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PubMed2005

The effects of a family fitness program on the physical activity and nutrition behaviors of third-grade children.

This study examined the efficacy of a school-based exercise and nutrition program with a parent component. Third-grade children (N = 238) from six elementary schools participated in the study, with three schools randomly assigned to a program group and the other three schools to a control group. The program group received a health-related fitness school-based program and a home program that required parents and children to complete activities and earn points for nutrition and exercise activities. The control group received their traditional physical education and nutrition education program. Univariate analysis of variance on pre- and posttest scores were completed on the following variables: height, weight, body mass index, skinfold, blood cholesterol, mile run, exercise and nutrition knowledge, calories, protein, carbohydrates, total fat, saturated fat, dietary cholesterol, fiber, sodium, percentage of calories from carbohydrates, and percentage of calories from fat. At pretest, the treatment and control groups did not significantly differ on the measures using schools as the unit of analysis. Girls scored significantly higher than boys on skinfold and pretest knowledge. At posttest, the treatment group scored significantly higher than the control group on exercise and nutrition knowledge and significantly lower than the control group on total fat intake, using schools as the unit of analysis. There was no improvement in physiological measures, including blood cholesterol. The study demonstrated that schools can adjust curriculum to meet some health needs of students and achieve modest changes in exercise and nutrition knowledge and diet. The family component of the program provided a practical approach to improving physical activity and nutrition behaviors for elementary school teachers who teach many participants in a crowded curriculum.

Child↗
PubMed1989

The effectiveness of an AIDS education campaign on a college campus.

This paper reports on an AIDS education campaign at a California college campus. A pretest-posttest design was used to determine whether the AIDS-related attitudes of students, faculty, and staff were affected by an AIDS Awareness Week. The results showed that the awareness week was successful in exposing the campus community to AIDS information. It was only marginally effective in changing AIDS-related attitudes because pretest attitudes were already at desirable levels, only a fraction of the campus community attended the highly motivating events of the campaign, and faculty did not actively support the goals of the campaign.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Does writing about the bereavement lessen grief following sudden, unintentional death?

Writing about traumatic events produces improvement in an array of areas including physical and psychological functioning. To see if these improvements extended to improved bereavement recovery after the accidental or homicidal death of a loved one, 64 undergraduates (51 women, 13 men) began, and 44 completed, a writing project. At pretest, they completed measures of depression, anxiety, grief, impact, and non-routine health visits. Then, they were randomly assigned to write about either the bereavement experience (profound condition), or innocuous topics (trivial condition). They wrote for 15 minutes a day for four days, then completed the same measures a second time (posttest). Six weeks later, they were mailed the same measures again (follow-up). A 2 (CONDITION: Profound versus Trivial) x 3 (Time: Pre-, Post-, or Follow-up) MANOVA yielded a significant main effect for time, but no main effect for condition and no interaction. Follow-up ANOVAs indicated that, across conditions, from pretest to follow-up testing participants reported less anxiety and depression, less impact, greater grief recovery, but about the same health center visits. A 2 (CONDITION) x 4 (Writing Day) MANOVA and follow-up tests indicated that those in the profound condition reported less subjective distress from Day 1 to Day 3, compared to those in the trivial condition. Combined with Kovac and Range (1999), present results suggest that writing projects may be more beneficial to those experiencing the unique bereavement of suicidal death, rather than those experiencing the nonintentional death of a loved one by accident or homicide.

Accidents↗
PubMed2001

Breast disease and undergraduate medical education: a randomized trial to assess the effect of a home study module on medical student performance.

BACKGROUND: This study sought to demonstrate the effectiveness of a home study module (HSM) on student performance at a large urban medical school. METHOD: Second-year students were randomized to receive: 1) a HSM in addition to regular teaching of clinical breast examination or, 2) the regular teaching alone. The HSM included adult learning principles, problem-based learning, and practice guidelines. Students completed a pretest, a post-test, and course evaluation. The pre- and post-tests examined students' knowledge and comfort levels. RESULTS: Of 176 students, 136 agreed to participate and 127 completed both pre- and post-tests. Baseline pretest indicated no significant difference between the intervention and control groups. Post-test showed that students receiving the HSM gained significantly more knowledge than had the control group, and their comfort levels shifted nonsignificantly more. Student evaluations indicated perceived value of the HSM. INTERPRETATION: Student performance can be enhanced and comfort levels increased by providing a critical core of knowledge in the form of a HSM. This approach may be applicable to other important subjects.

