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Health Education Research - current issue

Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT)
Burke, V., Beilin, L. J., Cutt, H. E., Mansour, J., Mori, T. A. Tue, 08 Jul 2008 00:00:00 -0000
We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits. Outcomes examined were saturated fat intake (% energy) and physical activity (hours per week). In total, 90/118 individuals randomized to usual care and 102/123 to the program-completed follow-up. Sex was a moderator of response post-intervention for diet and physical activity, with a greater response among women with usual care and among men with the program. Change in self-efficacy was a mediator of dietary change post-intervention [effect size (ES) –0.055, 95% confidence interval (CI) –0.125, –0.005] and at follow-up (ES 0.054, 95% CI –0.127, –0.005), and in physical activity post-intervention (ES 0.059, 95% CI 0.003, 0.147). These findings highlight different responses of men and women to the program, and the importance of self-efficacy as a mediator. Mediators for physical activity in the longer term should be investigated in other models, with appropriate cognitive measurements, in future trials.
Storage of household firearms: an examination of the attitudes and beliefs of married women with children
Johnson, R. M., Runyan, C. W., Coyne-Beasley, T., Lewis, M. A., Bowling, J. M. Tue, 08 Jul 2008 00:00:00 -0000
Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n = 185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon–Mann–Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.
Will patients agree to have their literacy skills assessed in clinical practice?
Ryan, J. G., Leguen, F., Weiss, B. D., Albury, S., Jennings, T., Velez, F., Salibi, N. Tue, 08 Jul 2008 00:00:00 -0000
If health providers are aware of their patients' literacy skills, they can more appropriately tailor their communication with patients. Few providers, however, assess patient's literacy skills for fear of offending patients, but no research has ever determined if patients object to such assessments. Our objectives were to determine the percentage of patients seen for routine health care that would agree to undergo literacy assessment and if satisfaction of patients differs in practices that perform literacy assessments versus practices that do not. We randomized 20 private and public medical practices to an intervention group that implemented literacy assessments with the Newest Vital Sign and a control group that did not. For intervention practices, we noted the percentage of patients agreeing to undergo the assessment. For both intervention and control practices, we assessed patient satisfaction. Of 289 patients asked to undergo literacy assessment in the intervention practices, 284 (98.3%) agreed to do so, including 125 (46.1%) with low or possibly low literacy skills. There was no difference in satisfaction between the intervention group and the control group. We conclude that patients are willing to undergo literacy assessments during routine office visits and performing such assessments does not decrease patient satisfaction.
Perceived risk factors of cardiovascular diseases and diabetes in Cameroon
Awah, P. K., Kengne, A. P., Fezeu, L. L. K., Mbanya, J.-C. Tue, 08 Jul 2008 00:00:00 -0000
We set out to assess the perceived risk factors of cardiovascular diseases (CVDs) and diabetes mellitus in an urban setting using focus group discussions and in-depth interviews to collect data from different stakeholders constituting the triangle of care. Ethnomethodological analyses were done manually and with Ethnograph® software. The results showed an awareness of emergence of CVD and diabetes in Cameroon and perceived relationships between risk factors and CVD and diabetes. The awareness of behavioural risk factors was higher than the biological ones, though perceptions about them were muddled. The main drawbacks for reducing risk factors were perceived to emerge from the lack of a national policy programme on non-communicable diseases; and the low level of awareness of the need to reduce these risk factors. The assessment illustrates that there is currently a mismatch between the needs and expectations of all the stakeholders regarding health promotion and advice on risk factors reduction and an apparent reluctance by health care providers to fulfil this role. This issue can only be addressed in countries of sub-Sahara through capacity building for control and prevention of CVD risk factors.
The role of life skills promotion in substance abuse prevention: a mediation analysis
Buhler, A., Schroder, E., Silbereisen, R. K. Tue, 08 Jul 2008 00:00:00 -0000
Research has shown that life skills programs are the most effective single activity in school-based substance abuse prevention. However, little is known about the processes through which they are effective. This study examines whether an evidence-based prevention program targeting general competence is effective through the promotion of knowledge about life skills and enhanced related behaviors. Based on a sample of 442 fifth graders participating in a quasi-experimental prevention study, as expected, mediation analyses revealed that increased knowledge about life skills paralleled an increase in students’ distant attitudes toward alcohol and nicotine use. Unexpectedly, behaviors manifesting enhanced life skills were found not only among program participants who remained experimental/non-smokers or stopped smoking but also among smokers. In general, findings suggest that favorable prevention outcomes may be influenced through building knowledge about general life skills. The notion of uniform mechanisms of effectiveness in prevention programs is discussed.
Girls and young women's participation in physical activity: psychological and social influences
Coleman, L., Cox, L., Roker, D. Tue, 08 Jul 2008 00:00:00 -0000
The importance of increasing young women's level of physical activity is recognized as a priority within the United Kingdom and other Westernized nations. This study, conducted in two distinct geographical locations in the United Kingdom, explores the leading influences upon levels of physical activity participation among 75 young women aged 15–19. Through in-depth interviews, this study explores the influence of psychological and social influences, by examining contrasting accounts from those young women who ‘always’ and ‘never’ participate in sport or physical activity. The main differences lie with the always participates, relative to the never participates, reporting more positive images of ‘sport’, positive perceptions of their own ability, low self-consciousness, firm motivations and personal choice to engage in activities and the supporting influence of their friends and family. The study also notes the detrimental impact of life transitions such as moving from college to full-time employment. Further case study analyses reveal the friendship group as the primary influence over all other factors considered. The research concludes by summarizing the influences on physical activity participation that are pertinent to this age group, highlights theoretical implications, suggests possible intervention strategies and reports areas of further investigation that are required.

