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At least 433 records · Page 24Linked to original sources
PubMed2000

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers.

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.

Diffusion of Innovation↗
PubMed1988

The well baby lottery: motivational procedures for increasing attendance at maternal and child health clinics.

A lottery system was used to improve attendance at four well baby clinics in four colonias in Tijuana, Mexico. Mothers earned one lottery ticket for each visit to each clinic during the intervention period. At the end of each month, ticket receipts were entered into drawings for one of three bags of groceries. The lottery system was evaluated within a "multiple baseline design" whereby the intervention was staggered across the four clinics on a month-by-month basis. Although attendance was not enhanced uniformly, an overall improvement of 25 percent was realized. The lottery system was at times hampered by administrative problems, such as the breakdown of a public address system used to announce the open hours of a clinic in one of the colonias.

Child Development↗
PubMed1993

Ethnicity as a risk factor for consultations in primary health care and out-patient care.

OBJECTIVE: To determine the influence of ethnicity, defined as foreign-born people, on consultation rates, admissions and prescriptions in out-patient care and primary health care. DESIGN: Prospective study of attenders at four different caregivers during seven consecutive weeks in 1988. Age-and sex-standardized relative risks and odds ratios with 95% confidence interval were calculated. SETTING: A suburban area in Lund, a city located in the south of Sweden, with 28% foreign-born people. SUBJECTS: This population (N = 5085) made 1,348 consultations. MAIN OUTCOME MEASURES: Ethnic group and consultation rates of the local primary health care centre, the emergency department, hospital out-patient department, and private care, admissions to specialist care, prescriptions, and certified sick leave. RESULTS: Swedes made fewer age-and sex-standardized visits to the emergency department (RR = 0.69(0.48-0.99)) while the foreign-born people showed an opposite non-significant trend (RR = 1.37(0.95-1.99)). Latin Americans (RR = 1.60(1.02-2.51)) visited the local Primary Health Care centre in the residential area more than expected, while people born in Asia and Africa consulted the Primary Health Care centre less than expected (RR = 0.44(0.28-0.69)). There were no differences between Swedes and foreign-born people in being put on the sick-list, but foreign-born people were given significantly fewer prescriptions (RR = 0.07(0.03-0.19)) than Swedes. Foreign-born people, Latin Americans, and non-Swedish Scandinavians were referred significantly more often to hospital than other groups. CONCLUSIONS: There were important differences in consultations between Swedes and foreign-born people. It seems important to study these differences further to find out if they were due to morbidity or cultural differences in order to be able to meet the demands and needs of different ethnic groups.

Africa↗
PubMed1987

Selecting health insurance: the importance of prescription drug coverage and pharmacy factors in consumer decision making.

This study determined how important prescription drug coverage was to consumers in selecting their health insurance plans, the specific pharmacy factors they considered, and the importance of factors considered. A mail survey questionnaire was sent to 800 state government and university employees residing in the Madison, Wisconsin area; 453 questionnaires were returned. The majority (59.0 percent) of respondents aware of health insurance prescription coverage placed at least moderate importance on that coverage when selecting their health insurance plan. The specific factors considered most often were cost, location, convenience, and flexibility to choose or change pharmacies. The importance ratings for cost, location, flexibility, and the pharmacist varied among respondents enrolled in different health insurance plans.

Community Participation↗
PubMed1988

The impact of the "grim reaper" national AIDS educational campaign on the Albion Street (AIDS) Centre and the AIDS Hotline.

The national educational programme on the acquired immunodeficiency syndrome (AIDS) caused a dramatic increase in the number of heterosexual persons who presented for human immunodeficiency virus (HIV) antibody testing at the Albion Street (AIDS) Centre. There was also a marked increase in the number of intravenous drugs abusers who presented, although the proportion of this high-risk group that has been tested remains low. There was no increase in the number of homosexual men who presented for testing. The increase in the number of telephone calls that were received by the Centre's AIDS Hotline was due to an interest in HIV-antibody testing, rather than an interest in information about safer sexual practices. The campaign was seen to have achieved its primary objective, namely, to alert sexually-active persons of the potential spread of the virus from the high-risk groups. However, it is clear that future educational campaigns need to target specific high-risk groups such as intravenous drug abusers.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Medical problems of detainees after the conclusion of major ground combat during Operation Iraqi Freedom.