Breast Diseases↗
PubMed2002

Impact of culturally, linguistically, and literacy relevant cancer information among Hispanic farmworker women.

BACKGROUND: This pilot investigation describes the impact of culturally, linguistically, and literacy relevant cancer information in terms of knowledge, satisfaction, comfort level, and intentional and actual breast/cervical cancer screening practices among Hispanic migrant and seasonal farmworker women. METHODS; Study phases were: 1) formative research; 2) instrument development and pretesting; and 3) pilot evaluation among 65 women using a one-group pretest-posttest design. RESULTS: Participants' reactions to the intervention were highly favorable. While an increase in knowledge (p < 0.001) was observed, no change in comfort was noted. Ninety-seven percent stated that they would be willing to miss a day of work (intent) to get a health check-up. CONCLUSION: Educational tools that are culturally, linguistically, and low-literacy can be promising interventions to promote awareness about breast and cervical cancer screening.

Adolescent↗
PubMed1992

A meal conference format to teach ambulatory nutrition concepts.

Third-year medical students participated in a program using a meal conference approach to teach ambulatory nutrition concepts called "Building Better Health Through Nutrition." The series of three interactive presentations was given during the required family medicine clerkship. A pretest and posttest were used to measure acquisition of nutrition knowledge. There was a statistically significant (P less than 0.05) average increase in posttest compared to pretest scores. Seventy percent of students rated the meal conference approach as "effective" or "very effective" and 76% stated that the series expanded their knowledge of nutrition's role in clinical medicine. We conclude that the meal conference format is an effective way to teach nutrition during the clinical years in medical school.

Ambulatory Care↗
PubMed1995

Using standardized patients to teach breast evaluation to sophomore medical students.

In response to the current emphasis on health maintenance and disease prevention, the authors developed a comprehensive education program in which sophomore medical students interview a standardized patient about breast problems and risk factors, receive one-on-one instruction from the standardized patient during the clinical breast examination, and practice recommendations for screening and instruction in breast self-examination. In this pilot study sophomore students who underwent the comprehensive education program were compared with students who received the traditional, didactic instruction and practiced on plastic breast models. The students who received the didactic instruction had mean scores on a multiple-choice knowledge-base pretest and posttest of 54.6% and 76.8%, respectively. The students who participated in the comprehensive education program had mean pretest and posttest scores of 51.2% and 78.5%, respectively. All students participated in a practical test of the clinical breast examination during an objective structured clinical examination. The students who had received the didactic instruction scored 69.9% (mean), compared with 84.1% for the students who had had the comprehensive education program. The comprehensive breast education program teaches medical students about risk factors, screening recommendations, and clinical breast examination more effectively than do traditional didactic methods.

Breast Neoplasms↗
PubMedDate not supplied

Education of paramedics regarding aspirin use.

OBJECTIVE: Paramedics (EMT-Ps) often care for patients having an acute myocardial infarction (AMI). The benefit of early administration of aspirin in AMI is well established. This study was undertaken to determine whether EMT-Ps are able to retain information regarding the use of aspirin in AMI after a standard didactic session. METHODS: The EMT-Ps from a suburban EMS system with an annual call volume of 4,000 were given a 12-question test regarding the out-of-hospital use of aspirin in AMI. They then received a 30-minute lecture about the use of aspirin in the out-of-hospital venue. Aspirin was then put into the treatment protocols for AMI. Three months after the educational session, a follow-up test was administered. A paired, two-tailed t-test was used to compare pretest and posttest scores with a p < or = 0.05 for statistical significance. RESULTS: The study was completed by 22 of 25 EMT-Ps. The scores on the pretest ranged from 50% to 100% correct, with an average score of 83%. The posttest scores ranged from 83% to 100%, with an average score of 94% (p = 0.002). The questions missed on the posttest were regarding: 1) the length of the effects of aspirin, 2) the bronchospastic effects of aspirin, and 3) the recently instituted indications for its out-of-hospital use. All paramedics correctly identified the contraindications to aspirin use. CONCLUSION: These results suggest that EMT-Ps can retain information regarding the out-of-hospital use of aspirin for AMI after a standard didactic session. Further study is needed to determine how this information is clinically applicable.

Aspirin↗
PubMedDate not supplied

Teaching ACLS stroke objectives to prehospital providers: a case-based approach.

