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PubMed2002

Cost-effectiveness of a program to prevent depression relapse in primary care.

OBJECTIVE: Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. MATERIALS AND METHODS: Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. RESULTS: Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. CONCLUSIONS: A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.

Antidepressive Agents↗

PubMed1999

[Job satisfaction in Portuguese physicians in general medicine].

OBJECTIVES: To identify the major areas of GP's job satisfaction and dissatisfaction and to study the most important reasons of GP's job dissatisfaction. DESIGN: Cross-section study. Survey by mail and personal interview. PARTICIPANTS: 1.097 GPs. SETTING: Northern region of the Portuguese Medical Association. MEASUREMENTS AND MAIN RESULTS: 46% of the 385 respondent GPs are dissatisfied with the overall job satisfaction. The rate of pay is the dimension that generates more job dissatisfaction, as also the major area that has the highest level of job dissatisfaction and has significant association with the overall job satisfaction, but has not predictive association with it. The majority declares that it is more adequate a payment system with fixed and variable components. The same regimen of work may generate satisfaction in some GPs, and dissatisfaction in others. Both the authoritarian leadership behavior and the laissez-faire style are almost nonexistent in the health centers of the satisfied GPs, but predominate in the health centers of the dissatisfied GPs. Those leadership styles are not desired by the dissatisfied GPs. CONCLUSIONS: The rate of pay generates more job dissatisfaction, but has not predictive association with the overall job satisfaction. The authoritarian leadership behavior and the laissez-faire style are by themselves generators of GP job dissatisfaction, even if the regime of work by itself does not generate it.

Adult↗

PubMed2006

Longitudinal trends in the use of individualized radiographic examinations at dental schools in the United States and Canada.

In the spring of 2002, a mail survey was conducted to determine the use of individualized radiographic examinations (selective radiography) for comprehensive care patients at all sixty-four U.S. and Canadian dental schools. Results from previous surveys were used to evaluate the long-term longitudinal trends. Among sixty-two schools (97 percent response rate), selective radiography was used by 34 percent of schools for dentulous adult patients, by 100 percent for edentulous adults, and by 28 percent for children. Having a credentialed chief of service increased the likelihood that selective radiography would be used for dentulous adults (odd ratio[OR]=2.36) and for children (OR=2.33). Selective radiography for dentulous adults increased from 2 percent of schools in 1977 to 36 percent in 1997 and leveled off thereafter. Between 1987 and 2002, selective radiography for edentulous adults was used at nearly all schools (96-100 percent) and for children at about a quarter of dental schools (22-28 percent). Among the sixty-one schools for which there are complete data since 1987, the continuous use of routine radiography was most common (39 percent of schools) for dentulous adult patients, whereas the continuous use of selective radiography was uncommon (7 percent).

Adult↗

PubMed1997

New blindness in diabetes reduced by more than one-third in Stockholm County.

To monitor changes over time in the incidence of blindness among people with diabetes, referrals (mentioning diabetes) to all vision rehabilitation centres in Stockholm County (1995 population 1 725 756) during 1981-1995 were registered. A mass mailing to people with diabetes in 1989 urged them to have their eyes examined. Mobile fundus photography teams initiated early diagnosis of diabetic retinopathy in primary health care in 1990. Referrals with diabetes and blindness, defined (WHO, ICD 10) as best-corrected visual acuity (VA) of the better eye less than 3/60 (0.05), occurred for 172 persons (7.6% of those referred with diabetes). During 1981-1985, 93 were referred (95% confidence interval 75 to 114); 1986-1990, 51 (38 to 67); 1991-1995, 28 (19 to 41). Five-year average annual incidence rate of referrals with blindness was reduced by 47% from 1.2 to 0.63 to 0.33 per 100,000 population. Mean yearly reduction during 1981-1995 was 11% (8 to 15%), 11.5% (8 to 15%) if blindness was defined as in the UK (VA 3/60 or less), and 7% (4 to 9%) for legal blindness (VA 6/60 or less); test for trend p < 0.001 (Poisson regression analysis). This is the first report of reduction in a geographical region of a proxy measure for new blindness in diabetes by one-third or more, attaining one of the main targets of the St Vincent Declaration.

