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Haiti. Educating factory workers.

There are approximately 50,000 workers employed in the light assembly industry in Haiti. About 70% are women, the majority of whom are aged between 25 and 34 years, and are either single or in a nonpermanent relationship with the father of their children. Many live and work in appalling conditions, surviving on very low wages to support several children and an extended family. The acquired immunodeficiency syndrome (AIDS) is now a visible problem in many factories. In October 1988, the Center for the Promotion of Women Workers (Centre de Promotion des Femmes Ouvriers/CPFO) launched a pilot AIDS education program for factory women. The Center, based in a large industrial zone near the airport, runs a health clinic and courses in literacy, communications skills, health promotion and family planning. The new AIDS program allowed CPFO staff to gain entry into factories for the 1st time. Other courses were held outside working hours and outside factory premises. Staff contacted manages by telephone to arrange a meeting to discuss AIDS and to ask permission to hold educational "round tables" with workers. Of 18 managers in the factories approached over a 12-month period, only 2 refused entry to CPFO staff. Almost all managers reported they had registered between 2 and 5 deaths from AIDS among their employees over the past couple of years. A total of 85 educational sessions, each lasting about 2 hours, were held within 28 different factories, community or labor organizations reaching 3063 workers (male and female). In each session, the presentation was carried out by 2 CPFO trained monitors and included a slide show, flip charts, and the video "Met ko," originally produced for Haitian immigrants in New York. The most important aspect of the program was the training of 38 volunteer factory-based health promoters. These promoters attended the round table sessions, where they facilitated discussion and distributed condoms and were subsequently available for counseling co-workers. Initially, the Center intended to recruit only literate women as promoters, but several nonliterate women were selected for training by labor organizations 18 hours of tuition and discussion of AIDS/human immunodeficiency virus were held over 2 1/2 weeks, including sessions on group dynamics and organizational skills. To improve communications skills, sessions included role play exercises which were videotaped and played back to trainees. Training in communication skills also helps promoters participate in activities aimed at supporting a broader range of workers' rights.

Acquired Immunodeficiency Syndrome↗

The role of hormonal contraception in adolescents.

Most pregnancies in women under age 20 years, as well as more than half of the pregnancies in the United States, are unintended. Contraceptive use is especially poor in adolescents, for whom the socioeconomic and educational consequences are great. A 1988 study indicated that more than 8% of sexually active adolescents had two or more sexual partners within the previous 3 months, higher than any other age group. The reasons why adolescents do not use contraception effectively fall into two categories: lack of access to contraceptive information and noncompliance with contraceptive recommendations. Studies have demonstrated that educational programs incorporating decision-making and communication skills, self-esteem enhancement, and peer influence can result in a decrease in the rate of adolescent sexual activity and pregnancy. Knowledge-based programs alone do not correlate with postponement of sexual activity or the use of contraceptives. In a survey of more than 4000 sex education teachers, 80% replied that they are in need of "factual information, materials, and strategies. In a true/false examination given to educators on contraception, few correct answers were recorded regarding potential side effects of oral contraceptives. Effective counseling and communication with adolescents require an understanding of adolescent development.

Adolescent↗

Special communication: mandate for creation of a national peripheral arterial disease public awareness program: an opportunity to improve cardiovascular health.

BACKGROUND: There has been increasing recognition of the detrimental effect of peripheral arterial disease (PAD) on the health of Americans, and yet there is no common national program of public PAD education designed to diminish this effect. FORMAT: To heighten awareness of this problem, a 2-day PAD Public Education Strategy Meeting was recently attended by representatives of 17 professional societies and public health associations whose missions support the prevention, diagnosis, treatment, and rehabilitation of vascular diseases. This Public Education Strategy Meeting was intended to provide the rationale and structure to create a national PAD public awareness campaign to diminish the health effect of PAD and to improve cardiovascular outcomes in the United States. This document (1) provides the rationale for creation of a national PAD public education program; (2) reviews the development and success of national hypertension, hypercholesterolemia, and Women's Heart Health public education programs as models of educational efficacy; (3) elucidates how the work of many vascular professionals has led to a national consensus for creation of a national PAD public educational program; (4) provides an overview of the National Heart, Lung, and Blood Institute PAD education meeting; and (5) outlines the "next steps" required to accomplish these goals. OUTCOME: This meeting achieved consensus that we share responsibility for developing accurate, unified messages to promote PAD awareness and improved care. Participants agreed that the creation of such messages should be linked to plans to disseminate them to all Americans at risk. A consensus was reached that such messages, when commonly created and offered to the public, are most likely to achieve the rewards in better health that all Americans deserve. The Vascular Disease Foundation, a not-for-profit foundation whose mission includes public education about the prevention, diagnosis, treatment, and rehabilitation of PAD, will devote its resources to guide a new coalition in this process and to create a national PAD awareness campaign. During 2003 and 2004, the coalition will create the organizational underpinnings and time line for what will undoubtedly be a multiyear effort. CONCLUSION: Participants of the Public Education Strategy Meeting agreed to create a broad coalition to develop a National PAD Public Awareness Program, with the objectives to develop and disseminate public education messages on PAD. A successful national PAD education program will contribute to creation of a broader mandate to improve global cardiovascular health in the United States.

Health Education↗

The parental experiences of mothers of adolescents with hearing impairments.

Adolescence is a difficult time in the life of any youth. In the hearing-impaired child it can be an especially stressful period. The mother, who in many families is the primary care giver, has probably put more of her time and energy into helping the child than any other individual. Familiarity with the thoughts and feelings of the mothers, then, should contribute to our understanding of the hearing-impaired adolescent. Yet, few studies have examined the experiences of mothers during this stage. In this study, five hearing mothers of hearing-impaired adolescents were interviewed on their experiences in rearing a hearing-impaired child. The information culled from these interviews and the subsequent analysis should help fill the void of knowledge on this aspect of the hearing-impaired child. Using qualitative analysis of the mothers' experiences the researchers identified six major themes from the data collected in the interviews: (1) the mothers' personal growth, (2) the mother-child relationship, (3) parent-professional relationships, (4) concerns about educational programming, (5) the importance of fluent communications, and (6) support systems available to the mothers. Suggestions are made for parents and to help improve parent-professional relationships and the programs that serve the hearing impaired and their families. Areas for further research on the subject of rearing hearing-impaired adolescents are identified.

Adolescent↗