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Health Education Research - current issue

African-American caregivers' breast health behavior
Inoue, M., Pickard, J. G., Welch-Saleeby, P., Johnson, S. This study utilizes a stress and coping framework which includes cognitive appraisal, personal and environmental resources, coping and stress to examine factors related to African-American caregivers’ breast cancer screenings, including mammograms, clinical examinations and self-examinations. Using data from the Black Rural and Urban Caregivers Mental Health and Functioning Study, we performed separate logistic regressions for each type of breast cancer screening. Results reveal that having a regular doctor checkup (coping), care recipients having a cancer diagnosis (cognitive appraisal, and living in urban areas (environment resources) are associated with receiving a mammogram. Having greater income, having at least a high school degree (both personal resources) and having a regular doctor checkup (coping) are associated with receiving a clinical examination. Increased caregiver strain (stress), being 40 years old or older, social support (coping) and living in rural areas are associated with performing a self-examination. Targeting African-American caregivers, particularly in rural areas, for increased education on the importance of receiving breast cancer screenings is crucial to addressing health disparities. Making resources available, encouraging caregivers to get a clinical examination and a mammogram and directing public education toward caregivers are important points of intervention.
Stages of mammography adoption in Asian American women
Wu, T.-Y., Hsieh, H. F., West, B. T. Asian American women have the lowest mammography screening rate and are often diagnosed at later stages of breast cancer compared with other ethnic groups. This study applied the Transtheoretical Model and examined the relationships between stages of mammography adoption and mammography-related beliefs while controlling for socio-demographic factors. The study consisted of a convenience sample of 315 participants from four populous Asian ethnic groups in Michigan (109 Asian Indians, 51 Chinese, 36 Koreans and 119 Filipinos). In this relatively small sample, Koreans appeared to be more likely to be at the pre-contemplation stage and less likely to be at the maintenance stage. Perceived barriers and decisional balance scores differed by stage, with pre-contemplators reporting highest barriers and lowest scores in decisional balance. In terms of specific barrier items, pre-contemplators also displayed significantly greater agreement for most of the barrier items. Participants in the action stage have less favorable decisional balance than those in two earlier stages (i.e. contemplation and relapse). Common barriers for this sample of Asian participants included the items related to access and modesty issues. Overall, the study supports the notion that assessing differences in mammography-related beliefs by stage of screening behavior may facilitate the development of stage-matched interventions for Asian ethnic groups.
A qualitative exploration of the community partner experience in a faith-based breast cancer educational intervention
Rodriguez, E. M., Bowie, J. V., Frattaroli, S., Gielen, A. Although community partner engagement is a key component in faith-based health promotion/disease prevention intervention research, the perspective of community partners on their experiences in the intervention process has been infrequently investigated. Semi-structured in-depth interviews were conducted with 12 African-American community partners [i.e. four pastors and eight lay health co-ordinators (LHCs)] from eight churches in greater Baltimore, MD, USA, that engaged in a breast cancer educational intervention that followed a community-based participatory research (CBPR) approach. Audiotaped interviews were transcribed, coded and content analysis was used to identify themes across the codes. Findings show that pastors support a holistic approach to health and that LHCs act as a link between the pastors, participants and academic researchers. In addition, pastors and LHCs emphasized that the religious and/or spiritual program elements should not overpower the importance of reaching participants with critical health information regardless of their religious or spiritual beliefs. Study findings suggest that faith-based educational intervention efforts that follow a CBPR approach are important in promoting cancer awareness in the African-American community. Including community partner assessment can further elucidate critical intervention impacts and helps to address health disparities in underserved communities.
Process evaluation of a school-based weight gain prevention program: the Dutch Obesity Intervention in Teenagers (DOiT)
Singh, A. S., Chinapaw, M. J. M., Brug, J., van Mechelen, W. Health promotion programs benefit from an accompanying process evaluation since it can provide more insight in the strengths and weaknesses of a program. A process evaluation was conducted to assess the reach, implementation, satisfaction and maintenance of a school-based program aimed at the prevention of excessive weight gain among Dutch adolescents [Dutch Obesity Intervention in Teenagers (DOiT)]. Our process evaluation involved data collections by means of questionnaires among students, teachers, school board and site staff. The results indicated immense difficulties in the recruitment phase and therefore a low reach at school level. However, among adolescents of the schools that participated, the reach was high (84%). Furthermore, the classroom intervention was implemented successfully based on the number of lessons taught. Most teachers rated the DOiT-intervention positively; students rated the intervention 6.6 on a scale of 1–10. The majority of the teachers planned to implement the DOiT-intervention program in the future, as they perceived DOiT feasible for pre-vocational education students.
Baseline survey of sun protection policies and practices in primary school settings in New Zealand
Reeder, A. I., Jopson, J. A., Gray, A. The SunSmart Schools Accreditation Programme (SSAP) was launched as a national programme in October 2005 to help reduce the risk of excessive child exposure to ultraviolet radiation. As part of the need for evaluation, this paper reports the findings of a national survey of a randomly selected sample of approximately 12% of New Zealand primary schools prior to the national launch of the SSAP. Principals at 242 schools completed a mail survey (81% response rate) relating to school sun protection policies, practices, curriculum and environment. Survey responses were evaluated according to the 12 criteria of the SSAP, with schools assigned a score from 0 to 12. No school fully met all 12 accreditation criteria, although 2% of schools attained 11 criteria and another 2% attained 10. Nine per cent of schools attained three or fewer criteria. Overall, 7 was the most common score, achieved by 23%. School socio-economic decile rating and roll size were positively associated with higher scores (both P < 0.02). Continued support and resources are needed to encourage schools to address sun protection across the spectrum of curriculum, practices and environment and through commitment to written policy.
Which patient-related factors determine self-perceived patient adherence to prescribed dyspepsia medication?
Fransen, G. A. J., Mesters, I., Janssen, M. J. R., Knottnerus, J. A., Muris, J. W. M. Patient adherence to medical treatment for dyspepsia is disappointing, whereas adherence is crucial for a proper evaluation of treatment. This prospective study used elements of the Integrated Change Model and Weiner's Attribution Theory to describe patients’ important cognitions and their interrelationships regarding self-perceived adherence to short-term medical treatment for dyspepsia. Patient questionnaires measured the predictors before treatment and self-perceived adherence after treatment. Approximately one-quarter of the patients indicated that they were non-adherent (n = 347). Univariate and multiple linear regression analyses revealed several significant predictors that explained 44% of the variance in self-perceived adherence. Patients with a low educational level, patients who claimed to regularly forget their medication in general, patients with a low self-efficacy or a low intention were less likely to be adherent. These results may indicate targets for interventions designed to improve adherence to medical treatment for dyspepsia. For instance, asking about expected difficulties in taking acid suppressants (e.g. forgetfulness or medication use at weekends) and making action plans to overcome these difficulties (e.g. using reminders) may result in improved adherence rates. Such an approach may reach a substantial number of patients since one in five patients in our study experienced some difficulties in taking medication.

