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PubMed1988

The design of school furniture for Hong Kong schoolchildren. An anthropometric case study.

Anthropometric data of Hong Kong schoolchildren have been collected and analysed in order to develop recommendations for the design of chairs and tables for use in Hong Kong Government coeducational schools. The anthropometric data for Hong Kong have been compared with data from a Western population (United Kingdom) and another Asian population (Japan). Five sizes of chair and table combinations have been proposed to accommodate six primary and seven secondary forms (pupils aged from 6 to 18 years). The recommended design dimensions, based on the anthropometric characteristics of the Hong Kong target populations, are discussed in relation to recommendations from previous research in this area.

Journal Article↗
PubMed1989

Smoking history and attitudes of nurses at a large tertiary care facility.

A study of the smoking behavior of nurses working at a large tertiary care facility with a major cancer program was conducted to address the issue of smoking in the health care professional. The study focused on the attitudes of nurses regarding cigarette smoking, their personal smoking behavior, their perception of the role of health care providers as behavioral models for patients, and their perception of the impact of a patient or professional smoking in a health care setting. Over 500 surveys were distributed to nurses at the facility and the response was analyzed by the demographic characteristics of the nurses and the areas of the facility in which they worked. Results of the study address several considerations. The prevalence of smoking among nurses and the association with specific demographic characteristics are compared to women in the general population. The nurse's perception of the profession's role as behavioral model for the patient is measured and analyzed for impact on personal smoking behavior. Future smoking cessation programs can be designed for nurses based on these findings. Specific target populations can be identified for special assistance in antismoking efforts.

Adult↗
PubMed1997

Outcome of African American men screened for prostate cancer: the Detroit Education and Early Detection Study.

PURPOSE: Will early detection impact on stage of disease and recurrence of prostate cancer in a high risk population? We initiated a community based study to educate and recruit African American men for early diagnosis of prostate cancer, that is the Detroit Education and Early Detection (DEED) study. Our objective was to evaluate our recruitment process for this target population, examine the percentage of organ confined prostate cancer in men undergoing radical prostatectomy and measure recurrence biochemically. MATERIALS AND METHODS: A community based study from February 1993 to February 1995 through the African American churches in metropolitan Detroit was initiated. We compared the early detection group treated with radical prostatectomy to the population presenting to our urological clinic during the same period. We tested and followed 1,105 African American men using the prostate specific antigen blood test. RESULTS: Pathologically organ confined prostate cancer was diagnosed in 11 of 17 men (65%) who underwent radical prostatectomy in the DEED project. Within the clinic population 35% of the African American men were diagnosed with pathologically organ confined prostate cancer. The difference between the 2 populations was statistically significant (p = 0.033). Disease recurred in 1 of 15 (7%) and 39 of 157 (25%) men in the DEED and clinic populations, respectively (p = 0.97). CONCLUSIONS: We demonstrated our ability to recruit African American men into a prostate cancer early detection program. We diagnosed early but clinically significant prostate cancers among African American men with characteristics similar to prostate cancers diagnosed in other early detection studies in which the overwhelming majority of men were white.

Aged↗
PubMed1987

Management of insecticide resistance in control of the Simulium damnosum complex by the Onchocerciasis Control Programme, West Africa: potential use of negative correlation between organophosphate resistance and pyrethroid susceptibility.

