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PubMed2001

Work-site health and fitness programs: Impact on the employee and employer.

Physical fitness and health lifestyle habits have been reported to lower the risk of death from disease, foster healthy muscles, joints and bones, and enhance personal function and mental health. Given these benefits, many employers are implementing health and fitness programs into their workplace with the goals of improving and maintaining the health of their employees and increasing worker productivity. However, research is still being conducted to determine if these programs are an effective means of achieving these goals. OBJECTIVE: The purpose of this paper is to investigate the impact of these programs on employee physical and mental health, employee work performance, and the employer. This paper also investigates the effectiveness of the specific program structures and intervention procedures that were used in the employee health and fitness programs that have been implemented. STUDY DESIGN: This paper analyzed 15 previously conducted studies to investigate the impact and design of employee health and fitness programs. RESULTS: The reviewed literature suggests that the incorporation of an employee health and fitness program can have positive effects for both the employee and the employer. Programs that are structured using a variety of physical fitness programs, health education classes, outreach and one on one counseling with follow up contact have proven to be most beneficial in terms of employee and employer satisfaction. CONCLUSION: The implementation of an employee health and fitness program can have positive lasting effects on both the employee and employer. In addition to implementing programs that offer a variety of choices and one on one counseling, employers would benefit from targeting the at-risk population to ensure that the programs benefit the greatest number of employees possible.

Journal Article↗
PubMed2002

[A questionnaire survey of the neurology training program in Japan].

A questionnaire survey was performed in order to see the current trends of the neurology training program in Japan. A questionnaire was sent out to 81 neurology program directors of the medical schools and large hospitals. 72 program directors answered the questionnaires. According to the summed results, each program had an average of 37 inpatient beds, 7 teaching staffs with the neurology board certification. The program had an average of 4 residents annually, and they served as junior neurology residents for 1.8 years, and as chief residents for 1 year with 6 months of hospital consultation. 1.4 years training in the internal medicine was prerequisite for the neurology program. The training of clinical neurophysiology was done mainly by the own faculty staff in each program, but the training of neuroradiology and neuropathology varied. A quarter of the training programs had their own teaching staffs of neuroradiology and the rest of three quarters asked for training to the neuroradiology department. 32 of 72 programs had their own teaching neuropathologists and 26 programs asked the training in the pathology department and 14 programs did not have any teaching staffs of neuropathology. It seems that these numerical data are quite similar to those of the American standard of Accreditation Councils. We must still improve the real contents of the neurology training program with more capable teaching staffs.

Education, Medical, Graduate↗
PubMed2006

Diffusing a research-based physical activity promotion program for seniors into diverse communities: CHAMPS III.

INTRODUCTION: Increasing the physical activity levels of older adults through diffusion of successful research-based programs into community settings is challenging because of differences between research and real-world settings. This project diffused the Community Healthy Activities Model Program for Seniors (CHAMPS) II, an individual-level research-based physical activity promotion program, through three community organizations to reach lower-income and minority (primarily Hispanic or Latino and African American) seniors. METHODS: Through an academic-community partnership, university staff worked with each organization to adapt the program to be appealing and effective, enable their staff and volunteers to provide the program, increase participants' physical activity, and leave sustainable programs in place. Evaluation was based on methods recommended by the Centers for Disease Control and Prevention. RESULTS: The adapted programs, referred to as CHAMPS III, differed from the original program and among organizations. Group-based components and resource guides were included and new features were added; however, individualized components were not offered because of limited resources. A total of 321 people enrolled among three organizations; there was a trend toward increased physical activity at two organizations (an estimated increase of 481 kcal/week [P = .08] and 437 kcal/week [P = .06] expended in physical activity). Evaluation revealed challenges and unexpected community-level benefits. All organizations are continuing efforts to promote physical activity for older adults. CONCLUSION: This project enabled community organizations to implement physical activity promotion programs. The overarching challenge was to retain original program features within each organization's resources yet be sustainable. Although the programs differed from the original research program, they were a catalyst for numerous community-level changes. Our findings can guide similar projects to reach underserved older adults.

Aged↗
PubMedDate not supplied

Admission requirements for radiography programs.

