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PubMed1985

Enhancing marital sexuality: an evaluation of a program for the sexual enrichment of normal couples.

The popular but little researched sexual enrichment program developed by LoPiccolo and Miller was modified and the revised Enhancing Marital Sexuality (EMS) program was evaluated using the Sexual Interaction Inventory (SII) and the Dyadic Adjustment Scale (DAS). A pretest-posttest-follow-up control group design was used to assess the effectiveness of EMS in improving couples' sexual and marital satisfaction. Thirty-four couples were randomly assigned (with replacements) to either the no-treatment control condition or the 11-hour EMS program. Results indicated extensive short-term improvements in sexual satisfaction for both sexes and some short-term gains in marital satisfaction for couples. At 3-month follow-up, improvement was sustained on SII scales of perceptual accuracy for both sexes, and on self-acceptance and pleasure scales for females. No marital satisfaction gains were evident at follow-up. It was concluded that long-term sexual satisfaction gains, especially for females, justify the continued use and refinement of the EMS program. Findings also indicated that marital satisfaction may be too broad a category to be affected by educational training with as specific a focus as sexual enhancement. Suggestions are made for further research.

Adult↗
PubMedDate not supplied

Nurse entrance test scores: a predictor of success.

A program evaluation was conducted to determine if requiring higher scores on critical thinking components of the Nurse Entrance Test would have a positive effect on the percentage of students that could be retained in a diploma nursing program. The program evaluation revealed that using the Nurse Entrance Test as a tool for admissions screening, specifically portions of the examination that predict critical thinking, was effective in helping to predict success through level I nursing courses.

Attitude of Health Personnel↗
PubMed1991

Smoking cessation program preferences associated with stage of quitting.

The purpose of this article is to report results from three exploratory studies which examined smoker preferences for cessation program attributes associated with stage of quitting. Study 1 was a telephone survey of 205 randomly selected smokers, in "precontemplative," "contemplative," and "ready-for-action" stages of quitting, who were queried about their preference for a wide variety of cessation program attributes. Study 2 entailed a computer-assisted telephone interview of 218 smokers in the same three stages of quitting. Interview data were used for multiattribute utility analysis of (a) preference for specific program attributes, selected partially on the basis of Study 1 results; and (b) preference for six different types of cessation programs, evaluated through computer simulations. Study 3 replicated Study 2 procedures using a smaller mall intercept sample which allowed in-person interviews and the use of display materials. Results suggested that there are limited but potentially significant differences among smokers in the three stages concerning program attribute preferences (e.g., use of self-help vs. facilitator-led programs, inclusion of relaxation techniques, quitting cold turkey, strategies for gaining social support). Nonetheless, there were no statistically significant differences among the three subgroups in level of preference for the six types of programs evaluated. Implications of these preliminary results are discussed.

Adult↗
PubMed1993

Faculty development in family medicine. A reassessment.

The 16 Canadian departments of family medicine were surveyed to ascertain the availability and content of faculty development activities. The results suggest numerous changes since 1985 and a strong commitment to faculty development. With the consolidation of many faculty development activities to date, departments should now consider other methods of faculty development, broaden their activities beyond the current emphasis on "teaching skills," examine the possibility of integrating faculty development with faculty evaluation, and conduct more systematic program evaluations.

Canada↗
PubMed2004

Phenotypic and genetic influences on test-day measures of acetone concentration in milk.

The objectives of this study were to estimate heritability of acetone concentration in milk, based on monthly samples of milk obtained as part of a routine milk testing program, and to evaluate the feasibility of using such data in a genetic evaluation program for selection against ketosis incidence. Milk samples were collected from January to December of 1999 in herds enrolled in the Ontario Dairy Herd Improvement Association, and acetone concentration was measured using an inline chemical procedure. The original data included more than 50,000 records. Because ketosis is generally a problem during early lactation, only the single test with the fewest days in milk was retained. In addition, data were retained only for cows with pedigree information. The final data set included 10,375 records. Among these data, only 6.56% had detectable levels of acetone. Acetone data were log-transformed prior to statistical analysis. Simple ANOVA indicated that herd, parity number, days in milk, and month of test had significant effects on acetone concentration. Acetone levels increased with lactation number and were higher in early lactation. Three approaches were applied for genetic analysis. First, REML was used with a simple linear animal model. Then, a separate procedure used data augmentation and Gibbs Sampling to obtain continuously distributed underlying values for records with zero acetone concentration, and these data were analyzed with both an animal and sire model. Heritability of acetone concentration was less than 1% for all 3 analyses. Herd effects accounted for about 5% of the phenotypic variance. Low estimates of heritability were due either to low actual levels of genetic variance or inability to detect all of the genetic variance present, due to infrequent recording during the early part of the lactation. Genetic evaluation based on recording of acetone concentration on a monthly basis seems of little use as a selection tool to decrease incidence of ketosis.