Health & Science - International Herald Tribune

In the U.S., a rise in medical efforts to treat the very old
By ANEMONA HARTOCOLLIS Fri, 18 Jul 2008 21:16:53 -0000
Some doctors are hailing surgery for centenarians, but others say such procedures can be wasteful and barbaric.
In a veterans' hospital, fighting a futile war
By MARIANNA CRANE Fri, 18 Jul 2008 21:16:53 -0000
On the screen I read: suspicious lesion, probable lung cancer. A Vietnam veteran decides it's just a shadow. The truth will surface soon enough.
Drugs to build bones may weaken them
By TARA PARKER-POPE Fri, 18 Jul 2008 21:16:53 -0000
A series of case reports indicates that a rare type of leg fracture is linked to osteoporosis treatment.
Deep flaws found in U.S. health care
By REED ABELSON Fri, 18 Jul 2008 21:16:53 -0000
A study highlights the stark contrast between what the U.S. spends on its health system and the quality of care it delivers, compared with other industrialized nations.
Take two Prozac and e-mail me in the morning
By RICHARD A. FRIEDMAN, M.D Fri, 18 Jul 2008 21:16:53 -0000
Should the therapeutic relationship include e-mail?
Scientists see major activity drop when kids become teens
By TARA PARKER-POPE Fri, 18 Jul 2008 21:16:53 -0000
A study that followed more than a thousand children from ages 9 to 15 indicates that there is a significant drop in the amount of physical activity that they participate in.

BBC News | Health | UK Edition

Human blood vessels grown in mice
Fri, 18 Jul 2008 22:59:43 -0000
Scientists have used human cells to grow new blood vessels in a mouse for the first time, a US journal reports.
Public heart shock scheme success
Fri, 18 Jul 2008 00:56:40 -0000
A scheme to provide defibrillators in public places in England and Wales should be extended, researchers say.
Scan 'detects obsessive disorder'
Fri, 18 Jul 2008 12:58:19 -0000
A brain scan could help identify those at risk of obsessive compulsive disorder (OCD), say scientists.
Nurse gave wrong woman abortion
Fri, 18 Jul 2008 17:15:08 -0000
A nurse is cautioned after wrongly giving a chemical abortion to a patient who had come in for a consultation and tests.
Alzheimer's drug trial 'promise'
Fri, 18 Jul 2008 01:31:04 -0000
A drug once used to treat hayfever "improves" symptoms in patients with Alzheimer's disease, research suggests.
Kenyans reject circumcision plan
Fri, 18 Jul 2008 16:44:51 -0000
Elders from Kenya's Luo community reject a government plan to promote circumcision to stem HIV/Aids.

Health & Science - International Herald Tribune

In the U.S., a rise in medical efforts to treat the very old
By ANEMONA HARTOCOLLIS Fri, 18 Jul 2008 21:16:53 -0000
Some doctors are hailing surgery for centenarians, but others say such procedures can be wasteful and barbaric.
In a veterans' hospital, fighting a futile war
By MARIANNA CRANE Fri, 18 Jul 2008 21:16:53 -0000
On the screen I read: suspicious lesion, probable lung cancer. A Vietnam veteran decides it's just a shadow. The truth will surface soon enough.
Drugs to build bones may weaken them
By TARA PARKER-POPE Fri, 18 Jul 2008 21:16:53 -0000
A series of case reports indicates that a rare type of leg fracture is linked to osteoporosis treatment.
Deep flaws found in U.S. health care
By REED ABELSON Fri, 18 Jul 2008 21:16:53 -0000
A study highlights the stark contrast between what the U.S. spends on its health system and the quality of care it delivers, compared with other industrialized nations.
Take two Prozac and e-mail me in the morning
By RICHARD A. FRIEDMAN, M.D Fri, 18 Jul 2008 21:16:53 -0000
Should the therapeutic relationship include e-mail?
Scientists see major activity drop when kids become teens
By TARA PARKER-POPE Fri, 18 Jul 2008 21:16:53 -0000
A study that followed more than a thousand children from ages 9 to 15 indicates that there is a significant drop in the amount of physical activity that they participate in.

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