NYT > Health

Patient Money: Getting Medical Help for the Mind as Well as the Body
By LESLEY ALDERMAN Fri, 06 Nov 2009 15:41:54 -0000
A new law requires that next year big group plans provide the same level of care for mental health as for medical ones.
Research Shows Neighborhoods Where AIDS Treatments Lag
By CAROL POGASH Fri, 06 Nov 2009 19:40:29 -0000
The San Francisco heath department is mapping the city to show where the sickest AIDS patients live, part of an effort to identify where care should be focused.
Recipes for Health: Puree of Chickpea Soup
By MARTHA ROSE SHULMAN Fri, 06 Nov 2009 20:58:09 -0000
This delicate, velvety soup is a surprising departure from the hearty stews in which chickpeas often appear.
Readers Ask: Ulcers
By The New York Times Thu, 05 Nov 2009 18:19:13 -0000
Dr. Neena S. Abraham answers readers' questions about ulcers.
After Setbacks, Small Successes for Gene Therapy
By GINA KOLATA Fri, 06 Nov 2009 07:15:55 -0000
Three recent successes, though small, prompted hopes among scientists that a still-experimental idea for correcting genetic disorders might be back.
F.D.A. Fighting False Online Claims About Swine Flu Treatments
By LESLIE WAYNE Fri, 06 Nov 2009 20:36:43 -0000
The Food and Drug Administration has identified 140 different dubious products sold online and has sent letters to 75 manufacturers.

BBC News | Health | UK Edition

Foetal heart rate monitor warning
Fri, 06 Nov 2009 00:35:31 -0000
Doctors are warning expectant parents that at-home foetal heart rate monitors can give false reassurance.
Babies 'cry in mother's tongue'
Fri, 06 Nov 2009 10:38:56 -0000
German researchers say babies begin to pick up the nuances of their parents' accents while still in the womb.
Experts map the body's bacteria
Fri, 06 Nov 2009 00:46:22 -0000
Scientists have developed an atlas of the bacteria that live in different regions of the human body.
Young 'must have swine flu jab'
Thu, 05 Nov 2009 17:13:16 -0000
All schoolchildren and college students should be vaccinated against swine flu, the Tories say.
Tiny tech sparks cell signal find
Thu, 05 Nov 2009 18:10:16 -0000
Tiny metal particles have been shown to cause damage to DNA across a cellular barrier - without having to cross it
Doctor says baby 'better at home'
Thu, 05 Nov 2009 17:57:04 -0000
A doctor says a baby in a right-to life case will be able to communicate with other people and will be better off at home.

NYT > Health

Patient Money: Getting Medical Help for the Mind as Well as the Body
By LESLEY ALDERMAN Fri, 06 Nov 2009 15:41:54 -0000
A new law requires that next year big group plans provide the same level of care for mental health as for medical ones.
Research Shows Neighborhoods Where AIDS Treatments Lag
By CAROL POGASH Fri, 06 Nov 2009 19:40:29 -0000
The San Francisco heath department is mapping the city to show where the sickest AIDS patients live, part of an effort to identify where care should be focused.
Recipes for Health: Puree of Chickpea Soup
By MARTHA ROSE SHULMAN Fri, 06 Nov 2009 20:58:09 -0000
This delicate, velvety soup is a surprising departure from the hearty stews in which chickpeas often appear.
Readers Ask: Ulcers
By The New York Times Thu, 05 Nov 2009 18:19:13 -0000
Dr. Neena S. Abraham answers readers' questions about ulcers.
After Setbacks, Small Successes for Gene Therapy
By GINA KOLATA Fri, 06 Nov 2009 07:15:55 -0000
Three recent successes, though small, prompted hopes among scientists that a still-experimental idea for correcting genetic disorders might be back.
F.D.A. Fighting False Online Claims About Swine Flu Treatments
By LESLIE WAYNE Fri, 06 Nov 2009 20:36:43 -0000
The Food and Drug Administration has identified 140 different dubious products sold online and has sent letters to 75 manufacturers.

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