Adult↗

PubMed2003

Management of recurrent locoregional breast cancer: oncologist survey.

Locoregional recurrence (LRR) after therapy for early breast cancer is common. A questionnaire was used to assess consensus between breast oncologists about the definition, prognosis and management of patients with LRR. The questionnaire was mailed to surgical, radiation and medical oncologists in Canada, the UK and the USA. Of 495 questionnaires, 322 (65%) were returned. Most clinicians sampled agree that disease in the skin of the chest wall, surgical scar, axilla, ipsilateral breast tumor recurrence (IBTR), infraclavicular lymph nodes, supraclavicular fossa lymph nodes and internal mammary lymph nodes constitute sites of LRR. The sites that were felt to be curable by the majority of respondents were: IBTR, surgical scar, axilla or chest wall. It was for these disease sites that local therapy was generally recommended. Irrespective of the site of recurrence, most respondents surveyed recommend initiation of a new systemic therapy at the time of LRR. While the results of this survey show general agreement regarding the definition of sites of LRR, treatment recommendations vary among oncologists. Due to the variation in sites of recurrence, time since initial diagnosis and prior therapy, the exact prognosis and optimal management of LRR remain undefined. In the absence of randomized prospective trial data, recommendations for local and systemic therapy of LRR will continue to mimic those offered at the time of initial presentation of breast cancer.

Biopsy, Needle↗

PubMed2003

Amalgam and composite use in UK general dental practice in 2001.

OBJECTIVE: This study determined the reasons for dentists' choice of materials, in particular amalgam and resin composite, in Great Britain. METHOD: A questionnaire was developed to elicit this information. The names and addresses of 1,000 UK-based dentists were selected at random. The questionnaire was mailed to these dentists with an explanatory letter and reply-paid envelope. RESULTS: Six hundred and fifty four replies were received. Regarding choice of material, 100% of respondents cited clinical indication as the most influential factor, although patients' aesthetic demands (99%), patients' choice (95%) and patients' financial situation (92%) were also reported to influence respondents' choice. Thirty-five per cent of respondents used composite 'sometimes', 15% 'often', and 1% 'always' in extensive load-bearing cavities in molar teeth. For composite restorations in posterior teeth, 92% 'always', 'often' or 'sometimes' used the total etch technique and 53% never used rubber dam. Seventy per cent of respondents agreed with the statement 'discontinuation of amalgam restricts a dentist's ability to adequately treat patients'. Eighty-one per cent considered that the growth in the use of composites increased the total cost of oral healthcare. CONCLUSIONS: Forty nine per cent of the respondents from England and Wales seldom or never place large composite restorations in molar teeth. Their choice of material is influenced greatly by clinical indications, and patients' aesthetic demands.

Acid Etching, Dental↗

PubMed2004

Sociodemographic and health behaviour factors associated with obesity in adult populations in Estonia, Finland and Lithuania.

BACKGROUND: The aim of this study was to analyse the pattern of sociodemographic variations in the prevalence of obesity in Estonia, Finland and Lithuania. In addition, the association between obesity and selected health behaviours was examined. METHODS: Cross-sectional surveys were conducted among representative national samples of adult populations in 1994, 1996 and 1998. The number of participants aged 20-64 was 3759 in Estonia, 9488 in Finland and 5635 in Lithuania. The data were obtained from mailed questionnaires (covering sociodemographic characteristics, health behaviour indicators, and self-reported height and weight). Obesity was defined as BMI > or = 30 kg/m2. RESULTS: The prevalence of obesity among men and women was 10% and 15% in Estonia, 11% and 10% in Finland, and 10% and 18% in Lithuania respectively. The prevalence of obesity increased only among Estonian men. Obesity was more prevalent among those aged over 50 in all three countries. It was also more prevalent among the less educated women in all countries and among the less educated men in Finland. Obesity was less prevalent among daily smokers among Estonian men and women and Lithuanian men. Physically inactive Estonian women and Finnish men and women were more likely to be obese. CONCLUSIONS: A significant association was found between low educational level and obesity in women in all the countries, but this association was found for men only in Finland. In Finland obesity was also more consistently associated with indicators of unhealthy behaviour than in Estonia and Lithuania. Thus, even though the social gradient of obesity was broadly similar in all the countries studied, differences emerged with regard to the behavioural correlates of obesity.