Acetone↗
PubMed2001

Reliability and validity of the Digigraph 100 in orthodontic diagnosis.

Cephalometric analyses of lateral cephalograms allow important statements to be made on diagnosis and treatment planning. Such radiographs should, however, be taken with a considerable reduction in radiation exposure. With the Digigraph 100 (Dolphin Imaging Systems Inc., USA) a cephalometric technique based on distance measurements of emitted sonic signals is now available. This study was aimed at determining the degree to which this procedure can cope with the requirements of reliability and validity in the field of orthodontics. For this purpose 50 volunteers were examined by conventional cephalometry with manual tracing of lateral cephalograms as well as by sonic cephalometry, with Jarabak analysis in both cases. In addition an option was available for reading lateral cephalograms into the Digigraph by means of a radiograph evaluation program. The 31 evaluated parameters were subjected to modified statistical analysis. Good reliability was recorded in the range between 0.96 and 0.99 for eleven sonic cephalometric measurements, whereas 26 values were between 0.69 and 0.95. The validity was significantly lower in comparison to radiocephalometry. In particular, measurements related to landmarks which were difficult to access or could be only indirectly determined, such as the sella point, the articulare point or the apices of the incisors, proved to be weak points of sonic cephalometry. The device is thus indicated rather in the field of communication with the patient or for intermediate examination without radiation exposure. Cephalometry without radiation exposure would represent decisive progress in orthodontic diagnostics. However, some developmental work on the processing software or even the development of a specific sonic cephalometry which deliberately dispenses with parameters that are difficult to record with this procedure is still needed.

Adolescent↗
PubMed1987

Clinical and demographic features of patients admitted to a new chemical dependency program in New York City.

We reviewed the clinical and demographic features of all 128 patients who were admitted to a new 28-day in-patient chemical dependency program in New York City during the first six months of operation. The medical records were reviewed retrospectively. Alcohol, cocaine, heroin, marijuana and diazepam were the most common substances abused. Parenteral drug abuse at any time was reported by 51 (40%) of the 128 patients, and 42 (33%) were current parenteral drug abusers. Abusers of alcohol only were significantly older than parenteral drug abusers or non-parenteral drug abusers. Patients who were employed at admission had a significantly longer mean length of stay and a higher rate of completion of the program than those who were not employed. We conclude that: (1) parenteral drug abuse is likely to be commonly seen in chemical dependency programs serving middle-income patients in urban areas, (2) alcohol abusers are older than abusers of other drugs, (3) a higher educational level is associated with successful completion of the chemical dependency program, and (4) evaluation programs are needed in all types of chemical dependency treatment.

Adult↗
PubMed1995

Description and evaluation of a program for the early discharge of infants from a neonatal intensive care unit.

The effect of a cost-containment program focused on decreasing the lengths of hospital stay of high-risk neonates was assessed by comparison of discharge weights and lengths of stay for 257 study infants, discharged from a neonatal intensive care unit (NICU) after an early-discharge program began, with those of 477 control infants discharged during a prior 1-year period. Demographic data and costs, as well as data on emergency department use and hospital readmissions, were included in the comparisons. There was a significant decrease in mean discharge weight and length of stay for infants in the study group. During a 7-month period, an estimated 2073 days of hospital care and approximately $2,700,000 in hospital charges were saved, or $10,609 per infant discharged. The cost of instituting and maintaining the program was $120,413, or $468 per infant. Seven visits were made to the emergency department by the study infants during the first 14 days after discharge. One infant was readmitted for a 4-day hospital stay for suspected sepsis. Significantly earlier discharge of high-risk neonates produced a decrease in hospital charges without causing excessive morbidity. The success of the program was coincident and presumed related to the institution of multiple elements focused toward family support through early-discharge planning. The reduction in hospital charges was 30 times higher than program expenses.