OBJECTIVES: To determine whether a case-based educational module would increase prehospital care providers' short-term and long-term knowledge about stroke and to compare the educational impact when the module was moderated by a physician versus an advanced cardiac life support (ACLS) instructor. METHODS: A stroke module consisting of two case-based scenarios was administered to emergency medical services (EMS) personnel by either an ACLS instructor or a physician. Identical 25-question tests (based on 1997 ACLS prehospital stroke objectives) were administered before and after the module. Descriptive statistics were calculated by groups, and Wilcoxon tests were used to assess the significance of improvement in scores based on the paired data. RESULTS: Two hundred six EMS personnel [112 (54%) emergency medical technician (EMT)-P, 91 (44%) EMT-B/EMT-I, and three (2%) other training levels] participated in the module, of whom 74 [30 (41%) EMT-P, 42 (57%) EMT-B/EMT-I, and two (2%) other training levels] participated in follow-up testing between six and seven months. Overall, there was a 32% improvement in test scores immediately after completion of the module (p < 0.001) and an 18% improvement at six months (p < 0.001). No significant difference in pretest scores existed between the physician-led and ACLS instructor-led groups (mean EMT-P pretest scores 69% versus 70% and EMT-B/EMT-I scores 55% versus 54%, respectively). There was no significant difference in short-term (p = 0.36) or long-term (p = 0.074) score improvements between the two groups. CONCLUSION: This case-based approach to EMS stroke education is effective and can achieve equal benefit when administered by a physician or an ACLS instructor.

Advanced Cardiac Life Support↗
PubMedDate not supplied

Effectiveness of a simple Internet-based disaster triage educational tool directed toward Latin-American EMS providers.

BACKGROUND: A previous survey demonstrated a lack of standardization related to disaster triage among Latin-American providers. OBJECTIVE: To assess the effectiveness of a short Internet-based educational intervention in disaster and mass-casualty triage. Using three Spanish Internet emergency medical services (EMS) forums, Latin-American providers were invited to participate in the study. The tool consisted of two educational modules: an introduction to disaster triage module and a START (simple triage and rapid treatment) module. Pre- and post-intervention tests were administered, each consisting of five standardized scenarios. Factorial analysis was used to measure the weight of each scenario. The first and fifth scenarios were identical for intraclass correlation. Skill retention was assessed through a one-month follow-up survey. Statistical analysis was performed using chi-square and Fisher's exact test. A total of 55 EMS providers participated in the study. Five of 55 (9.1%) participants correctly answered four or more scenarios on the pretest intervention, compared with 53 of 55 (96.4%) on the posttest [p < 0.001, relative risk 10.60 (95% CI 4.59-24.49)]. Similar findings were obtained for those accurately triaging all five scenarios, with zero of 55 (0%) in the pretest compared with 49 of 55 in the posttest (p < 0.001). Follow-up at one month was 69%. Four or more scenarios were correctly answered at follow-up by 34 of 38 (89.5%) respondents. No significant difference was noted compared with the immediate post-course survey (p = 0.18). Although initial ability of the cohort to accurately triage patients was suboptimal, a short Internet-based educational tool significantly impacted the cohort's ability to perform triage in a simulated patient environment. This improvement was maintained after one month.

Disaster Planning↗
PubMed2005

Gender-specific computer-based intervention for preventing drug abuse among girls.

This study developed and tested a gender-specific intervention for preventing substance abuse among adolescent girls. Delivered on CD-ROM by computer, the program was compared with a conventional substance abuse prevention program delivered live in a group setting. Seventh-grade girls in New York City middle schools completed pretests, and, by school, were randomly assigned to receive either gender-specific computer intervention (GSI) or conventional intervention, and were posttested. Analyses of pretest to posttest gain scores showed GSI girls compared to girls receiving conventional intervention to possess a larger repertoire of stress-reduction methods, to report lower approval of cigarettes, alcohol, and drugs, to identify more unhealthy ways to deal with stress, to report lower likelihood of cigarette use or alcohol consumption if asked to do so by best friends, and to hold stronger plans to avoid cigarettes, alcohol, and drugs in the next year. These modest findings lend credence to the promise of gender-specific, computerized interventions for substance abuse prevention among adolescent girls.

Adolescent↗
PubMed1998

Genetic testing for breast-ovarian cancer susceptibility: a regional trial.

