre-arrest clinical characteristics were not significantly different between the age groups. Prior to arrest the majority of patients were functionally active, and over one-third were hospitalized for acute coronary artery syndromes. In approximately 85% of the patients, the arrest was witnessed, and 70% of the patients had their cardiac rhythm monitored at onset of the arrest. Survival was not significantly different between the age groups; 26% of the total 151 patients were discharged. No significant difference was noted in pre-post arrest functional status of survivors. Survival at 1, 2, and 3 years in elderly and younger survivors was 86% versus 80%, 76% versus 67%, and 71% versus 61%, respectively. Multivariate analysis identified the presence of coronary artery disease, admission systolic blood pressure, and functional level to be independent pre-arrest predictors of mortality. At the time of the arrest, the initial cardiac rhythm and duration of CPR were found to be independent predictors of mortality. CONCLUSIONS: Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.

Adult↗

Asthma educational videoconferencing for parents: a case-control study.

We used a case-control, pre-post study to determine the effectiveness of educational videoconferencing in the delivery of an asthma education programme. The participants were immigrant parents attending scheduled classes on English as a second language. The cases participated in the educational videoconferences, while the controls attended a class on American civics. Knowledge in both groups was assessed with 10 true/false statements. Ninety subjects participated (47 cases and 43 controls). Controls showed no significant post-test improvement in knowledge scores (6.6 for pre-test, 6.4 for post-test). In contrast, cases demonstrated significant knowledge gain after the videoconference (7.3 vs 8.3). Educational videoconferencing was an effective tool for the delivery of health education in asthma.

Adult↗

Evaluation of an advanced health assessment course for acute care nurse practitioners.

The Acute Care Nurse Practitioner (ACNP) role is being implemented in many centres in Canada. Administrators need to be aware there are very few universities in Canada that prepare ACNPs for advanced health assessment. Therefore, a need may exist for continuing education in the work environment. The ACNPs in London, Ontario recognized such a need, and developed and implemented an Advanced Health Assessment Course using available resources, and administrators supported participation in the course. A pre-post course evaluation based on Bandura's Self-Efficacy theory (1997) was performed. From pre-test to post-test there were significant increases in: (a) the use of health assessement skills; (b) confidence in performing these skills; and (c) confidence in recognizing abnormalities on health assessment. The reasons most often cited for infrequent skill use were "inappropriate to clinical setting" and "used only if problem suspected". The majority of participants agreed that the course met their needs. Implications for practice include administrative support for continuing education at other centres to enhance health assessment skills of ACNPs.

Acute Disease↗

The effect of a primary care intervention on management of patients with diabetes and hypertension: a pre-post intervention chart audit.

BACKGROUND: A principal goal in enhancing primary care in Canada is to increase emphasis on health promotion, disease prevention and the management of chronic diseases in the primary care setting. To achieve this goal in Nova Scotia, collaborative practice teams with a nurse practitioner and at least one physician were established, and both alternative funding arrangements for physicians and an information system were implemented. This study reports on the impact of this primary healthcare reform initiative on the quality of process-of-care, self-care and proxy measures for specific health outcomes for patients with diabetes and hypertension. METHODS: A pre- (April 1, 1999-March 31, 2000) post- (April 1, 2001-March 31, 2002) intervention audit of consenting patients was conducted at the four sites participating in the Strengthening Primary Care Initiative. Two hundred and eleven charts of patients with diabetes and 541 charts of patients with hypertension were audited. Process-of-care, targeted health outcomes, patient education and self-care items were measured for patients with diabetes. Process-of-care and outcome measures related to clinical management, blood pressure, lifestyle modifications and laboratory investigations were measured for patients with hypertension. Frequencies and proportions were calculated. McNemar's test was used to compare paired data pre- and postintervention. RESULTS: The percentage of patients with diabetes who achieved target blood pressure control rose from 20.4 to 28.5%. Annual screening for retinopathy increased from 33.8 to 41.9% and nephropathy from 61.7 to 71.3%. The percentage of patients monitoring blood glucose levels at home increased from 61.5% to 69.1%. HYPERTENSION: The percentage of patients with hypertension who had their blood pressure checked at least twice a year dropped from 89.1% to 85.0%; however, more patients achieved target systolic (rising from 40.6 to 55.3%) and diastolic (from 77.9 to 85.3%) blood pressure readings. Body mass index was recorded and moderate exercise prescribed to more patients. The percentage of patients with recorded fasting blood glucose levels (from 37.7 to 67.1%) and lipid profiles (from 62.6 to 69.1%) was markedly higher. CONCLUSION: Overall patient care related to diabetes and hypertension was either maintained or improved over the course of the initiative.

Adult↗

Collaborative writing: the effects of metacognitive prompting and structured peer interaction.