CONTEXT: Radiography program applicants far outnumber available class capacity in many programs. Educational accountability requires that programs justify their admission practices, work to retain all qualified students and evaluate their attrition rates. Thus, radiography programs are interested in identifying the best candidates for admission. PURPOSE: The purpose of this small survey study was to document admission requirements of entry-level programs in radiography accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) in Oklahoma and Texas. METHODS: A 14-question survey was sent to 45 JRCERT-accredited entry-level radiography programs in Oklahoma and Texas. The survey included questions concerning program demographics, admission criteria and admission practices. RESULTS: Cumulative grade point average, interviews, successful completion of math and science courses, and performance on standardized tests were the most commonly used admission criteria, although no criteria were used by all of the programs surveyed. CONCLUSION: The current study is the first step toward identifying the most effective admission criteria for radiography programs. Future research should examine the correlation of specific admission criteria with program success (ie, program retention, program completion and professional certification).

Educational Measurement↗
PubMed2006

Data entry workers perceptions and satisfaction response to the "stop and stretch" software program.

Cumulative Trauma Disorder (CTD) is a collection of chronic musculoskeletal disorders caused by frequent, sustained, and repetitive movements, most notably by computer usage at the workplace. A computer based break reminder program (Stop and Stretch) has been developed and installed to prevent CTDs caused by prolonged computer usage at the workplace. We investigated users' opinions to the Stop and Stretch program at their work place. 19 computer users were recruited as the subjects of the study. We conducted a survey after all the subjects used the Stop and Stretch program for one month. Among the nineteen subjects, 52.5% or 10 noticed a difference of symptoms after using the program; 63.3% or 12 thought the program had positive effect on their productivity; 100% or all 19 thought the program was easy to follow; 100% or all 19 thought it was helpful; 94.7% or18 were satisfied with the program; and the same value would recommend the program to others. When grouped into those who had prior experience with using stretch and exercise as part of their work routine15 subjects had no prior experience; and 14 participants within that group were satisfied or very satisfied with the program; 93.3% or 14 would recommend it to co-workers; and over half of those 15 thought the program is easy to use. The study provided insight to the response to using "stretch break software" and provided indicators of satisfaction with the Stop and Stretch program and that the program had sufficient usability and acceptance within a workplace setting which might be applied in other work settings similar to these.

Consumer Behavior↗
PubMed1990

The whole is greater than the sum of its parts: the anatomy of the Department of Veterans Affairs Medical District 17 Health Services Research and Development Field Program.

The Medical District 17 Health Services Research and Development (HSR&D) Field Program was funded by the Veterans Administration (now the Department of Veterans Affairs--VA) in January 1983. This article describes the organization, progress, and accomplishments of this field program, and it provides a review of the breadth of health services research that is being conducted in Medical District 17. Overall, the field program has conducted research that addresses significant problems in the delivery of health care within the VA system. Resource utilization, cost effectiveness, and the care of geriatric patients have been some of the areas in which the Medical District 17 HSR&D Field Program has provided important research findings for VA. The field program plans to continue its response to the needs of VA. Moreover, HSR&D investigators will be collaborating with researchers of other services to conduct research that is both enlightening and highly relevant to the delivery of health care to the nation's veterans. The proposal for an HSR&D field program was developed by the Edward A. Hines Jr. VA Hospital in collaboration with the Center for Health Services and Policy Research (CHSPR) of Northwestern University. The program was funded in January 1983, as the result of a national competition to establish an HSR&D field program in each of the VA regions. The goals of the Medical District 17 Field Program are to improve the health care of veterans by conducting relevant research on the processes and outcomes of patient care; to provide comprehensive technical research assistance; and to educate VA managers, planners, and clinicians, as well as the general medical community, about advances in health care delivery. The field program's commitment to excellence is strengthened by its multidisciplinary approach, which enables physicians, nurses, social workers, psychologists, sociologists, economists, statisticians, administrators, and individuals in various related disciplines to cooperate in efforts to address a wide range of topical issues. These collaborations are a major strength of the field program. Primary research priorities of the field program are cost effectiveness of VA services (e.g., patient care technologies, delivery systems), long-term care, and rehabilitation. Investigators, however, are not limited to these topics and explore many other health services research issues of particular interest to them.