To evaluate receptivity to testing for a genetic susceptibility to breast-ovarian cancer, information is needed on the response when the offer is open to all qualifying women in a given region. To qualify in this trial, a woman who had not had breast or ovarian cancer had to have at least two first-degree relatives or one first- and one second-degree relative with breast and/or ovarian cancer, whereas a woman who had had breast or ovarian cancer had to have at least one first-degree relative with breast or ovarian cancer and a first- or second-degree relative without cancer willing to be tested. Of 140 women qualifying and interested enough to return questionnaires requesting baseline information, 111 were referred by their physician and 29 were identified from a regional tumor registry. Of these 140, 112 came for pretest education and 98 of these chose to be tested. Thus, the acceptance rate was 70% for all those returning baseline questionnaires, but 88% for those interested enough to come for pretest education. The most common reasons for accepting testing were to take extra precautions if a mutation were found (42.9%) and to determine if offspring were at risk (24.5%). The most common reasons for declining were anxiety and absence of specific interventions. Factors predicting who chose testing were years of education (p < 0.005) and family closeness (p < 0.02). Fourteen deleterious BRCA1 or BRCA2 mutations were found in 13 of the 87 families actually tested. If the criteria for testing had been three or more affected family members rather than two or more, the number of families tested would have been reduced by 46%, but the number of families found to have a deleterious mutation would have been reduced by only 9%.

Adult↗
PubMed2005

Genotype-based screening for hereditary hemochromatosis: II. Attitudes toward genetic testing and psychosocial impact--a report from a German pilot study.

In collaboration with the German Sickness Fund (Kaufmännische Krankenkasse-KKH), we conducted a pilot study on DNA-based population screening of hereditary hemochromatosis (HH) in Germany. The health insurance organization KKH briefly informed their members about the possibility to participate voluntarily in this pilot project. A total of 5882 KKH members contacted us and received detailed information on the aim of the project and clinical and genetic aspects of HH. Of these individuals, 3961 requested HFE genotyping. After genotype results had been communicated to the participants' general practitioner, we sent a self-administered questionnaire to all homozygous (n = 67) and heterozygous (n = 485) as well as 448 wild-type study participants (sigma = 1000) to assess the psychosocial impact of HFE genotyping. In addition, questionnaires were sent to 8000 randomly selected members of the KKH to investigate their attitude toward genetic testing. Six hundred thirty-one (63.1%) of the test participants and 2141 (26.8%) of the randomly chosen KKH members responded. A total of 59.1% of the members would generally accept predictive genetic testing and 3.7% objected to such tests in principle. Individuals with higher educational status accepted predictive testing significantly more often than individuals with less education. Of the tested individuals, 69.9% thought that participation in the pilot study was probably beneficial for them and 1% (5 heterozygotes and 1 wild-type) thought that it was probably harmful. Of the participants, 94.6% judged their decision to have participated in the pilot study as right and 0.3% (2 heterozygotes) as probably wrong. Only very few of the tested individuals underwent pretest (1 case) or posttest (11 cases) genetic counseling. We conclude that genotype- based screening for HH is generally accepted and was perceived as beneficial. Negative psychosocial consequences are rare and could presumably have been prevented by delivering appropriate pretest and posttest information.

Attitude↗
PubMed2006

End-of-life care: a retreat format for residents.

BACKGROUND: The challenge of teaching end-of-life care involves finding ways to incorporate both the science and the art of medicine. OBJECTIVES: To develop a curriculum so that internal medicine residents could more effectively (1) elicit patient's values, goals, and preferences for health care at the end of life, (2) communicate "bad news," (3) discuss patient preferences for nutrition and hydration, ventilator withdrawal, and cardiopulmonary resuscitation, (4) prescribe opioids using different routes of administration and, (5) recommend appropriate treatment of symptoms common at the end of life. DESIGN: The daylong retreat utilized case presentations and problems for presenting scientific content and the film Wit to convey information related to communication, whole-patient assessment, and the palliative care approach. Materials from the Education for Physicians on End-of-Life Care (EPEC) project and the film Wit provided the main educational resources. SETTING: All second-year internal medicine, and family medicine residents, and geriatric fellows from a community hospital in South Carolina attended. RESULTS: The residents positively evaluated the seminar content and format. Pretests and posttests revealed that residents significantly improved their knowledge regarding pain management (p<0.001), symptom management (p<0.001) and whole-patient assessment (p<0.014). Scores on the pretest and posttest related to communication skills did not significantly change (p=0.092). Yet, qualitative postretreat evaluations showed that residents perceived that the retreat would affect their communication with patients and other less easily quantifiable factors. CONCLUSION: Quantitative methods that work well for documenting scientific principles and learning may not apply as well in assessing the art of medicine.