BACKGROUND: The structured system for peer assisted learning in writing named Paired Writing (Topping, 1995) incorporates both metacognitive prompting and scaffolding for the interactive process. AIM: This study sought to evaluate the relative contribution of these two components to student gain in quality of writing and attitudes to writing, while controlling for amount of writing practice and teacher effects. SAMPLE: Participants were 28 ten- and eleven-year-old students forming a problematic mixed ability class. METHODS: All received training in Paired Writing and its inherent metacognitive prompting. Students matched by gender and pre-test writing scores were assigned randomly to Interaction or No Interaction conditions. In the Interaction condition, the more able writers became 'tutors' for the less able. In the No Interaction condition, the more able writers acted as controls for the tutors and the less able as controls for the tutees. Over six weeks, the paired writers produced five pieces of personal writing collaboratively, while children in the No Interaction condition did so alone. RESULTS: On pre- and post-project analyses of the quality of individual writing, all groups showed statistically significant improvements in writing. However, the pre-post gains of the children who wrote interactively were significantly greater than those of the lone writers. There was some evidence that the paired writers also had more positive self-esteem as writers. CONCLUSION: The operation and durability of the Paired Writing system are discussed.

Child↗

[The effect of aroma inhalation method on stress responses of nursing students].

PURPOSE: The purpose of this study is to identify the effect of aroma inhalation on stress responses (physical symptoms, levels of anxiety, perceived stresses)of nursing students. METHOD: This study was a quasi-experimental research using a non-equivalent pre-post design and was conducted from June 1 to June 5, 2002. The subjects consisted of 77 junior nursing students who were divided into 39 experimental group members and 38 control group members. A pretest and Post-test were conducted to measure body symptoms, the level of anxiety, and the level of perceived stress. In the experimental group, aromas were given using an aroma lamp, lavender, peppermint, rosemary and Clary-Sage. In the control group, the treatment was not administered. RESULT: As a result of administering aroma inhalation to nursing students, their physical symptoms decreased, their anxiety scores were low, and their perceived stress scores were low, showing that aroma inhalation could be a very effective stress management method. CONCLUSION: Nursing educators should play an important role in contributing to college students' physical and psychological health by helping enhance their recognition of stress management and effectively relieving their stress using essential oils.

Aromatherapy↗

Outcomes monitoring and the testing of new psychiatric treatments: work therapy in the treatment of chronic post-traumatic stress disorder.

OBJECTIVE: To evaluate the effectiveness of a work therapy intervention, the Department of Veterans Affairs (VA) Compensated Work Therapy program (CWT), in the treatment of patients suffering from chronic war-related post-traumatic stress disorder (PTSD); and to demonstrate methods for using outcomes monitoring data to screen previously untested treatments. DATA SOURCES/STUDY SETTING: Baseline and four-month follow-up questionnaires administered to 3,076 veterans treated in 52 specialized VA inpatient programs for treatment of PTSD at facilities that also had CWT programs. Altogether 78 (2.5 percent) of these patients participated in CWT during the four months after discharge. STUDY DESIGN: The study used a pre-post nonequivalent control group design. DATA COLLECTION/EXTRACTION METHODS: Questionnaires documented PTSD symptoms, violent behavior, alcohol and drug use, employment status, and medical status at the time of program entry and four months after discharge from the hospital to the community. Administrative databases were used to identify participants in the CWT program. Propensity scores were used to match CWT participants and other patients, and hierarchical linear modeling was used to evaluate differences in outcomes between treatment groups on seven outcomes. PRINCIPAL FINDINGS: The propensity scaling method created groups that were not significantly different on any measure. No greater improvement was observed among CWT participants than among other patients on any of seven outcome measures. CONCLUSIONS: Substantively this study suggests that work therapy, as currently practiced in VA, is not an effective intervention, at least in the short term, for chronic, war-related PTSD. Methodologically it illustrates the use of outcomes monitoring data to screen previously untested treatments and the use of propensity scoring and hierarchical linear modeling to adjust for selection biases in observational studies.

Chronic Disease↗

The association between prenatal and or post natal growth disorder and lipid profile in adolescents aged 12 - 15 years old in Tanjungsari Subdistrict, Sumedang, West Java.

AIM: to investigate association between growth disorders in pre and post natal period and abnormal lipid profile in adolescents aged 12 -15 years old in Tanjungsari population. METHODS: a cohort study was conducted in 3350 children who were born in 1988-1990 in Tanjungsari Subdistrict, Sumedang, West Java. A complete anthropometric data since their birth were collected from October 2002-February 2003. INCLUSION CRITERIA: Children who had birth weight in the range of +/- 3 of standard deviation (SD). Post natal growth disorder based on Z score of height according to age group and height changes at the age of 0-12 months and 12-36 months. SGA criteria were determined based on cross tabulation between weight and birth length at birth. Study subjects were divided into control group, groups of pre natal, post natal and pre-postnatal growth disorder. All subjects were checked for lipid profiles. Statistical calculation used analysis of variance, t test and logistic regression. 312 subjects were included in this study, 73 were in control group, 90 subjects in postnatal, 96 subjects were in pre natal and 53 subjects were in pre-post natal growth disorder group. RESULTS: this study has not shown significant difference in risk factor of having abnormal lipid profile between normal control group and growth disorder group except for those in prenatal growth disorder group with RR = 2.375 (p = 0.014). CONCLUSION: the post natal growth disorder had not influenced lipid profile in adolescents with SGA. Recent BMI was an additional risk factor for pre-post natal growth disorder group.

