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At least 613 records · Page 34Linked to original sources
PubMed1998

Intervention mapping: a process for developing theory- and evidence-based health education programs.

The practice of health education involves three major program-planning activities: needs assessment, program development, and evaluation. Over the past 20 years, significant enhancements have been made to the conceptual base and practice of health education. Models that outline explicit procedures and detailed conceptualization of community assessment and evaluation have been developed. Other advancements include the application of theory to health education and promotion program development and implementation. However, there remains a need for more explicit specification of the processes by which one uses theory and empirical findings to develop interventions. This article presents the origins, purpose, and description of Intervention Mapping, a framework for health education intervention development. Intervention Mapping is composed of five steps: (1) creating a matrix of proximal program objectives, (2) selecting theory-based intervention methods and practical strategies, (3) designing and organizing a program, (4) specifying adoption and implementation plans, and (5) generating program evaluation plans.

Decision Support Techniques↗
PubMed1986

Rho Chi lecture. Pharmacy in a smaller world.

Health care is a business. Pharmacy is in the health business. The health care delivery system in the U.S. is rapidly becoming a managed system by corporations. Further, these corporations are moving toward international markets where some already have considerable experience. There are many parts of the world not participating in these developments in health care. Some are just off our shores in the Caribbean Basin. A review of activities occurring in recent years by various groups suggests that more could be done. Two modest approaches are presented. Support of the American Association of Colleges of Pharmacy's "Pharmacy School Twinning Project" through which U.S. pharmacy schools would work with pharmacy schools in Central and South America is recommended. Also, national pharmacy associations jointly with pharmaceutical companies would work together using their expertise in continuing pharmacy education to develop new education models for the needy areas of the world.

Delivery of Health Care↗
PubMed2000

[Analysis of a proposal for changing the educational paradigm in bacteriology and virology. Facultad de Ciencias Médicas, Universidad Nacional de Córdoba].

The productive character of the scientific thought points out a methodological means that include the demand of the students' job about the information and not his mere reception and reproduction. It is essential to give the students the opportunity of discovering the cognitive processes used in the production of the scientific knowledge. In this work, we present the result of the starting of a workshop dynamic in a basic subject, the students' answers, and the analysis of the subject. In the Chair of Medical Bacteriology and Virology of the School of Medical Sciences, the National University of Córdoba, 1700 students attended classes in 1997. The subject was developed with the activities that worked the same contents from two different learning conceptions: (I) workshop activity, non obligatory, constructive, and (II) theorico-practical activity, obligatory and traditional. Two voluntary and anonymous interviews were done about the valuation that the student gave to these two activities and their basis, one in the middle and the other at the end of the course. 90.55% classified the traditional activity as positive, and 9.45% as negative. Regarding the workshop activity, the 60.5% classified it as positive and the 39.5% as negative. The same developed content with two activities made possible the analysis of the impact that the two different methodologies produced on the students. The student's answer to the traditional activity was better than the workshop activity (p < 0.001). The differences in the student's acceptance between the two option revealed the major difficulty of an alternative methodological strategy in the current educational model.

Argentina↗
PubMed1989

Extending access to care: preparing allied health practitioners for nontraditional settings.

Promoting access to quality health care is a primary emphasis in the allied health professions. However, many populations cannot access primary care services through traditional health care settings, due to financial, geographic, cultural, and manpower distribution barriers. Allied health programs typically prepare graduates to function in traditional health care settings. However, if one of the goals of allied health is to increase access to care, graduates need to be prepared to function in a variety of nontraditional settings. This paper examines the problems inherent in preparing allied health graduates for traditional roles, and presents a model educational program that provides practitioners with the knowledge and skills necessary to provide quality health care services in a variety of settings. Mechanisms for utilizing this model in allied health disciplines are addressed, as well as how this model promotes increased access to care.

Allied Health Personnel↗
PubMed2004

Women's health education initiatives: why have they stalled?

Since the U.S. Congress first requested an assessment of women's health content in medical school curricula ten years ago, surveys indicate at least a two-fold increase in the number of schools with a women's health curriculum and no change in the number that offer a women's health clinical elective or rotation. Despite a marked increase in the number of schools with an office or program responsible for integration of women's health and gender-specific content into curricula, change has been modest. Reasons for this slow progress include uncertainty about the domain of women's health and what should be included in a curriculum, a lack of practical guidelines for implementation, and institutional resistance to change. The dominant factors that will influence future curriculum development are the increasing scientific knowledge base on sex and gender differences and the emerging scientific field of sex-based biology, both of which have potential to benefit the health of women. Evidence-based data on significant sex and gender differences will provide compelling reasons for schools to integrate this information into curricula, and new educational initiatives must further develop educational models to help implement change. As women's health becomes synonymous with the term "sex and gender differences," the challenge to schools is to address equally in their curricula those unique aspects of women's health that were part of the original intent of the congressional mandate.