1. Resistance of some populations of the Simulium damnosum complex to temephos (100-fold at the LC50 level), with degrees of cross-resistance to chlorphoxim (14-fold) and other organophosphate insecticides, follows intensive larvicidal control of S. damnosum s.l. in West African river systems since 1975 by the WHO Onchocerciasis Control Programme. 2. Larvae of at least three sibling species of the S. damnosum complex have become organophosphate-resistant: these are the forest species S. sanctipauli Vajime & Dunbar and the savanna species S. sirbanum V. & D. and S. damnosum Theobald sensu stricto. 3. Organophosphate-resistant S. damnosum s.l. larvae show increased susceptibility to some organochlorine and pyrethroid insecticides, especially to permethrin (up to 11-fold) and OMS 3002 (up to 17-fold), as compared with organophosphate-susceptible populations. 4. This differential susceptibility is reflected by increased pyrethroid efficacy in operational use for river treatments against organophosphate-resistant field populations of S. damnosum s.l. larvae. Treatment of 100 km of the lower Bandama River in 1985 showed that permethrin at the highly selective dosage of 10 min exposure to 0.01 mg/l caused reversion towards organophosphate-susceptibility of the target population of S. sanctipauli. This effect was less pronounced when the Comoe River was treated at the lower dosage of 0.005 mg/l for 10 min. 5. To overcome temephos-resistance, it is proposed that the most rational usage of currently available larvicides would involve the following annual sequence of treatments: Bacillus thuringiensis serotype H-14 when river discharge is below 75 m3/s; chlorphoxim for about eight weekly treatment cycles after river discharge rises; permethrin (or alternative pyrethroid) for up to six treatment cycles--this should eliminate any incipient selection for chlorphoxim-resistance; resume chlorphoxim (or perhaps carbosulfan) treatments until river discharge falls below 75 m3/s permitting resumed use of B.t. H-14.

Africa, Western↗
PubMedDate not supplied

The Tribal Health Initiative model for healthcare delivery: a clinical and epidemiological approach.

BACKGROUND: Tribal populations generally have poor health outcomes, often because of a healthcare delivery system that does not cater to their needs. This study evaluates a current healthcare model for tribals, and explores it in combination with the health status of the target population, placing emphasis on the long term sustainability and cross-implementation of the model. METHODS: We examined the health system from the perspective of the base hospital, by concentrating on mortality patterns, inpatient incidence of selected infectious and non-infectious illnesses, and the preventive and curative health services administered by the hospital to the community. RESULTS: Gender susceptibility patterns revealed disparities in anaemia and tuberculosis besides fluctuations in gastrointestinal disorders, tuberculosis and typhoid. A combination of gender- and age-susceptibility patterns revealed specific age intervals for mental health-related disorders. Mortality patterns indicated an Increase in youth deaths and suicide, with an overall reduction in infant mortality. However, an increased tribal confidence in allopathic medicine was noted after implementation of the health system. CONCLUSION: The base tribal hospital is important in administering primary and secondary healthcare, health education, disease surveillance, community outreach and for continued confidence in allopathic medicine. Diet-based morbidities may be combated via organic farming and banning local alcohol production, while anaemia may be combated through continued iron, salt and folic acid supplementation to women. The formulation of mental health programmes and long term educational initiatives at the village level are critical to reducing suicide and infant mortality. Further epidemiological studies are required to gain a complete picture of health within the population, and successful implementation of the model elsewhere must factor in sociocultural disparities among tribes.

Adolescent↗
PubMed1998

Patients' attitudes to prostate cancer.

OBJECTIVE: To ascertain the knowledge of and attitudes to prostate cancer among older men in a general practice population. METHOD: All men aged 40 years and older attending a solo suburban general practice during a 12 month period were invited to take part in the study. RESULTS: A total of 353 completed questionnaires (99.4%) were obtained from a targeted population of 355. The major areas of knowledge deficiency were in prostate gland function and possible side effects of treatments used for cancer management. The vast majority were in favour of getting rid of the cancer even if this resulted in incontinence or impotence. A sizeable minority (22.4%) would prefer aggressive treatment rather than 'watchful waiting' even if their cancer was slow growing. CONCLUSION: Despite heightened public awareness about prostate cancer in recent years, significant deficiencies exist in patients' knowledge about the condition. General practitioners, as the point of first contact with the health system, have a major role to play in ensuring their prostate cancer patients are well informed about the nature of the condition and the treatment options available.