Adult↗

PubMed2004

Antibiotic treatment of acute respiratory tract infections in the elderly: effect of a multidimensional educational intervention.

OBJECTIVES: : To measure and improve antibiotic use for acute respiratory tract infections (ARIs) in the elderly. DESIGN: : Prospective, nonrandomized controlled trial. SETTING: : Ambulatory office practices in Denver metropolitan area (n=4 intervention practices; n=51 control practices). PARTICIPANTS: : Consecutive patients enrolled in a Medicare managed care program who were diagnosed with ARIs during baseline (winter 2000/2001) and intervention (winter 2001/2002) periods. A total of 4,270 patient visits were analyzed (including 341 patient visits in intervention practices). INTERVENTION: : Appropriate antibiotic use and antibiotic resistance educational materials were mailed to intervention practice households. Waiting and examination room posters were provided to intervention office practices. MEASUREMENTS: : Antibiotic prescription rates, based on administrative office visit and pharmacy data, for total and condition-specific ARIs. RESULTS: : There was wide variation in antibiotic prescription rates for ARIs across unique practices, ranging from 21% to 88% (median=54%). Antibiotic prescription rates varied little by patient age, sex, and underlying chronic lung disease. Prescription rates varied by diagnosis: sinusitis (69%), bronchitis (59%), pharyngitis (50%), and nonspecific upper respiratory tract infection (26%). The educational intervention was not associated with greater reduction in antibiotic prescription rates for total or condition-specific ARIs beyond a modest secular trend (P=.79). CONCLUSION: : Wide variation in antibiotic prescription rates suggests that quality improvement efforts are needed to optimize antibiotic use in the elderly. In the setting of an ongoing physician intervention, a patient education intervention had little effect. Factors other than patient expectations and demands may play a stronger role in antibiotic treatment decisions in elderly populations.

Acute Disease↗

PubMed1995

Emergency medicine resident moonlighting: a survey of program directors. CORD Task Force on Resident Moonlighting.

OBJECTIVES: 1) To systematically describe emergency medicine (EM) program directors' perceptions of the benefits and risks of resident moonlighting. 2) To assess moonlighting policies of EM residencies, the degree of compliance with these policies, and the methods of dealing with residents who are out of compliance. METHODS: A written survey was mailed or hand-delivered to all allopathic and osteopathic EM residency directors in the United States in 1992-93. Incomplete and ambiguous surveys were completed by phone. RESULTS: There was a 96% response rate (113/118). The average EM resident clinical workweek ranged from 38 to 50 hours while the resident was assigned to ED rotations. Most (90%) of the program directors believe moonlighting interferes with residency duties to some degree. Few (10%) programs prohibit moonlighting altogether, although 44% limit moonlighting to an average of 41.5 hours per month. Program directors believe residents moonlight primarily for financial reasons. Most (60%) of the program directors believe moonlighting offers experience not available in the residency, primarily related to autonomous practice. Fifteen programs reported residents who had been sued for malpractice while moonlighting, with one program director named along with the resident. One third of program directors have penalized residents for abuse of moonlighting privileges. CONCLUSIONS: EM residency directors are concerned about the effect of moonlighting on resident education. The directors' concerns regarding litigation, excessive work hours, and interference with residency duties are balanced by a general acceptance of the financial need to supplement residency income.

Adult↗

PubMed1994

Food service trends in NSW hospitals, 1986-1993.

In 1993 a survey of the food service departments in 159 hospitals in New South Wales was carried out using a mailed questionnaire, and the results were compared with those of a similar survey in 1986. The results reveal that over the past seven years there has been a significant increase in the proportion of hospitals using cook-chill systems, from 5 per cent in 1986 to 18 per cent in 1993. Hospitals with cook-chill systems do not appear to be operating more efficiently than those with conventional catering systems: in cook-chill hospitals the mean food service staffing ratio was 7.1 beds/full-time equivalent (FTE) compared to 7.8 beds/FTE in hospitals with cook-serve systems. Most hospitals in New South Wales still use traditional hot food delivery to the wards, and more of these are now using effective heat maintenance systems for patient meals. The proportion of special diet meals has increased over the past seven years to 17.1 per cent in public hospitals. The percentage of food service departments with an unqualified person in charge fell from 47 per cent in 1986 to 22 per cent in 1993. Meal times remain largely unchanged, with more than 90 per cent of hospitals still serving the evening meal before 5.30pm.