Academic Medical Centers↗
PubMed1999

The Wisdom Project: virtual education in primary care.

This article examines the development of the Wisdom Project, a pilot for the teaching of informatics to primary health care professionals, using an original educational model based on e-mail and Web pages. The article begins by placing the development of the Wisdom Project in the context of changes in medical education and training. The aims and objectives of Wisdom are outlined, and the methodologies for setting up and evaluating the project are described. The article then presents the results of the evaluation, including the identification of significant improvements in knowledge of CD ROMs (P = 0.01), e-mail (P = 0.03), Medline (P = 0.02), operating systems (P = 0.02), Web browsers (P = 0.003) and word processing (P = 0.03). Improvements in evidence-based practice (EBP) did not reach significance. Finally, a number of conclusions are presented, considering the lessons learnt for the future development of such projects.

Attitude to Computers↗
PubMed1993

A breast cancer screening educational intervention targeting medical office staff.

There is persistent evidence that breast cancer screening techniques remain under-utilized. While physicians cite lack of time as a barrier to the provision of preventive services, nurses and other medical office staff are in an ideal position to educate women and motivate adherence to screening recommendations. This paper describes the design, implementation and process evaluation of a breast cancer screening educational program targeting primary care medical office staff. This intervention was conducted in two Washington State counties as part of a larger community organization study. The PRECEDE model, educational outreach principles and focus groups were used to guide the program development. Consistent with 'academic detailing' concepts, the sessions were delivered at health care facilities. The program included a review of breast cancer-related data and screening methods, an overview of the nurse's role as a 'change agent' and breast self-examination instructor, and a discussion of women's barriers to mammography. Community-level penetration was relatively high, with sessions being completed by approximately 50% of the eligible staff. Overall, participants were positive about the value of the program. Medical office-based educational sessions have the potential of reaching a large proportion of primary health care workers and increasing disease prevention in communities.

Breast Neoplasms↗
PubMedDate not supplied

Health literacy as an empowerment tool for low-income mothers.

Health literacy commonly refers to the extent to which one can access and accurately interpret healthcare information. Statistics reveal that limited health literacy is prevalent among those of lower socioeconomic status. When working with low-income mothers, it is recommended in this article that healthcare professionals operationalize a broader conceptualization of health literacy than assessment of reading levels and translating knowledge of risk factors for illness and disease. Nutbeam's continuum of functional, interactive, and critical health literacy directs healthcare professionals to expand their health education mandate to encompass equipping low-income mothers with the necessary knowledge and skills to gain control over their lives and optimize the healthy development of their children. Tenets from social cognitive theory, principles from interdependence theory, and strategies from Freire's empowerment education model are integral to successful progression along Nutbeam's health literacy continuum.

Educational Status↗
PubMedDate not supplied

[Public health facilities, international modernization and cooperation. Venezuela's National Nursing School Project, 1936-1950].

In the end of the 19th century, the Venezuelan public health system was in the hands of religious women who ran the public health facilities. A new educational model would produce professional nurses who came to raise the standards of their occupation. Undoubtedly, this objective could not be properly met due to the candidates' low educational level and the need of a health service that searched for more economical means to face its demands with trained personnel but without real educational improvements. Another hindrance was the resistance of traditional medicine, which prevented a view of health as a whole, which comprehends social and preventive aspects. It was rather difficult for the founders of nursing schools to make public health facilities develop health orientation.

Education↗
PubMed2001

[Socioeconomic aspects and cardiovascular risk factors: experience at the Cardiovascular Epidemiologic Observatory].

BACKGROUND: Cardiovascular diseases are more frequent among the poorer social classes of the population. Studies including social and economic factors offer useful information when planning the strategy required in primary prevention. The aim of this investigation was to evaluate the association between socio-economic levels and cardiovascular risk factors in 3198 women and 3218 men aged 35-74 years enrolled for a cross sectional study within the Cardiovascular Epidemiologic Observatory, carried out in 1998 to evaluate the distribution of risk factors and the prevalence of cardiovascular risk conditions. METHODS: The level of education was used to determine the socio-economic status; the distribution of the risk factors and the prevalence of risk conditions were analyzed for the different levels of education. Models of logistic regression were used to evaluate the relation between the socio-economic status and obesity, cigarette smoking, hypertension, and hypercholesterolemia. RESULTS: A higher level of education is significantly protective against both obesity and cigarette smoking. With regard to obesity among males compared to those with a university degree the odds ratio increased to 1.6 for those with an upper secondary education diploma (95% confidence interval--CI 1.09-2.51) and to 3.5 for those without any qualification (95% CI 1.97-6.21). Among women the odds ratio increased to 3.2 (95% CI 1.81-5.81) and to 4.8 (95% CI 2.55-8.98) for the same levels of education. With regard to smoking among males compared to those with a university degree the odds ratio increased to 1.4 for those holding an upper secondary education diploma (95% CI 1.07-1.94) and to 2.3 for those without any qualification (95% CI 1.40-3.68). For men living in central or southern Italy, the odds ratio for cigarette smoking increased to 1.3 (95% CI 1.06-1.57) and to 1.5 (95% CI 1.24-1.82) and the odds ratio for hypercholesterolemia decreased to 0.8 (95% CI 0.62-0.95) and to 0.7 (95% CI 0.58-0.89); with regard to women, living in the same geographic areas the odds ratio for obesity increased to 1.3 (95% CI 1.03-1.65) and to 2.3 (95% CI 1.81-2.83). CONCLUSIONS: In primary prevention it is important to focus the attention on obesity and on smoking habits among the poorer social classes.