Forecasting↗
PubMed1988

Developing a videocassette program for pharmacy education.

The development of a videocassette program to educate pharmacists about congestive heart failure (CHF) is described. The CHF videocassette program was developed to provide the equivalent of four hours of instruction to pharmacists in continuing-education programs or Pharm.D. degree programs. CHF was chosen as the topic because it is a common medical problem that pharmacists likely would encounter, and the material would lend itself well to visual illustration. A program-development team consisting of a pharmacist-author, an educational-design specialist, and a writer-producer was established. The group dealt first with treatment of ideas, or discussions of ways in which the educational material could best be illustrated. The pharmacist-author developed the text for the program, and the writer-producer converted the text into a script with numbered scenes. Information that could be presented more appropriately in written format was gathered into a supplemental guidebook. A storyboard script that linked the text with the audio and visual elements was developed with the help of a professional director and medical illustrator, and the program was filmed using volunteer and professional actors as well as simple animation. The program comprises two videocassettes that are 40 and 44 minutes long, respectively. The estimated cost of the production was +28,000, which includes estimates of the value of time volunteered by the pharmacist-author, educational-design specialist, nonprofessional talent, and secretaries. The program has been used for six continuing-education programs and two classes of Pharm.D. students; subjective evaluations of the program have been favorable. Videocassette technology can be applied successfully to educational programs for pharmacists.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗
PubMed1979

Resource requirements for teaching continuity in primary care: contrasts between a graduate and an undergraduate program.

Two similar primary care training programs for family practice residents and for medical students are compared to find differences and similarities in costs and the use of certain nonmonetary resources. Both programs emphasize long-term continuity, and trainees in both programs average two half-days per week at ambulatory care practice sites. Comparisons of the resource requirements of teaching high-continuity primary care curriculum segments between graduate and undergraduate programs will help determine where scarce medical teaching resources can be most beneficially used. It is hypothesized that there would be lower faculty costs, higher auxiliary staff and space requirements, and larger patient panel requirements for the residency program than for the undergraduate program. Extent of these differences could not be predicted. In the residency program, faculty costs were one quarter of total expenses and in the undergraduate program they were half of the program expenses. The residency recouped 81 percent of expenses from practice revenues while the undergraduate program recouped only 59 percent. The residency program averaged 814 visits per trainee during one year; the undergraduate program had only 268 visits per student.

Education, Medical, Graduate↗
PubMed1982

Preventive dental programs for school-age children in 8 countries: pilot survey, 1979.

This paper reports the results of a pilot project, sponsored by the FDI Working Group on Oral Health Promotion, which was designed to describe preventive dental programs for school-age children in 10 countries. A mail questionnaire was developed to obtain information about program philosophy, target population, preventive program components, promotion and educational methods, barriers to program development, program priorities and evaluation methods. In this pilot phase, a total of 27 questionnaires were returned from 8 countries (Argentina, Federal Republic of Germany, France, Japan, Singapore, Sweden, Thailand, United Kingdom). Respondents generally recognized the need to include three major program elements in order to build comprehensive programs, primary preventive measures, early detection and treatment services, and instructional activities for children and adults. Financial problems were cited most frequently as barriers to program development, followed by manpower, public acceptance, policy decisions, policy-maker attitudes, legal constraints and transportation. The domain of educational problems associated with initiating and maintaining children's preventive dental programs is broad and diverse. Educational problems, roles and methods seemed to be pervasive, cutting across all program components. Although the greatest educational emphasis appeared to be on oral hygiene, the need was also recognized to include educational components for each dental program element or service, such as fluoride rinsing. Educational needs related not only to children, but to policy-makers, dental and other health professionals and program and school personnel. The FDI Working Group has expanded the survey and collected data from a much larger number of countries during 1979-1981. Results of the larger survey will be presented at the Annual World Dental Congress of the FDI in Vienna, 1982.

Asia↗
PubMed1994

Overview of the New York State program for prescription drug benefits.