Aftercare↗
PubMed1992

New methods for evaluating utilization management programs.

Blue Cross and Blue Shield of Massachusetts, Inc (BCBS), has developed two new methods for measuring the effect of utilization management (UM) in reducing unnecessary hospital use. The "program component" method measures the separate effect of preadmission review, concurrent review, and discharge planning. The "savable days" method produces a composite measure of the effectiveness of the program as a whole. The use of these two methods is illustrated with five years of utilization review data from the BCBS nongroup insurance product. The results can be used by operations managers and policymakers to measure the performance of individual UM components and the program as a whole, to establish goals and monitor program performance, to modify the program in response to changing utilization patterns, to assist in developing premiums, to establish risk-sharing agreements with employers or providers, and to demonstrate the effectiveness of the program for use in marketing.

Blue Cross Blue Shield Insurance Plans↗
PubMed2003

The measurement of influenza vaccine coverage among health care workers.

BACKGROUND: Annual influenza vaccination is recommended for health care workers in both the United States and Canada. Estimations of vaccine coverage are commonly used to evaluate these vaccination programs. PURPOSE: We identify, discuss, and illustrate challenges including definitions of health care worker (HCW), selection of indicators, and data sources in the estimation of staff influenza vaccination coverage rates. METHODS: To illustrate the impact of the factors we discuss, we created a database of a simulated pool of HCWs that included varying proportions of permanent, casual, and contract staff under differing scenarios of staff turnover and differing probabilities of individuals being vaccinated. The Excel 97 random number generator (Microsoft) was used to randomly allocate the HCW to different strata under differing staff turnover rates and to designate individuals as being vaccinated. RESULTS: The nature of the staff targeted in the program policy has a large impact on the estimations of vaccine coverage. Different indicators provide data that might be useful for different purposes. The counts in the numerator and denominator of a period prevalence may be useful for estimation of the total workload required of the vaccination program. An incidence density might be useful as an indicator of the efficiency of the program in "capturing" staff for vaccination. The indicator that may be easiest is the point prevalence. CONCLUSION: Program evaluators must think carefully when planning to estimate staff vaccination coverage to avoid invalid comparisons of estimates over time and place. State or province-wide targets for health care worker (HCW) vaccination may be meaningless unless appropriate criteria for the calculation of influenza vaccination rates are developed and specified.

Allied Health Personnel↗
PubMed2000

Watch, Discover, Think, and Act: a model for patient education program development.

In this report we describe the development of the Watch, Discover, Think and Act asthma self-management computer program for inner-city children with asthma. The intervention focused on teaching two categories of behaviors--asthma specific behaviors such as taking preventive medication and self-regulatory processes such as monitoring symptoms and solving asthma problems. These asthma self-management behaviors were then linked with empirical and theoretical determinants such as skills and self-efficacy. We then further used behavioral science theory to develop methods such as role modeling and skill training linked to the determinants. We matched these theoretical methods to practical strategies within the computer simulation and created a culturally competent program for inner-city minority youth. Finally, we planned a program evaluation that linked program impact and outcomes to the theoretical assumptions on which the intervention was based.

Asthma↗
PubMed2004

[Development, implementation and evaluation of a program for the cessation of smoking for adolescents and young adult smokers].

AIM: Assessment of the smoking cessation programme "Just be smoke free". METHOD: Follow-up data assessment of the participants who registered for the programme between April 2002 and March 2003. INTERVENTION: "Just be smoke free" is a smoking cessation programme targeting adolescents and young adults. Target groups are not only smokers, but also non- and ex-smokers. Moreover the project takes into account the different stages smokers undergo with regard to their motivation to stop smoking. Smokers who are not prepared to quit smoking are offered an individualised "smoker's profile" in order to sensitise them to their smoking behaviour, motives and risk situations. Smokers who are prepared to give up, are provided with a self-help cessation manual. As an incentive, on four occasions per year, participants can win cash prizes of up to 1,000 Euro. RESULTS: From April 2002 to March 2003, 1,417 smokers registered for the programme, of which 1,265 wanted to quit and 152 were interested in a "smoker's profile". The mean age of the participants was 21.5 years and 56.7 % were female. In addition, 2,132 used the internet page for the programme. 408 smokers took part in the follow-up measurement (retention rate 32.3 %). Of these, 46.1 % (N = 188) reported to have ceased to smoke. In a projected analysis considering those who did not take part in the follow-up measurement as smokers - the quit rate was 14.9 %. CONCLUSIONS: A large number of smoking adolescents and young adults were covered by the programme. The quit rate can be considered as good, also in comparison to international smoking cessation studies.