Adult↗
PubMed2003

Oral health education for nursing personnel; experiences among specially trained oral care aides: one-year follow-up interviews with oral care aides at a nursing facility.

The improved dental health in most industrialized countries is not apparent among elderly and long-term care patients. Oral healthcare has been found to have low priority in nursing care. To create lasting positive effects in oral healthcare education, a new educational model was tested in an oral healthcare project. After approval from ethical committee, nursing assistant and nurses' aides took part in a dental auscultation period at a dental clinic to serve as oral care aides additional to traditional oral healthcare education. Following this period, the aides were given responsibility for the oral healthcare at their ward. After serving as oral care aides for 1 year, interviews were made and analysed based on the Grounded Theory methodology. The aim was to investigate how the oral care aides had experienced their new duties regarding oral healthcare. The results indicated that, despite several environmental changes, reluctant residents and occasional lack of commitment from colleagues, the oral care aides felt responsible for the oral healthcare provision. The oral care aides expressed courage, the capacity to cope with reality, confirmation and empathy, characteristics that propelled them from novices to oral care aides with an expert competence.

Adaptation, Psychological↗
PubMed1980

The school as a force for community change in Tanzania.

In newly independent countries where traditional theories of educational policy have continued to be followed, education has persisted as little more than a sophisticated mechanism for the recruitment of elites, and there has been an increased dependence on the advanced industrial nations for aid, experts, and educational models. Tanzania, however, has attempted to break away from traditional strategies, and the author here describes and analyzes the impact of 2 of the most far-reaching reforms--Education for Self-Reliance and Decentralization--on national goals and policies. President Nyerene enunciated the objectives for Education for Self-Reliance in 1967 as relating education to rural life, correcting the elitist bias of education, and changing negative attitudes among students towards agriculture and rural life. 5 major programs of reform covering primary and secondary education, teacher and higher education, and examinations were to be pursued, ensuring a closer integration of schools with local communities; e.g., through school farms and cooperative shops, and making curricula directly relevant to local needs. A policy of Decentralization is being implemented, allowing, theoretically at least, a much greater participation at the community level in decisionmaking. In primary and adult education this has already been effected to some extent, though there is evidence to suggest that decentralization in some regions and districts has resulted in the creation of local bureaucratic machinery for control, defeating the intentions of the reform. Decentralization of secondary and teacher education is likely to follow, leaving only higher education centrally controlled for manpower training and allocation purposes. Finally the author discusses the question of the transferability of the Tanzanian reforms.

Africa↗
PubMedDate not supplied

Evaluation of an HIV/AIDS continuing education program.

An HIV/AIDS education model was implemented for rural nurses as a demonstration project in Georgia. The overall goal of the project was to increase the quality of and access to HIV/AIDS-specific services in rural communities. Public health and community nurses were the focus of this effort due to their current roles in providing health care to rural and underserved populations and their potential for networking across health care and social services agencies to form an HIV/AIDS response network. One hundred and seventy-five nurses completed the program. Program evaluations revealed that, after completing the HIV/AIDS course, participants' professional preparedness, attitudes toward people with HIV/AIDS, and knowledge had improved. Consistently, participants' scores in each of these areas increased from the pretest to the posttest. Additionally, nurses participating in the program reported in a follow-up survey that they felt better prepared to care for people with HIV/AIDS. While there is a need for further HIV/AIDS education in rural communities, results of the program support its potential use as a model for other rural communities.

Adult↗
PubMed1998

Factors associated with the initiation of smoking by Kuwaiti males.