Food Handling↗

PubMed2002

A survey of the use of matrix bands and their decontamination in general dental practice.

AIMS: The aims of this study were to determine the pattern of use and re-use of matrix bands in general practice in Scotland, to demonstrate which type of matrix band is most commonly used and to examine infection control measures of relevance to the safe use and re-use of matrix bands. MATERIALS AND METHODS SUBJECTS: 621 of Scotland's 1,849 general dental practitioners were randomly selected. DATA COLLECTION: A 19-item self-reported questionnaire was mailed in June 1999 with a follow-up mailing sent in August 1999. ANALYSIS: Data analysis involved descriptive statistics and cross-tabulation. Where appropriate, differences between categories were tested for significance by a Chi-square test. RESULTS: A total of 479 questionnaires were returned, representing a response rate of 77%. Reported compliance with routine glove wearing was high (91%). Most dentists (92%) provided training on instrument cleaning and sterilisation for their dental nurses. Ultrasonic baths were used by 59% of practitioners; the remainder soaked or manually scrubbed instruments to remove debris before autoclaving. The Siqveland matrix was the matrix of choice for 96% of respondents. 7% provided a new matrix band for each patient. Most (64%) changed bands only when they were bent or damaged; 29% changed them daily or weekly. Deterrents to use of a new band for each patient were cost (39%) and time (52%). A total of 54% of respondents considered matrix band replacement unnecessary between patients. CONCLUSIONS: The Siqveland matrix band is the most popular among the study group of dental practitioners. Re-use of matrix bands is common. Guidelines for the safe re-use of matrix bands are required.

Attitude of Health Personnel↗

PubMedDate not supplied

Infection control practices of Rhode Island dental hygienists and certified dental assistants.

PURPOSE: Limited studies document the infection control practices of dental hygienists and dental assistants even though both groups play a vital role in the prevention of disease transmission in the dental office. The purpose of this study was to survey Rhode Island registered dental hygienists and certified dental assistants to (1) determine their current infection control practices; (2) to document attendance at an infection control course; and (3) to identify the need for additional infection control education. METHODS: In October of 1993 a fixed-response survey was mailed to a random sample of 267 registered dental hygienists (RDHs) and 260 certified dental assistants (CDAs) in Rhode Island. Data were analyzed using descriptive statistics, cross-tabulations, and the chi-square statistic. RESULTS: Responses were received from 171 RDHs and 153 CDAs for adjusted response rates of 64% and 59%, respectively. Most responding RDHs and CDAs were wearing gloves but substantially fewer were utilizing one of the two acceptable combinations of personal protective barriers. Other procedures that were not always practiced by a substantial number of respondents included the use of disposable barriers, following recommended handwashing protocol, utilizing appropriate procedures for disinfection and sterilization of dental instruments and handpieces, updating medical histories, and biological monitoring of sterilization equipment. Although the majority of both groups reported having attended an infection control course within the past year, having written infection control protocols in place, and being satisfied or very satisfied with the level of infection control, many recommended procedures were not practiced routinely. CONCLUSIONS: These findings indicate that lack of compliance with infection control guidelines is multifactorial. Even though there is a need for continuing infection control education for dental hygienists and certified dental assistants, education alone is not the answer.

Chi-Square Distribution↗

PubMed1997

Improving cancer prevention at the worksite: how are Belgian companies dealing with smoking regulations?