Adult↗
PubMed2005

Impact of water supply, domiciliary water reservoirs and sewage on faeco-orally transmitted parasitic diseases in children residing in poor areas in Juiz de Fora, Brazil.

The objectives of this study were to characterize faeco-orally transmitted parasitic diseases and to identify the factors associated with these diseases, with emphasis on environmental factors, in children ranging from 1 up to 5 years old residing in substandard settlement areas. A population-based cross-sectional epidemiological design was used in a non-random selection of 29 out of the 78 substandard settlement areas in the municipality of Juiz de Fora, Brazil. A sample of 753 children were assessed from the target population consisting of all children of the appropriate age range residing in the selected areas. Data were collected by means of domiciliary interviews with their mothers or with the person responsible for them. The Hoffmann-Pons-Janer method was used in the parasitological examination of faeces. Binary logistic regression models were used to identify the factors associated with the diseases. A total of 319 sample children presented faeco-orally transmitted parasitic diseases. The factors associated with these parasitic diseases included the children's age, family income, number of dwellers in the domicile, consumption of water from shallow wells, consumption of water from natural sources, absence of covered domiciliary water reservoirs, and the presence of sewage flowing in the street.

Brazil↗
PubMed1991

Silent mutations in the phenylalanine hydroxylase gene as an aid to the diagnosis of phenylketonuria.

Direct sequencing of the phenylalanine hydroxylase (PAH) gene indicated the existence of silent mutations in codons 232, 245, and 385, linked to specific RFLP haplotypes in several Caucasian populations, namely Germans, Bulgarians, Italians, Turks, and Lithuanians. All three mutations create a new restriction site and can be easily detected on PCR amplified DNA. The usefulness of the silent mutations for diagnostic purposes depends on the haplotype distribution in the target population. The combined analysis of these markers and one or two PKU mutations forms a simple panel of diagnostic tests with full informativeness in a large proportion of PKU families, which helps to avoid the problems of genetic heterogeneity and of prenatal genomic Southern blot analysis.

Base Sequence↗
PubMed1996

Large bowel adenomas: markers of risk and endpoints.

In many large bowel chemoprevention trials adenomas have a double duty: they are used to identify subjects at risk for large bowel neoplasia, and also serve as endpoints. Many features of adenomas make them suitable for these tasks. Patients with adenomas are fairly numerous and easy to identify; further, the 'adenoma-carcinoma' sequence suggests that adenomas are logical endpoints. The high recurrence risk among adenoma patients means that a relatively modest number of subjects will suffice for adequate statistical power. The are some limitations to the use of adenomas, however. There is clearly heterogeneity of risk for subsequent cancer. Patients with only small adenomas may have rates of colorectal cancer that are not much greater than those of the general population. Certainly subjects with large adenomas, and those with villous or highly dysplastic adenomas have a higher risk. Often, one would chose the high-risk patients for preventive interventions. Such a strategy makes sense from a risk-benefit point of view. However, from a population perspective, such a strategy may well have only a minor impact on the overall colorectal cancer burden. For more complete population-based prevention, efforts will have to be directed to the numerous individuals who are each at small risk, but who collectively account for most colorectal cancer. For this preventive approach, patients with any adenoma would certainly be part of the target population, and so are sensible subjects in chemoprevention trials. There are similar complexities in consideration of the use of adenomas as endpoints of chemoprevention trials. The adenomas that occur in prevention trials are generally small, and may not be associated with a greatly increased cancer risk. The issue for chemoprevention trials however, is not whether the endpoints are truly intermediate in the causal chain-but whether the intervention under study alters the adenoma recurrence risk to the same extent as it does for colorectal cancer risk. This is a difficult matter to verify, but the limited data available are encouraging. The epidemiology of colorectal adenomas (largely small adenomas) is similar in many regards to that for colorectal cancer itself. Thus to the extent that data are available, one can tentatively conclude that external influences affect adenomas and colorectal cancer similarly. To date, more than ten adenoma prevention trials have reported results. The data have been fairly consistent. Vitamin C (with or without vitamin E) has provided at most a modest protective benefit, except in one small trial in which it was combined with vitamin E and preformed vitamin A. beta-Carotene seems to be without any effect, and interventions to increase fiber and decrease fat intake have not indicated substantial effects. On the other hand, trials among familial polyposis patients have provided evidence for an impact of nonsteroidal anti-inflammatory drugs. Studies in progress have the potential to clarify greatly the preventive potential of the currently promising-but yet unproven-chemopreventive regimens.