New York State's prescription drug benefits program is described. The Empire Plan, a part of the New York State Health Insurance Program, includes a prescription drug benefits program. The prescription drug program began in 1986 and covers more than 700,000 people. In 1988 the state started a therapeutic drug-use-evaluation (DUE) program in correct with the supplier, Health Information Designs, a subsidiary of ValueRx Pharmacy Program. In 1991 the partnership with ValueRx was expanded to include patient profilling and physician education. In 1993 the state implemented a prior-authorization program for certain high-technology drugs, also administered by ValueRx. New York's public work force is heavily unionized, and the unions have been deeply involved in program design and vendor selection. Program participants have access to a large network of community pharmacies. The program also provides mail-order service. Quality is at the center of the state's and the unions' prescription drug program philosophy. Saving money is also a major objective; savings totaling $19.5 million were realized from 1988 through 1993 under the partnership between the state and ValueRx. The Empire Plan's prescription drug benefits program is building quality and saving money by integrating DUE, prior authorization, education, community pharmacy, and mail-order service.

Cost Control↗
PubMed1994

Educating physicians about women's health. Survey of Canadian family medicine residency programs.

OBJECTIVE: To identify which women's health issues are taught in the 2-year core curriculum of Canadian family medicine residency programs and whether educators think their current teaching of women's health is adequate. DESIGN: Mailed survey using a questionnaire. PARTICIPANTS: All program and unit directors of the 16 Canadian family medicine residency training programs were surveyed. Replies were received from 63% (10 of 16) of program directors and 79% (55 of 70) of unit directors. MAIN OUTCOME MEASURES: Percentage of programs teaching specific women's health topics from a list of 21 possible topics; percentage offering educational opportunities with sexual assault teams and women's shelters; participants' assessment of the adequacy of current teaching in each training program; plans to increase women's health education. RESULTS: Topics such as violence against women and medical conditions more common among women were taught in more than 80% of programs, but poverty and the health care concerns of Native and immigrant women were included in fewer than 40% of programs. Half of the program directors indicated that residents were given educational opportunities with sexual assault teams or women's shelters. Unit directors gave a lower estimate. Most (90%) program directors thought their current teaching of women's health issues was inadequate and had plans to increase it, as did 64% of unit directors. CONCLUSION: Violence against women and the traditional medical topics of osteoporosis, weight disorders, and reproductive and breast cancer are frequently taught in family medicine training programs. However, the social and cultural aspects of health are addressed less often. It is encouraging that many family medicine programs plan to increase their teaching of women's health.

Attitude of Health Personnel↗
PubMed1997

Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up.

In a randomized, blinded study, we compared the outcome from a full-time functional restoration program with the outcome from shorter active rehabilitation programs for patients with chronic, disabling low back pain. The study initially included 132 patients, randomized into one of three treatment programs: (1) an intensive 3-week multidisciplinary program; (2) active physical training and back school; or (3) psychological pain management and active physical training. Nine of the randomized patients never started in any program, so the studied population consisted of 123 patients. Of these, 14 patients (11%) dropped out. The results presented here are at 1 year following treatment, where we achieved a 92% response rate, including the drop-outs. The functional restoration program was superior to the shorter programs as to work-ready rate, health care contacts, back pain level, disability level, staying physically active, and reduction in analgesics. There was no significant difference between Programs 2 and 3 in most of these parameters. As for sick leave and leg pain, there was no significant difference between Programs 1 and 2, although a difference was observed when comparing Program 3 with each of the other two. Conclusively, it seems that there is human, as well as economical, benefit from a functional restoration program compared to less intensive programs for these patients.

Adolescent↗
PubMed1998

[Effectiveness and feasibility of a strategy for increasing participation in the Japanese Stomach Cancer Examination programs by incorporating serum pepsinogen tests].