Adolescent↗
PubMed2002

Evaluation of a program to train nurses to screen for breast and cervical cancer among Native American women.

BACKGROUND: Routine screening for breast and cervical cancers lowers mortality from these diseases, but the benefit has not permeated to Native American women, for whom the five-year survival rate is the lowest of any population group in the United States. To help address this problem, an educational/training program was designed to enhance the skills of nurses and other health service providers and develop clinic support systems to better recruit, screen, and follow clients for breast and cervical cancer screening services. METHODS: A total of 131 nurses participated in the training program at 33 different sites between 1995 and 2000. Prior to and following training, each participant was given a questionnaire to determine knowledge of breast and cervical cancer screening techniques and recommendations, cancer survival and risk factors, and situational scenarios. RESULTS: The average score for the pretest was 54% correct. The posttest average was 89% correct. The percent correct increased 35% from pre- to posttest (p < 0.001). CONCLUSION: The knowledge to implement a successful screening program can be acquired through the current curriculum.

Breast Neoplasms↗
PubMed1999

Multifactorial evaluation of a program for lifestyle behavior change in rehabilitation and secondary prevention of coronary artery disease.

A comprehensive, multifactorial lifestyle behavior change program was developed for rehabilitation and secondary prevention of subjects with coronary artery disease. The purpose of the present report is to describe this intervention model and to analyze results achieved in a first group of consecutive participants. Main inclusion criteria for the 292 subjects were a recent history of acute myocardial infarction, coronary artery bypass surgery, or percutaneous transluminal coronary angioplasty. The program commenced with a 4-week residential stay, with the focus on health education and the achievement of behavior change in major lifestyle areas. During the year of follow-up a systematic maintenance program included regular contact with a nurse. Morbidity and mortality was low. Self-reported quality of life improved and there were significant improvements in blood lipids, exercise capacity and body mass index. There were also significant changes both in psychological variables such as Type A behavior, anger, hostility, and in major lifestyle areas such as stress reactions, diet, exercise and smoking. These changes compared favorably with data from relevant samples from the Swedish normal population. This program had a considerable effect on a number of important factors for rehabilitation and secondary prevention of coronary artery disease.

Analysis of Variance↗
PubMed2003

Evaluation of a program supporting scholarly productivity for new investigators.

PURPOSE: Like many groups, the March of Dimes Birth Defects Foundation has a long-term interest in funding new investigators. This study documents the career outcomes related to scientific productivity, research support, and current faculty positions of new investigators funded by the Foundation. METHOD: All successful applicants from 1983 to 1987 (n = 244) were compared with unsuccessful applicants from 1986 and 1987 (n = 195). Outcomes over a ten-year period were examined. Online databases were used to measure quantity and quality of scholarship, as well as federal grant awards. Institutional prestige was based on the 1982 and 1995 reports from the Conference Board of Associated Research Councils. A follow-up survey of successful applicants identified current employment and research activities. RESULTS: Successful and unsuccessful applicants did not differ significantly except that women were underrepresented among successful applicants. Applicants receiving funding were more productive in terms of the quantity and quality of publications as well as federal grant support. A greater proportion of successful applicants came from top-ranked institutions and at follow-up the proportion of successful applicants in top-ranked programs increased. At follow-up, most successful applicants had tenure-track appointments with significant time dedicated to research. CONCLUSION: The findings document the Foundation's investment in new investigators to promote scholarly productivity and career development and validate the criteria and process used to select successful applicants. The award provides new investigators with control over resources to facilitate their research programs and enhances the confidence and recognition of recipients.

Achievement↗