Little is known about the impact of smoking policy on companies' policies related to smoking in Belgium. The study was designed in order to compare the companies' policies related to smoking (CPRS) in 1990 and in 1993. During this 3 year period, numerous information and regulation inputs (media, brochures) were aimed at companies to regulate smoking behavior in the workplace, so as to reduce the risks of passive smoking. A short questionnaire was mailed to 3543 Belgian companies in October 1990 and in June 1993 to assess: designation of smoke free areas (SFA); willingness to offer a worksite information program (WIP); willingness to offer a worksite smoking cessation program (WSCP); willingness to subsidize a WSCP; willingness to offer a WSCP during working hours; willingness to offer a meeting room for a WSCP and actual organization of a WSCP. In 1990, 773 companies (22%) and in 1993, 890 companies (25%) responded to the questionnaire. The results showed that small companies and companies with a high blue/white collar ratio were less able to implement health policy recommendations. A total of 325 (9%) companies responded to the 1990 and 1993 questionnaires. Comparison of 1990 and 1993 dataset showed that during this 3 year period, no major changes occurred for a majority of companies. Amongst the small positive changes, only the designation of smoke free areas and the organization of a small number of WSCP was observed. The conclusion is that despite inputs, little impact on smoking policies is noticeable. Strategies designed to intensify inputs and to promote implementation of regulation of WSCP should therefore further be studied.

Belgium↗

PubMed1995

Irritable bowel syndrome in a community: symptom subgroups, risk factors, and health care utilization.

The clinical relevance of subdividing the irritable bowel syndrome (IBS) into subgroups based on bowel habit is largely unknown. We therefore obtained an age- and sex-stratified random sample of Olmsted County, Minnesota, residents aged 20-95 years. All subjects were mailed a valid self-report questionnaire during the years 1988-1993; the response rate was 74% (n = 3,022). Among subjects with IBS (n = 536), four symptom-based subgroups of similar size were identified: constipation predominant, diarrhea predominant, alternating constipation and diarrhea, and neither. The prevalence of IBS was significantly greater in females, primarily because of a higher prevalence of constipation-predominant IBS in women. Of persons > or = 60 years of age, 23% reported the initial onset of IBS in the previous year compared with 10% in younger subjects; the age at onset of IBS was similar among the subgroups. Marital status, education level, smoking, and alcohol use were not significantly different among the subgroups. Of those with IBS, 25% reported visiting a physician for abdominal pain or disturbed defecation in the prior year compared with only 8% of persons without IBS. Female sex, an increased number of Manning's symptom criteria, and the individual IBS subgroups were not associated with higher rates of physician visits. We conclude that the onset of IBS may not be limited to early adulthood and that subgroups of IBS based on bowel patterns may not identify clinically distinct entities.

Adult↗

PubMed2004

Prevalence of lower urinary tract symptoms in men aged 45-79 years: a population-based study of 40 000 Swedish men.

OBJECTIVE: To estimate the age-specific prevalence and severity of lower urinary tract symptoms (LUTS) among Swedish men, the intercorrelations between different symptoms, and to assess quality of life and health-seeking behaviour among men with LUTS. SUBJECTS AND METHODS: In 1997, an International Prostate Symptom Score (IPSS) questionnaire, together with other questions about lifestyle, was mailed to all men aged 45-79 years living in two counties in Sweden; the analyses included 39 928 men. RESULTS: Overall, 18.5% and 4.8% of the men were moderately and severely symptomatic; the prevalence of at least one symptom was 83%. LUTS were strongly age-dependent, with 1.8% of severe symptoms among men aged 45-49 years and increasing to 9.7% among those 75-79 years old. Frequent urination was the most common symptom among men aged < 70 years and nocturia among those aged >70 years. Symptoms like hesitancy, poor flow and intermittency were highly correlated with each other (Spearman coefficients 0.56-0.60). There was a high correlation between the IPSS and a poor score for quality of life resulting from the bothersomeness of LUTS (r = 0.70). Among symptomatic subjects, 36% reported a poor quality of life (fairly bad, very bad or terrible). Only 29% of symptomatic subjects (IPSS >7) reported that they had been diagnosed previously for their urinary problems, and only 11% received medication for that. CONCLUSION: Although the prevalence of LUTS in Sweden is high, the percentage of men whose quality of life is substantially affected is much lower.

Age Distribution↗

PubMed2000

Non-Hodgkin's lymphoma and occupational exposure to chemicals in Canada. Canadian Cancer Registries Epidemiology Research Group.