Adenoma↗
PubMed2006

Germline mutations of the hMLH1 and hMSH2 mismatch repair genes in Belgian hereditary nonpolyposis colon cancer (HNPCC) patients.

BACKGROUND: Hereditary nonpolyposis colon cancer (HNPCC-Lynch syndrome) is caused by mutations in genes involved in DNA mismatch repair (MMR), mostly in the hMLH1 and hMSH2 genes. The mutation spectrum in the Belgian population is still poorly documented. AIM: To report our experience on the mutation screening in Belgian familial colorectal cancer (CRC) patients, including the investigation of the pathogenicity of the missense and splice mutations. To increase the mutation detection rate by selecting the target population. METHODS: Two hundred and twenty five Belgian patients with familial clustering of CRC were genetically tested. Point mutations in the hMLH1 and hMSH2 genes were screened by denaturing gradient gel electrophoresis (DGGE) followed by direct sequencing. Genomic deletions and duplications were assessed by multiplex ligase dependent probe amplification (MLPA) and multiplex PCR. Missense mutations were examined for pathogenicity by means of cosegregation of the mutation with the disease, microsatellite instability (MSI) in tumors, immunohistochemical staining of tumors and determination of the population frequency of the particular mutation. RESULTS: Twenty five pathogenic mutations were identified from which 16 were novel: 7 frameshifts, one in frame deletion, 5 genomic deletions, 5 splice defects, 4 nonsense (stop) mutations and 3 missense mutations which were classified as pathogenic (out of 10 missense mutations). In retrospect, a mutation detection rate of 71% was obtained if MSI was used as a supplementary selection criterion in addition to familial clustering. CONCLUSION: Different types of pathogenic mutations in the hMLH1 and hMSH2 genes were identified in a Belgian CRC group with familial clustering. The mutation detection yield drastically increased by preliminar selection of those familial CRC patients with a microsatellite instable tumor. Considerable attention went to the assessment of the pathogenicity of the missense mutations. In practice, the cosegregation with the disease was the most relevant criterion.

Adaptor Proteins, Signal Transducing↗
PubMed2004

Assessing multiple risk behaviors in primary care. Screening issues and related concepts.

The concept of behavioral risk refers to health behaviors that increase the likelihood of a variety of illness conditions. With increased scientific research, it has become clear that this concept is useful in understanding the linkage between behavior and health. This paper reviews scientific, conceptual, and practical issues related to the identification of health risk behaviors in primary care. It includes both a literature review and an analysis of the feasibility of screening and health risk appraisal from a public health perspective, giving special attention to four behavioral risk factors: cigarette smoking, alcohol misuse, physical inactivity, and unhealthy diet. The review indicates that there are a wide variety of acceptable screening tests that can be used for population screening programs, and a large number of health risk appraisal instruments to employ in medical and work settings where preventive health services are available. Given the variety of available assessment procedures, the choice of a given instrument will depend on the target population, the purpose of the program, the time available for assessment, and a number of other practical considerations, such as cost. Multiple risk factor screening is feasible, but there is no single instrument or procedure that is optimal for all risk factors or populations. Based on the results of this review, the specific test or combination of tests is less important than the use of screening to make both patients and healthcare providers more aware of the critical importance of monitoring behavioral risk factors on a routine basis. We conclude that while further research and development work needs to be done, sufficient progress has been made to warrant a more ambitious effort that would bring behavioral risk factor screening into the mainstream of preventive medicine and public health.

