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PubMed2000

Peer promotion programs and social networks in Ghana: methods for monitoring and evaluating AIDS prevention and reproductive health programs among adolescents and young adults.

This article summarizes the observations and lessons learned regarding the application of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention and reproductive health evaluation methodologies in the context of adolescent and young adult populations and discusses the use of peer network evaluation to understand the dynamics of peer promotion. To examine the interpersonal communication process of peer education, this study tested a new approach using multiple semistructured interviews and network analysis to collect data on 106 peer educators and 526 of their contacts. These evaluation activities were conducted at three sites in Ghana during April 1998, in both periurban and rural locations in both in-school and out-of-school settings. By evaluating the social networks of peer educators it was possible to gain a better understanding of the process of peer education in terms of (a) defining the composition of peer contacts, (b) identifying the social norms that play a critical role in youth decision making, and (c) observing the range of messages and services transmitted during peer education. The objective of this paper is to disseminate the experience of the Center for Education and Development of Population Activities (CEDPA) and Focus on Young Adult's cooperative development of evaluation methodologies for peer promotion and to highlight utilization of these methodologies in a case study in Ghana. The results will be discussed in terms of their possible implications for program managers, researchers, and international agencies.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The role of parents and older peers in school-based cardiovascular prevention programs: implications for program development.

This article describes a set of studies which compare the effectiveness of innovative interventions led by older peers and which included a parent component with teacher-led interventions for nutrition, blood pressure, and smoking prevention. Information about the agreement between parents' and children's (grades six through eight) perception of the children's health behavior and family interaction was also found, by surveying parents and children in 1051 households. Both teacher-led and older peer-led interventions were successful in increasing behavioral capabilities for nutrition and blood pressure, measured one year after the interventions. Results of the parent-child survey showed reasonable agreement between parents and children for reports of the child's exercise, dieting, and fast food consumption, but poorer agreement for smoking and perceptions of family interaction. Results are discussed in relation to the planning of future programs designed to address the importance of peer and parental role models.

Adolescent↗
PubMed1995

Medicaid program; rescission of the guidelines for documenting Medicaid recipient access to immunizations under the Vaccines for Children (VFC) Program--HCFA. Notice.

This notice rescinds the guidelines that we published in the Federal Register on October 3, 1994, that required States to document equal access to immunizations for Medicaid children if States elected to use lower vaccine administration fees than the maximum charges that were published and applicable under the Vaccines for Children program. These guidelines are rescinded in response to public comments on the October 3, 1994 notice. States indicated that there were numerous problems regarding the collection of useable data.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1996

Using clinical data in program design: a family support program for families with preterm infants.

HMOs can use clinical data culled from computerized medical records and provider and patient interviews to examine the impact of premature infant births on the family. The results can help guide health plans in developing a clinical intervention program to address the physical and emotional consequences of low birthweight babies. The Harvard Pilgrim Health Care experience describes the data collection process administrators are taking to design such a clinical intervention.

Case Management↗
PubMed1997

Program activity in the second year of the Rural Telemedicine Grant Program Part 2.

Part 1, in our last issue, detailed the activity levels, number and types of consults, and transmission costs of the 13 telemedicine networks funded in 1994 by the Office of Rural Health Policy's Rural Telemedicine Grant Program. This concluding section presents the authors' conclusions drawn from the objective data in Part 1.

California↗
PubMed1998

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE program; nonavailability statement requirements--DoD. Final rule.

This final rule revises certain requirements and procedures for the TRICARE Program, the purpose of which is to implement a comprehensive managed health care delivery system composed of military medical treatment facilities and CHAMPUS. Issues addressed in this rule include priority for access to care in military treatment facilities and requirements for payment of enrollment fees. This rule also includes provisions revising the requirement that certain beneficiaries obtain a non-availability statement from a military treatment facility commander prior to receiving certain health care services from civilian providers.

Government Agencies↗
PubMed1988

Medicare program; End Stage Renal Disease Program; responsibilities of network organizations--HCFA. Final rule.

This final rule revises final regulations published on August 26, 1986 (51 FR 30356) pertaining to the End Stage Renal DIsease (ESRD) networks and organizations to reflect certain provisions of the ESRD program amendments contained in sections 9335 (d) through (h) of the Omnibus Budget Reconciliation Act of 1986. These regulations revise the responsibilities of network organizations.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Medicare program; changes to the Medicare+Choice program. Health Care Financing Administration (HCFA), HHS. Final rule.

The purpose of this final rule is to set forth limited changes to the Medicare+Choice regulations published in our June 26, 1998 interim final rule (63 FR 34968). Those regulations implemented section 4001 of the Balanced Budget Act of 1997 (BBA), which established the Medicare+Choice (M+C) program. This final rule addresses selected issues raised by commenters on the June 26, 1998 interim final rule where we have identified the need for changes or where we believe that clarifications are needed as soon as possible. Among these issues are provider participation procedures, beneficiary enrollment options, and several access-related issues, including initial care assessment requirements, notification requirements when specialists are terminated from an M+C plan, and several coordination of care requirements.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

National Vaccine Injury Compensation Program: addition of vaccines against rotavirus to the program. Department of Health and Human Services (HHS), Public Health Service (PHS), Health Resources and Services Administration (HRSA). Final rule.