BACKGROUND: The incidence of non-Hodgkin's lymphoma (NHL) has been increasing in Canada. This study assessed the effect of occupational exposure to specific chemicals on the risk of NHL. PATIENTS AND METHODS: Mailed questionnaires were used to obtain data on 1469 newly diagnosed, histologically confirmed NHL cases and 5073 population controls between 1994 and 1997 in eight Canadian provinces. Data was collected on socioeconomic status, life-style, diet, occupation, and years of exposure to any of 17 chemicals. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived by logistic regression. RESULTS: The study found an increased risk of NHL among males exposed to benzidine, mineral, cutting, or lubricating oil, pesticides, and herbicides. Compared with non-exposure to each specific chemical, the adjusted ORs were 1.9 (95% CI: 1.1-3.4) for benzidine, 1.3 (95% CI: 1.0-1.5) for mineral, cutting, or lubricating oil, 1.3 (95% CI: 1.0-1.6) for herbicides, and 1.3 (95% CI: 1.0-1.6) for pesticides. Excess risk of NHL among females was associated with exposure to pesticides and wood dust. ORs increased with increasing exposure in years to benzidine and herbicides for males and with increasing exposure years to wood dust for females. These trends were statistically significant (P < 0.05). CONCLUSIONS: The findings in this study suggest that occupational exposure to specific chemicals plays an important role in the development of NHL in Canada.

Adult↗

PubMed2002

Evaluation of patients by private general practitioners: associations with patient, visit, and service characteristics.

OBJECTIVE: To examine evaluations of patients by dentists, and analyse these by patient, visit and service characteristics. BASIC RESEARCH DESIGN: Mailed questionnaires collected from a random sample of Australian dentists in 1997-98 (response rate = 60.3%; n = 345 private general practitioners provided service data). MAIN OUTCOME MEASURES: Three factor-based sub-scales ('payment', 'no problems', and 'knowledge') and an overall scale ('evaluation') were derived from a 5-item battery. Scale and sub-scale scores ranged between I and 5. Lower scores indicated better evaluation ratings. RESULTS: Nearly 60% of patients had better ratings (scores < or = 2) on the 'payment' and 'no problems' sub-scales, 39.9% on the 'knowledge' sub-scale, and 36.4% on the 'evaluation' scale. Better ratings on all sub-scales and the overall scale were associated with dentate patients, non-emergency visits, insurance, and no decayed teeth (chi2; P<0.05). Those with better 'evaluation' scale ratings (scores < or = 2.0), had higher [Poisson regression, P < or = 0.05; RR=Rate ratio] preventive (RR = 1.30), and crown and bridge rates (RR = 1.88), but lower extraction rates (RR = 0.52). CONCLUSIONS: Desirable characteristics of patients were associated with more favourable evaluation scores by their dentists. Patients with better evaluation scores received a more favourable service pattern.

Adolescent↗

PubMedDate not supplied

Needs assessment and intervention strategies to reduce lead-poisoning risk among low-income Ohio toddlers.

OBJECTIVE: Examine parental receipt of lead-poisoning prevention information and preferred methods of receiving this information. DESIGN: Cross-sectional mailed survey of parents with children 1-2-year-old-enrolled in Medicaid. SAMPLE: Respondents (n=532) were primarily female, white, with at least a high school education, and between the ages of 20-30 years. MEASUREMENTS: Items from the Blood Lead Education and Screening Tool concerning parental receipt of lead-poisoning prevention information, persons with whom parents had discussed lead-poisoning prevention, parental receipt of a reminder about blood lead testing, and parents' preferred methods of obtaining lead-poisoning prevention information. RESULTS: Most respondents had obtained lead-poisoning prevention information, but only 28% reported receiving a reminder to have their child's blood lead level assessed. Brochures and discussions with health care providers were the preferred methods of obtaining lead-poisoning prevention information. More minority respondents preferred receiving information via videos, billboards, and home visits. Younger parents preferred brochures, billboards, and speaking with someone at the health department or women, infants, and children supplemental nutrition (WIC). Most respondents identified multiple means by which they would like to receive lead-poisoning prevention information. CONCLUSIONS: Implementation of individual, community, and system-level interventions by public health nurses are needed for comprehensive lead-poisoning prevention education.

Adult↗