Alcohol Drinking↗
PubMed2006

Knowledge and beliefs about end-of-life care and the effects of specialized palliative care: a population-based survey in Japan.

To clarify the knowledge and beliefs of the Japanese general population related to legal options, pain medications, communication with physicians, and hydration/nutrition in end-of-life care, and to explore the associations between end-of-life care they had experienced and these beliefs, a questionnaire survey was conducted on two target populations: 5000 general population subjects and 866 bereaved family members of cancer patents who died in 12 palliative care units in Japan. The respondents were requested to report the legal knowledge about end-of-life options, pain-related beliefs, communication-related beliefs, and hydration/nutrition-related beliefs, and their experiences with end-of-life care. A total of 3061 responses were analyzed (effective response rate, 54%). The respondents were classified into six groups: no bereavement experience (n = 949), those who had lost family members within the past 10 years from noncancer diseases at institutions (n = 673), those who lost family members from noncancer disease at home (n = 264), those who lost family members from cancer at institutions other than palliative care units (n = 525), those who lost family members from cancer at home (n = 86), and those who lost family members from cancer at palliative care units (n = 548). Across groups, 32-45% and 50-63% of the respondents stated that treatment withdrawal and double effect act were legal, respectively. Between 34% and 44% believed that cancer pain is not sufficiently relieved, 27-38% believed that opioids shorten life, and 24-33% believed that opioids cause addiction. Communication-related beliefs potentially resulting in barriers to satisfactory end-of-life discussion were identified in 31-40% ("physicians are generally poor at communicating bad news") and in 14-25% ("physicians are not comfortable discussing death"). The bereaved family members of the patients who died in palliative care units were significantly more likely than the other groups to believe that cancer pain is sufficiently relieved, and significantly less likely to believe that opioids shorten life, that opioids cause addiction, that physicians are generally poor at communicating bad news, and that physicians are uncomfortable discussing death. Between 33% and 50% of the respondents, including families from palliative care units, believed "artificial hydration should be continued as the minimum standard until death," while 15-31% agreed that "artificial hydration relieves patient symptoms." A significant proportion of the Japanese general population has beliefs about legal options, pain medications, and communication with physicians that potentially result in barriers to quality end-of-life care. As their experiences in specialized palliative care significantly influenced their belief, systematic efforts to spread quality palliative care activity are of value to lessen these barriers and achieve quality end-of-life care.

Adult↗
PubMed2004

Adolescent and adult pertussis vaccination: computer simulations of five new strategies.

Approximately one million adult pertussis cases occur annually in the US, and infants still die from pertussis. Computer simulations were used to predict the impact of vaccination of children, adults and/or adolescents, and household members of newborns (cocoon strategy). Childhood vaccination greatly reduced cases in children, but increased the incidence in adolescents and adults. Routine adolescent and adult vaccination had a large direct effect, whereas the cocoon strategy had a predominantly indirect effect on young infants. The number needed to vaccinate (NNV) to prevent a case of typical pertussis in the entire population was lowest for the adolescent strategy. The cocoon strategy had the lowest NNV to prevent a case of typical pertussis in young infants. The current vaccination schedule, local epidemiological data, age-specific cost of pertussis cases, and accessibility of the target population will determine which strategy has the highest likelihood of success in achieving the public health goal.

Adolescent↗
PubMed2006

Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study.