PURPOSE: To estimate the age patterns in cumulative probability of smoking initiation among Kuwaiti adult males and to study the differentials in smoking initiation in relation to factors such as age-cohort, marital status, educational level, income, type of residence, and history of smoking among family members and friends. METHODS: A stratified three stage cluster sampling design was implemented for the selection of the sample. A self-administered questionnaire was completed by 1798 Kuwaiti adult males working in different ministries. RESULTS AND IMPLICATIONS: Of the 1798 respondents, 34.4% were classified as current smokers, 17.7% as former smokers and 47.9% as non-smokers. The highest probability of smoking initiation (among current and former smokers) was found for the age group 15-20 years, where almost 29% of the respondents initiated smoking. In the univariate analysis, marital status, education, income, type of residence, and history of smoking among family members and friends showed significant variation in the age-patterns of initiation. In the Cox proportional hazard regression model, education, type of residence, and history of smoking among family members and friends were found to be independently associated with the risk of initiation. The highest risk of initiation (Relative Risk (RR) = 1.85; 95% CI: 1.62-2.10) was found among those who had a history of smoking in family and friends. Individuals in the lowest education category (RR = 1.64; 95% CI: 1.32-2.04) and those residing in apartments (RR = 1.65; 95% CI: 1.43-1.92) were at a higher risk of initiation compared with those who had university education or those who resided in villas. The results of the study should prompt further efforts to develop tobacco control policies in Kuwait and the other Arabian Gulf countries to help establish norms for not initiating smoking through persistent messages to not start or to stop smoking. There is also a need to enhance awareness about the influence of smokers in family or friends on other people to initiate smoking.

Adolescent↗
PubMedDate not supplied

Career paths of geriatric nurse practitioners employed in nursing homes.

The career paths of geriatric nurse practitioners (GNPs) trained with support from the W. K. Kellogg Foundation through the Mountain States Health Corporation (MSHC) were studied. Under this program, GNPs were recruited from sponsoring nursing homes and returned to GNP positions in the sponsoring facilities following training. Training was carried out under a continuing education model offered through six university-based schools of nursing. Questionnaires were sent to the 111 GNPs trained. Of the 102 respondents, 97 provided complete information about past and present education, work experience, and job functions. The GNPs were women with a median age of 45 years, and they were employed in rural settings in the western United States. More than 45 percent of the nurses had at least a baccalaureate degree at the time of GNP training. The GNPs remained employed in long-term care positions that implemented the practitioner role. The median length of GNP employment in their first jobs after training was more than 4.5 years. The resignation rate from this first position was 1.66 resignations for each 10 years of GNP employment. Job changes were likely to be attributed to organizational changes with subsequent positions shifting toward a diversification of the GNP role. The study demonstrates the success of the MSHC program in introducing and retaining GNPs in nursing homes.

Career Mobility↗
PubMedDate not supplied

Current controversies in occupational medicine education in Europe.

The progressive implementation of the framework directive concerning occupational health and safety into che legislation of single European Union members is leading to changes in the role of occupational health professionals. It is important that Schools of Occupational Medicine contribute to training for competence and that occupational physicians continue to provide a high quality occupational health service in a changing environment. This could lead to a new and emerging role for the occupational physician, a key figure in prevention and health protection, capable not only to act as an expert but also as an advisor able to comply with employee and employer needs. The changing role of occupational physician will require new educational models which should allow the occupational physicians to be able to cope with problems and situations which can be encountered during their professional life. This will require a better harmonisation of educational and training programmes across the European Schools of Occupational Medicine. In fact, a variety of educational and training methods are currently adopted, although there is a substantial agreement about core values, core knowledge and core skills, which characterise the speciality.

Clinical Competence↗
PubMed1999

Youth living with HIV as peer leaders.

Community-based service providers often hire youth living with HIV (YLH) as peer leaders for delivering HIV education to uninfected adolescents. Life narratives were collected from 44 YLH during a hypotheses-generating two-year ethnographic study. About 30% of the youth were employed as peer educators. While 60% of the 44 youth had a lower-class background, only 23% of the peer leaders were lower class. One-fifth of the sample were female, but more than one-half of the peer leaders were female. After identifying and categorizing difficulties experienced by the peer leaders, a frequency count of each theme was conducted. Issues about professional boundaries were evident in 38.5% of the youth's narratives, indicating conflicts in their roles as peer leaders; 23% of the youth engaged in substance use and sexual behaviors that placed themselves and uninfected youth in their peer educator programs at risk; and 8% of the youth reported relapse while peer leaders. The observations suggest reconsideration or restructuring of existing peer-education models that employ YLH.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Interdisciplinary education for health professionals: issues and directions.

With the increasing use of the team approach in health care delivery, many patterns of team practice have evolved. There is cumulating concern about how comprehensive care can be delivered and how to train health professionals for this model. Educators and practitioners and examining and experimenting with approaches to holistic training. This paper summarizes some of the issues in interdisciplinary training of health professionals and makes a number of recommendations.

Clinical Competence↗