Curriculum↗
PubMed1989

Dietary fructose or starch: effects on copper, zinc, iron, manganese, calcium, and magnesium balances in humans.

A balance study was conducted to assess the effects of consuming low-copper diets, high in fructose or cornstarch. The study involved 19 apparently healthy males, aged 21-57 y. The two experimental diets averaged 0.35 mg Cu/1000 kcal and provided 20% of the calories from fructose or cornstarch. Cu, zinc, calcium, magnesium, and iron balances were determined 1 wk before the study (pretest) when the subjects consumed self-selected diets and after consuming the experimental diets for 6 wk. No major differences in mineral balances were evident between the two groups during the pretest study when the subjects ate self-selected diets. In contrast, when fed the test diets, the group consuming the low-Cu fructose diet had significantly more positive balances for all minerals studied than the group fed the low-Cu cornstarch diet. The results indicate that dietary fructose enhances mineral balance.

Adult↗
PubMed1998

Teaching the clinical interpretation of peripheral blood smears to a second-year medical school class using the PeripheralBlood-Tutor computer program.

The interpretation of peripheral blood smears has an important role in the diagnosis of hematologic diseases and is, therefore, part of the education of physicians and technologists. We describe a computer program, PeripheralBlood-Tutor (Lippincott-Raven, Philadelphia, Pa), that teaches the morphologic features of normal and abnormal peripheral blood smears; we also describe the evaluation of the effectiveness of the program in 133 second-year medical students who were required to use the program in their hematology course. The version of the PeripheralBlood-Tutor used in the study had 2 distinct but equivalent 20-question examinations; one examination, the pretest, was taken before the students viewed the contents of the program, and the other examination, the posttest, was taken after completing the program. The mean score on the pretest was 61% (SD, 14%), the mean on the posttest was 91% (SD, 10%), and the improvement was significant. In addition, 4 questions about peripheral blood smears, which were based on printed images, were administered at the end of the hematology course. The students scored an average of 2.75 (SD, 0.86), and a positive correlation was found between these scores and the scores on the Tutor posttest. The results of the study suggest that PeripheralBlood-Tutor is feasible to implement, and it helps students learn to interpret peripheral blood smears. The use of PeripheralBlood-Tutor is now a requirement in the medical school curriculum, the medical technology program, and the pathology residency at the University of Washington, Seattle.

Blood Cell Count↗
PubMed2002

An intervention program for promoting deaf pupils' achievement in mathematics.

Our past research identified two aspects of deaf children's functioning that places them at risk for underachievement in mathematics. The first is their reduced opportunities for incidental learning, and the second is their difficulty in making inferences involving time sequences. This article examines the effectiveness of an intervention program to promote deaf children's numeracy that was designed to deal with these two factors. The design involved a comparison of 23 deaf pupils participating in the project with a baseline group formed by 65 deaf pupils attending the same schools in the previous year. The project pupils were tested before and after the intervention on the NFER-Nelson Age Appropriate Mathematics Achievement Test. The intervention was delivered by the teachers during the time normally scheduled for mathematics lessons. The project pupils did not differ from the baseline group at pretest but performed significantly better at posttest. They also performed at posttest better than expected on the basis of their pretest scores, according to norms provided by the NFER-Nelson Age Appropriate Mathematics Test for assessing the progress of hearing pupils. We conclude that the program was effective in promoting deaf pupils' achievement in numeracy.

Journal Article↗
PubMed2003

Can the Emotion Recognition Ability of Deaf Children be Enhanced? A Pilot Study.

We evaluated the effectiveness of an 11-lesson psychoeducational program designed to enhance the ability of deaf children to understand the emotional experience of themselves and other people. The "Funny Faces Program" was provided to 14 children, aged 9 to 13, with moderate to profound hearing impairments. All children were enrolled in an "oral" education program at a school for the deaf. Alternate forms of the Emotion Recognition Scales (Dyck, Ferguson, & Shochet, 2001) were administered at pretest and posttest. Results indicate significant increases in emotion vocabulary and emotion comprehension but not in the speed or accuracy of emotion recognition (ER), from pretest to posttest. At posttest, children whose hearing loss was moderate to severe did not differ from hearing children in ER abilities but children with profound hearing loss continued to show substantial ability deficits.

Journal Article↗