The number of people examined in "the Japanese Stomach Cancer Examination" programs under "Health Services Law for the Aged" has not increased, and a strategy is needed to increase participation in the programs. We have thought out a plan to persuade people to the programs by using serum pepsinogen tests without changing the framework of the programs. The plan is as follows: The subjects are those who undergo phlebotomy in "the General Health Examination" programs and who do not undergo the Stomach Examination programs. Serum pepsinogen levels are measured using the sera and those with high risk for stomach cancer are persuaded to attend "the Stomach Examination" programs. To estimate the effect of the plan, we asked several local governments to complete a questionnaire on the numbers of subjects. The ratio of the number of the subjects in the plan to the number of screenees in recent Stomach Examination programs was 0.61. An increase of about 15% was expected in screenees of the Stomach Examination Programs, if 40% of the subjects in the plan were diagnosed as high risk and 60% of the high risk subjects attended the Stomach Examination programs. From the economical stand point, it was expected that detection rate would increase and that the plan did not raise the cost for detecting a patient with stomach cancer. We also conducted a questionnaire survey of those who would be the subjects of the plan. Eighty-two percent of the subjects answered that they would attend the Stomach Examination programs, if they were told that their risk of stomach cancer was high by the serum pepsinogen tests. These results seem to suggest that more people would participate in cancer examination programs when informed that their risk for cancer is high as determined by blood tests.

Humans↗
PubMed2005

Heterogeneity of heart failure management programs in Australia.

BACKGROUND: Heart Failure Management Programs (HFMPs) have proven to be cost-effective in minimising recurrent hospitalisations, morbidity and mortality. However, variability between the programs exists which could translate into variable health outcomes. OBJECTIVE: To survey the characteristics of HFMPs throughout Australia and to identify potential heterogeneity in their organisation and structure. METHOD: Thirty-nine post-discharge HFMPs were identified from a systematic search of the Australian health-care system in 2002. A comprehensive 19-item questionnaire specifically examining characteristics of HFMPs was sent to co-ordinators of identified programs in early 2003. RESULTS: All participants responded with six institutions (15%) indicating that their HFMP had ceased operations due to a lack of funding. The survey revealed an uneven distribution of the 33 active HFMPs operating throughout Australia. Overall, 4450 post-discharge HF patients (median: 74; IQR: 24-147) were managed via these programs, representing only 11% of the potential caseload for an Australia-wide network of HFMPs. Heterogeneity of these programs existed in respect to the model of care applied within the program (70% applied a home-based program and 18% a specialist HF clinic) and applied interventions (30% of programs had no discharge criteria and 45% of programs prevented nurses administering/titrating medications). Sustained funding was available to only 52% of the active HFMPs. CONCLUSION: Inequity of access to HFMPs in Australia is evident in relation to locality and high service demand, further complicated by inadequate funding. Heterogeneity between these programs is substantial. The development of national benchmarks for evidence-based HFMPs is required to address program variability and funding issues to realise their potential to improve health outcomes.

Aftercare↗
PubMed2003

A formative evaluation in maternal and child health practice: the Partners for Life Nutrition Education Program for pregnant women.

OBJECTIVES: This paper describes the formative evaluation of the Partners For Life Program that was developed to change dietary behavior of low income pregnant women in the Mississippi Delta region. METHODS: A diverse group of nutrition/health professionals, adapted the Expanded Food and Nutrition Education Program's (EFNEP) methodology for pregnant patients in the local Women, Infants, and Children program who were receiving maternity care at the county health department. Formative evaluation activities included gathering data to determine 1) whether a new nutrition curriculum, modeled after EFNEP could be created, 2) whether peer educators could be recruited and trained to deliver the intervention, 3) whether pregnant women could be recruited to participate in the new program, 4) whether a pilot test of the new intervention would produce short-term impact in nutrition knowledge and dietary behavior, and 5) reactions of pregnant women on the usability of the new program. Data were gathered through use of the Program Implementation Index, focus groups, and a retrospective record review. Pilot test assessments included tests of nutrition knowledge and self-reported changes in dietary behavior. RESULTS: The formative evaluation demonstrated both positive and negative outcomes. Positive data included 1) successful recruitment and training of the peer educators to deliver the intervention; 2) successful recruitment of the targeted population for the pilot study; 3) complete information on project questionnaires and measuring forms; and 4) among those who completed the program, a statistically significant improvement in nutrition knowledge and dietary behavior. Two negative aspects in this formative study were 1) the Program Implementation Index quantitatively showed that the program experienced problems retaining participants it recruited and 2) deviation of the timeframe for intervention delivery. Program length was identified as the primary reason for participant attrition. CONCLUSIONS: It is important for program developers to use results from formative evaluations to make changes in problem areas prior to implementation of a full-scale impact evaluation.