This final rule amends the existing regulations governing the National Vaccine Injury Compensation Program (VICP) by adding vaccines against rotavirus to the Table of Injuries, which lists the vaccines covered under the VICP. This action is taken under section 2114(e) of the Public Health Service Act (the Act). The VICP provides a system of no-fault compensation for certain individuals who have been injured by specific childhood vaccines. The two prerequisites for adding vaccines against rotavirus to the VICP have been satisfied. An excise tax of 75 cents per dose was enacted on October 21, 1998, and took effect for sales of the vaccines after October 21, 1998. The Centers for Disease Control and Prevention (CDC) has recommended to the Secretary of HHS that this vaccine be routinely administered to children. Thus, vaccines against rotavirus are now included in the VICP.

Humans↗
PubMed2001

A mobile mammography program in the workplace. Successful program.

United States companies recognize health care costs are rising and the prevention, early detection, and treatment of disease can help with cost control. Onsite mobile mammography can provide a convenient, effective, and time saving service for employees. Establishing a mobile mammography program requires some planning, but is relatively easy to administer and maintain.

Adult↗
PubMed1991

Government intervention programs in HIV/tuberculous infection. Outline of guidelines for national tuberculosis control programs in view of the HIV epidemic.

Tuberculosis is one of the most widespread infections known in the world. WHO estimates that in 1990, 1.7 billion people, or one third of the world population, are or have been infected with the tubercle bacillus. Fortunately, few of those infected develop active forms of the disease but it is estimated that in 1990, there will be 8 million new cases and 2.9 million deaths from tuberculosis in the world. This already alarming situation of the tuberculosis problem is getting worse, mainly due to the AIDS epidemic. A basic understanding of tuberculosis/HIV epidemiology is necessary and priority actions are to be strongly recommended for application in government intervention programs. They are specified in the present article.

Adolescent↗
PubMed1984

Five-year findings of the Hypertension Detection and Follow-up Program: mortality by race-sex and blood pressure level. A further analysis. Hypertension Detection and Follow-up Program Cooperative Group.

The Hypertension Detection and Follow-up Program (HDFP) data are reported by diastolic blood pressure (DBP) stratum for four race-sex subgroups. For Stratum I (entry DBP 90-104 mm Hg) in each of the race-sex subgroups (black male, black female, white male, and white female). Stepped Care (SC) participants experienced a reduced mortality as compared to Referred Care (RC). For black males and females in all three entry DBP strata, mortality was lower in the SC than RC. Only in three subgroups did the SC mortality exceed RC: Stratum II (entry DBP 105-114 mm Hg) white females and Stratum III (entry DBP 115 + mm Hg) white males and females. Possible explanations for these deviant findings are discussed. The HDFP was designed to determine the difference in total 5-year mortality between SC and RC; subgroup analyses may be subject to large chance variation and must be interpreted with great caution. The value of vigorous treatment of "mild" hypertension (Stratum I) in males and females, black and white, and the value of treatment for all blood pressure strata in blacks are confirmed by this analysis.

Adult↗
PubMed1977

[Global program of smallpox eradication. 1. Smallpox in the world before acceptance of the program of its eradication by the World Health Organization].

Despite a considerable success in control smallpox in a number of countries reached as a result of vaccination the problem of eradication of this infection could not be solved without uniting the efforts of all the countries in the world. Guided by humanity principles the delegation of the USSR suggested in 1958 a program of smallpox eradication in the whole world. World smallpox morbidity is analyzed in this work.

Africa↗
PubMed1995

Physical activity within a community-based weight control program: program evaluation and predictors of success.

OBJECTIVES: To assess the feasibility and effectiveness of adding physical activity sessions to a weight control program in a community health center and to identify individuals suitable for outpatient group treatment with and without physical activity. METHODS: The study population included 42 overweight women who were randomly divided into treatment groups. Both treatment groups received guidance in nutrition and behavior modification and the exercise group also participated in physical activity sessions. Both treatments included 20 sessions and participants were followed up for eight months. RESULTS: In both treatments, significant improvements were seen in physical fitness, anthropometric measurements, nutritional knowledge, food consumption, and eating behaviors. Weight loss following three months of weekly sessions did not differ by treatment group. At follow-up there was a trend towards increased maintenance of weight loss in the exercise group, however differences were not statistically significant. Attrition rates were low in both treatments and participant satisfaction was high. Lower baseline BMI predicted larger weight losses, in particular in the exercise group. Other predictors of weight loss included poorer baseline eating behaviors and employment outside of the home. Perceived spouse support predicted continual participation.

Adult↗
PubMed1979

Five-year findings of the hypertension detection and follow-up program. II. Mortality by race-sex and age. Hypertension Detection and Follow-up Program Cooperative Group.

Data are reported for four race-sex and three age subgroups of the Hypertension Detection and Follow-up Program (HDFP). Throughout the HDFP trial, for black men, black women, white men, and white women and for persons aged 30 to 49, 50 to 59, and 60 to 69 years at entry, control of blood pressure was consistently better for Stepped Care (SC) than Referred Care (RC) participants. This difference in degree of control was least for white women; it was less for whites than for blacks of the same sex. For white men, black men, and black women and for age subgroups 50 to 59 and 60 to 69 years, five-year all-cause death rates were substantially lower--by 15% to 28%--for the SC subgroups compared to the RC subgroups.

Adult↗