BACKGROUND: Convulsive status epilepticus is the most common childhood medical neurological emergency, and is associated with significant morbidity and mortality. Most data for this disorder are from mainly adult populations and might not be relevant to childhood. Thus we undertook the North London Status Epilepticus in Childhood Surveillance Study (NLSTEPSS): a prospective, population-based study of convulsive status epilepticus in childhood, to obtain a uniquely paediatric perspective. METHODS: Clinical and demographic data for episodes of childhood convulsive status epilepticus that took place in north London were obtained through a clinical network that covered the target population. We obtained these data from anonymised copies of a standardised admission proforma; accident and emergency, nursing, ambulance, and intensive-care unit notes; and interviews with parents, medical, nursing, and paramedic staff. We investigated ascertainment using capture-recapture modelling. FINDINGS: Of 226 children enrolled, 176 had a first ever episode of convulsive status epilepticus. We estimated that ascertainment was between 62% and 84%. The ascertainment-adjusted incidence was between 17 and 23 episodes per 100,000 per year. 98 (56%, 95% CI 48-63) children were neurologically healthy before their first ever episode and 56 (57%, 47-66) of those children had a prolonged febrile seizure. 11 (12%, 6-18) of children with first ever febrile convulsive status epilepticus had acute bacterial meningitis. Conservative estimation of 1-year recurrence of convulsive status epilepticus was 16% (10-24%). Case fatality was 3% (2-7%). INTERPRETATION: Convulsive status epilepticus in childhood is more common, has a different range of causes, and a lower risk of death than that in adults. These paediatric data will help inform management of convulsive status epilepticus and appropriate allocation of resources to reduce the effects of this disorder in childhood.

Adolescent↗
PubMed2002

Exploring sex differences in case fatality in acute myocardial infarction or coronary death events in the northern Sweden MONICA Project.

OBJECTIVES: To investigate sex differences in reaching diagnosis, medical management and case fatality (CF) in acute myocardial infarction (AMI) in the population aged 35-64 years in northern Sweden. METHODS: Within the framework of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) Project, definite AMI was monitored in people aged 35-64 years from 1989 through 1995 (target population 510 000 in 1991). SETTING: In a population based coronary register, all coronary events were recorded in nine hospitals in 1989-95. RESULTS: The number of events included in the definite coronary myocardial infarction register was 2483 men and 669 women. On admission, a higher proportion of men with definite AMI had chest pain or ECG changes typical for AMI (P < 0.0001). Disagreement between clinical diagnosis and classification by MONICA criteria occurred more often in women (P=0.008). A significantly higher proportion of men was admitted in the coronary care unit and they were significantly more often treated with thrombolytics, nitroglycerine, beta-blockers, or antiplatelet agents. Women received significantly more diuretics, inotropics or calcium antagonists. Diabetes, conferring a worse prognosis, was more common in women (20 vs. 15%; P=0.003). Prehospital CF was significantly higher in men (24.1 vs. 18.3%; P=0.005), but in patients treated in hospital, the CF was significantly lower in men (12.7 vs. 21.2%; P < 0.001). Total CF was equal in men and women. CONCLUSIONS: Several factors contributing to the excess in-hospital CF in women were identified, including greater problems in diagnosis of AMI in women which may be one of the reasons for less intensive treatment in women. Differences in co-morbidity, most notably diabetes and medical treatment between men and women with acute AMI may also have played a part.

Adult↗
PubMed2004

Mammography screening in Switzerland: limited evidence from limited data.