Adolescent↗

The effects of high-volt pulsed current electrical stimulation on delayed-onset muscle soreness.

OBJECTIVE: We investigated three 30-minute high-volt pulsed current electrical stimulation (HVPC) treatments of 125 pps to reduce pain, restore range of motion (ROM), and recover strength loss associated with delayed-onset muscle soreness (DOMS). DESIGN AND SETTING: Randomized, masked comparison of three 30-minute treatment and sham HVPC regimens over a 48-hour period. SUBJECTS: Twenty-eight college students. MEASUREMENTS: Subjects performed concentric and eccentric knee extensions with the right leg to induce muscle soreness. Assessments were made before and after the exercise bout and each treatment at 24, 48, and 72 hours postexercise. RESULTS: Three separate 2 x 3 x 2 ANOVAs were used to determine significant differences (p < .05) between days, treatments, and pre-post treatment effects and significant interaction among these variables. Scheffe post hoc tests showed no significant reduction in pain perception or improvement in loss of function at 24, 48, and 72 hours postexercise. Mean pain perception assessments (0 = no pain, 10 = severe pain) for the HVPC group were 2.9, 4.5, and 3.5 and for the sham group 3.8, 4.8, and 3.5). Mean ROM losses for the HVPC group were 9.0 degrees , 22.3 degrees , and 26.2 degrees , and for the sham group were 9.5 degrees , 23.1 degrees , and 23.0 degrees . Mean strength losses (1RM) for the HVPC group were 25.9, 25.7, and 20.8 lbs and for the sham group were 22.3, 22.3, and 13.8 lbs. CONCLUSIONS: HVPC as we studied it was ineffective in providing lasting pain reduction and at reducing ROM and strength losses associated with DOMS.

Journal Article↗

Influence of body hair removal on physiological responses during breaststroke swimming.

Nine male collegiate swimmers (EXP) were studied 8 d before (PRE) and 1 d after (POST) shaving the hair from their arms, legs, and exposed trunk. A control group (CON, N = 4) of their teammates was also tested at these times but did not remove body hair. In PRE and POST, distance per stroke (SL), VO2, heart rate (HR), and post-swim blood lactate concentration (BL) were measured during a 365.8 m breaststroke swim at approximately 90% effort. Subjects also performed a tethered breaststroke swim with retarding forces of 6.27, 7.75, and 9.26 kg. The EXP group experienced a significant (P less than 0.05) reduction in BL (mean +/- SE: 8.48 +/- 0.78 to 6.74 +/- 0.74 mmol.l-1), a decreased VO2 (3.60 +/- 0.15 to 3.27 +/- 0.14 l.min-1), an increase in SL (2.07 +/- 0.08 to 2.31 +/- 0.10 m.stroke-1), and an insignificant (P = 0.08) decline in HR (174 +/- 5 to 168 +/- 4 beats.min-1) during the free swim. The CON group showed no changes in BL, SL, or HR. During the tethered swim, there were no significant PRE-POST differences in VO2, HR, or BL for either group. In a separate group of swimmers (nine who shaved body hair and nine controls), removing body hair significantly reduced the rate of velocity decay during a prone glide after a maximal underwater leg push-off. It is concluded that removing body hair reduces active drag, thereby decreasing the physiological cost of swimming.

Adult↗

Sustained effects of educating retailers to reduce cigarette sales to minors.

Despite state laws prohibiting the purchase of tobacco by minors, the ease with which underage youth can purchase cigarettes has been documented nationwide. The public health community as well as policy makers have called for a combination of retailer education and enforcement of laws prohibiting tobacco sales to minors. Enforcement activity may not be feasible in many communities, however, and an educational intervention may be the only option. This paper reports results of a 6-month followup assessment following a face-to-face education intervention with retailers to reduce cigarettes sales to minors in San Diego County, CA. A control-experimental group, pre-post design was employed to study the sustained effects of the program on the illegal sale of cigarettes to minors. A total of 236 stores were visited by minors, ages 14-17 years, with the intent of purchasing cigarettes. Information was collected three times: pre-test, immediately following the intervention, and 6 months after the intervention ended. The groups included a no-treatment control group of 108 stores and an intervention group of 128 that received three educational visits from project staff over a 1-year period. Community education via media and informational presentations was also conducted. As previously reported, a 68-percent pretest sales rate was found for stores overall. Immediately following the intervention, 32 percent of the intervention group and 59 percent of the control group sold cigarettes to minors. These results were maintained 6 months following the conclusion of the intervention. Results are discussed in terms of education versus use of enforcement.

Adolescent↗

Suicide intervention training evaluation: a preliminary report.

To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

Adult↗