After the conclusion of major ground combat operations during Operation Iraqi Freedom, the focus of the mission changed, although intense armed conflict continued. Included in this mission was management of security detainees, including provision of their medical care. We retrospectively reviewed the admission records identified at a short-term holding facility over 2 months and diagnoses of detainees admitted to a combat support hospital over 4 months as a health care service utilization statistics review. Six thousand six hundred thirty-one detainee encounters occurred at the short-term facility with approximately 45% of detainees reporting medical problems during each daily evaluation. Most frequent complaints were neurological (11%), gastrointestinal (10%), and respiratory (8%). Two hundred nineteen detainees' admission diagnoses were retrospectively reviewed from the combat support hospital, 98 (45%) due to gunshot or fragmentary injuries and 121 (55%) to other medical problems. Medical problems included cardiac (29%), gastrointestinal (17%), neurological (14%), musculoskeletal (11%), and pulmonary (6%) disease. Medical problems not traditionally dealt with in a combat theater, including management of transplant recipients, patients with cardiac valve replacement, and cancer patient, were also seen.

Delivery of Health Care↗
PubMed1986

Effects of cost sharing on seeking care for serious and minor symptoms. Results of a randomized controlled trial.

To estimate the effect of cost sharing on seeking care for serious and minor symptoms, we analyzed data for 3539 persons aged 17 to 61 from the Rand Health Insurance Experiment. Participants were randomly assigned to a free-care group or to insurance plans requiring them to pay part of the costs (cost-sharing group). Annual surveys were administered to determine if participants had serious and minor symptoms during the preceding month and whether they saw a physician. Serious symptoms were judged by a panel of physicians to warrant care in most instances; minor symptoms were judged neither to be severe nor to warrant care in most instances. The cost-sharing group was nearly one third less likely than the free-care group to see a physician when they had minor symptoms (6.3% compared with 9.0%; p less than 0.04). The free-care and cost-sharing groups did not differ significantly in seeking care for serious symptoms (22.3% compared with 17.9%; p = 0.095). However, for participants with low socioeconomic status who began the study in poor health, the prevalence of serious symptoms was higher in the cost-sharing than the free-care group (29.1% compared with 23.8%, p less than 0.004).

Adolescent↗
PubMed1992

Hospital image: a correspondence analysis approach.

In today's competitive health care industry, understanding hospital image is becoming increasingly important. The authors employ a method of analysis that is new to hospital image research--correspondence analysis. They use it to assess the images of 16 hospitals in a competitive health care market in terms of their associated features. Strategic implications of the study findings are presented.

Catchment Area, Health↗
PubMed1998

[BCG vaccine. Its efficacy and impact on the results of tuberculin screening in a high-risk population].

In a housing estate population with a high prevalence of tuberculosis, the authors conducted tuberculosis screening with the tuberculin test, and an investigation with three purposes: evaluation of tuberculosis infection (defined as > 10 mm on tuberculin test), evaluation of BCG effect on tuberculin test, and evaluation of BCG efficacy. The data was collected by nurses during the screening and completed with observation of vaccination records in a health center. The diagnosis of tuberculosis was done by local specialized health services. The statistical significance was tested with Chi Square and Fisher Tests. Vaccine efficacy was calculated on the basis of relative risk of contracting tuberculosis according to vaccination status. The authors tested tuberculin reactivity on 396 persons -53.5% of whole population resident in the neighbourhood. The infection was more prevalent in the 15-44-years-old group (31.2%), in males (25.9%) and black population (30.5%). Only the differences between age groups were statistically significant. After the discussion of probable bias, the authors conclude that BCG does not convert the tuberculin test significantly when the cutpoint is of 10 mm, in a high prevalent tuberculosis population. Therefore, the tuberculin test could be a good diagnostic test for infection, even in vaccinated groups. Lastly, the vaccine efficacy was not confirmed, probably because of the small magnitude of sample size.

Adolescent↗