Advisory Committees↗
PubMedDate not supplied

Developing a community program on cancer pain and fatigue.

PURPOSE: The overall purpose of this project was to establish a community-based educational model on pain and fatigue management for individuals with cancer. The specific aims were: 1) to develop an appropriate educational program; 2) to pilot test this program in a community setting that supported a self-care approach; and 3) to evaluate the program process and outcomes. DESCRIPTION OF PROGRAM: The I Feel Better program was implemented through a two-session educational workshop taught by masters-prepared oncology nurses and was held at four Southern California sites of The Wellness Community. The focus of the sessions was to provide participants with general information about each symptom, assessment and management of those symptoms, and strategies for effectively communicating with their healthcare providers. Sessions of 2.5-hour duration were held on Saturday mornings and required preregistration. RESULTS: The participants were primarily female and White, with an average age of 58 years. Participants reported considerable pain and fatigue. They also lacked accurate information about pain management. Program evaluation revealed that the content and format were well received by the participants. They rated the program as extremely useful and reported positive outcomes after the first session. CLINICAL IMPLICATIONS: This pilot educational intervention program has strong implications for multidisciplinary educational approaches for patients with cancer. Limitations resulted from the setting selected and the possibility that participants were already active in their fight against cancer. Generalization to other community settings may not be as successful. Programs could be cosponsored by several collaborating institutions to share resources. Referral to community programs by physicians, nurses, and social workers can occur as needed when identified during patient interventions. The voluntary participation of health professionals in community education programs could provide a valuable service for patients and a rewarding experience for educators.

Adult↗
PubMed1997

Office ergonomics programs. A case study of North American corporations.

Subject matter experts from 13 North American corporations provided detailed descriptions of the historical development and the current components and operations of their office ergonomics programs. Results were summarized across corporations and presented for the following programmatic topics: backgrounds of key people, initial awareness and preliminary needs assessment, program development, program implementation, program monitoring and evaluation, program components, education and training, workstation and job analysis, early identification of cases, case management, and alternate office environments. The subject matter experts also provided comments about the strengths of their programs, their advice to others, and lessons they learned. These observations suggested the need for an office ergonomics program, and possibly other occupational health programs, to fit into a corporation's culture and capitalize on its infrastructure. Most corporations used multidisciplinary task forces or teams to develop their programs. Communication, which included training, awareness, advertising, and feedback, was also an important issue. Flexibility and simplicity were important attributes of these programs. It is hoped that this descriptive information will be helpful to some occupational health managers interested in or concerned about managerial perspectives and skills related to the development and implementation of programs within their own corporations.

Ergonomics↗
PubMed2005

Chile's national nutritional supplementation program for older people: lessons learned.

Demographic changes in developing countries have resulted in rapid increases in the size of the older population. As a result, health-care budgets face increasing costs associated with the declining health and function of older people. Some governments have responded to this situation by designing innovative programs aimed at older people. One such program, implemented by the government of Chile, distributes an instant food mix fortified with vitamins and minerals to all persons over 70 years old who are registered by the national health service. The national health service covers approximately 90% of the older population. The program specifically targets nutritional vulnerability and micronutrient deficiency, which are common among poor older people in Chile. We present here the findings of a one-year investigation into all aspects of Chile's program for the elderly. The research included in-depth interviews with policy makers and program implementers, focus group discussions with user groups, analysis of the micronutrient content of the nutritional supplement, and telephone interviews of a random sample of older people. The results demonstrate that there can be a considerable degree of self-targeting within national programs; programs need to be sufficiently flexible to permit periodic protocol change; user groups must be consulted both before and during program implementation; and the design of an effective program evaluation must be in place before program implementation. It is hoped that these results will be useful to policy makers and implementers planning programs aimed at improving the health and function of older people.

Aged↗