QUESTIONS UNDER STUDY: In Switzerland controversy exists on how to summarise the evidence on the efficacy and effectiveness, as well as adverse effects, of mammography screening, and breast cancer mortality trends are often discussed in the context of the impact of mammography. PRINCIPLES/METHODS: Single-study publications, meta-analyses, and reports by international expert groups on mammography screening are reviewed. Breast cancer mortality trends from 1970-2000 are reported and discussed in the context of the Swiss screening situation. RESULTS: In Switzerland breast cancer mortality rates for female Swiss nationals aged 50-79 years fell between 1990 and 2000 by some 25% in all language regions. The data from randomised studies in large populations in several countries with well organised mammography programmes prompt the conclusion that participation in organised screening programmes with rigorous quality standards reduces breast cancer mortality. The achievable long-term reduction in breast cancer mortality ranges from 5-20% in the target population provided that appropriate diagnostic investigation and treatment are available. To achieve this in Switzerland 830 to 3300 women need to be invited to screening for ten years to prevent one death from breast cancer. The risk-benefit profile of mammography screening is likely to be less favourable if mammographies are performed outside the context of organised screening programmes. In Switzerland we are now confronted with growing regional disparities in access to screening mammography which is under systematic quality control. CONCLUSIONS: The decrease in breast cancer mortality in Switzerland is most probably due to treatment developments and changes in cause-of-death coding. Public health measures in Switzerland should aim at regulating quality control for screening mammography, monitoring mammography use and improving the information on mammography available to women. For an evidence-based decision regarding health insurance coverage of screening mammography in 2007, large gaps need to be filled. The current coexistence of systematic screening programmes and opportunistic screening, with distinct regional differences, provides a unique opportunity for research into the merits and drawbacks of the two approaches.

Aged↗
PubMed2006

Legacy of the Pacific Islander cancer control network.

The groundwork for the Pacific Islander cancer control network (PICCN) began in the early 1990s with a study of the cancer control needs of American Samoans. The necessity for similar studies among other Pacific Islander populations led to the development of PICCN. The project's principal objectives were to increase cancer awareness and to enhance cancer control research among American Samoans, Tongans, and Chamorros. PICCN was organized around a steering committee and 6 community advisory boards, 2 from each of the targeted populations. Membership included community leaders, cancer control experts, and various academic and technical organizations involved with cancer control. Through this infrastructure, the investigators developed new culturally sensitive cancer education materials and distributed them in a culturally appropriate manner. They also initiated a cancer control research training program, educated Pacific Islander students in this field, and conducted pilot research projects. PICCN conducted nearly 200 cancer awareness activities in its 6 study sites and developed cancer educational materials on prostate, colorectal, lung, breast, and cervical cancer and tobacco control in the Samoan, Tongan, and Chamorro languages. PICCN trained 9 students who conducted 7 pilot research projects designed to answer important questions regarding the cancer control needs of Pacific Islanders and to inform interventions targeting those needs. The legacy of PICCN lies in its advancement of improving cancer control among Pacific Islanders and setting the stage for interventions that will help to eliminate cancer-related health disparities. Cancer 2006. (c) 2006 American Cancer Society.

American Samoa↗
PubMed2000

International quit and win 1996: standardized evaluation in selected campaign countries.

BACKGROUND: Quit and Win '96 recruited 70,000 smokers in 25 countries. The participants tried to abstain from smoking for at least 4 weeks. All participating countries followed the jointly agreed rules. Half of the countries implemented the campaign nationally and half, regionally. METHODS: A 1-year follow-up study was conducted in the participating countries. The aim of this study was to provide a standardized evaluation based on data from eight European campaign sites. Three measures were used to evaluate the effectiveness of the campaigns. The first measure was the participation rate, which is the proportion of participants among the smoking population targeted in each site. The second measure was a cautious estimate for the continuous 1-year abstinence rate, which is the proportion of abstainers among the follow-up sample regarding all non-respondents as relapsed. Third was the measure of the population impact, which is the efficacy of the intervention multiplied by its reach, where the efficacy equals the abstinence rate and the reach equals the participation rate. RESULTS: The participation rates varied from 0.1 to 2%, being highest in North Karelia, Finland, and Pitka;auranta, Russia. The abstinence rates varied from 12 to 35%, being highest in Hungary, Ukraine, and Russia, where the prevalence of smoking is also relatively high. The population impacts varied from 0.02 to 0.5%, being highest in Pitka;auranta, where both the reach and the efficacy of the Quit and Win were relatively high. CONCLUSIONS: There was great variation in effectiveness, with population impact being affected more by participation rate than abstinence rate. Quit and Win contests are feasible interventions in diverse European populations. To improve the effectiveness, future campaigns should increase the reach of the intervention.

Adult↗