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Could It Be Asthma? Using Social Marketing Strategies to Increase Parent and Caregiver Knowledge of Asthma Symptoms in Children in a Rural Community

Briones, K., Lustik, F., LaLone, J. — Wed, 28 Oct 2009 09:44:14 PDT

Many parents and caregivers do not recognize the symptoms of asthma in children, and consequently children may not receive the appropriate diagnosis and treatment for this potentially fatal disease. This article describes how Steps to a HealthierNY used social marketing strategies to design a media campaign called "Could It Be Asthma?" to educate parents and caregivers about the symptoms of asthma. The campaign used television advertising, brochures, and posters to educate parents and caregivers in rural Jefferson County, New York, about asthma symptoms. The campaign ran in March and April 2005. A follow-up survey was conducted among 756 parents and caregivers in collaboration with four local pediatricians’ offices. Results showed that approximately 60% of participants were familiar with "Could It Be Asthma?" Of those participants, approximately 68% indicated that the ads had a positive impact and 46% indicated that they had learned the symptoms of asthma. The campaign and survey were repeated in the fall of 2005. Results were consistent, with a significant increase in the percentage of people who were familiar with the campaign. This social marketing campaign was successful in reaching parents in a rural community with important educational messages; similar strategies should be considered in educating the public about asthma and other health issues.

Relaunching a National Social Marketing Campaign: Expectations and Challenges for the "New" ParticipACTION

Faulkner, G., McCloy, C., Plotnikoff, R. C., Tremblay, M. S. — Tue, 27 Oct 2009 16:23:35 PDT

ParticipACTION is a Canadian physical activity communications and social marketing organization that has been relaunched in 2007 after a 6-year hiatus. The purpose of this study is to qualitatively identify and describe the expectations and challenges the relaunch of the new ParticipACTION may present for existing physical activity organizations. Using a purposeful sampling strategy, the authors conduct semistructured telephone interviews with 49 key informants representing a range of national, provincial, and local organizations with a mandate to promote physical activity. Overall, there is strong support in seeing ParticipACTION relaunched. However, organizational expectations and/or their ideal vision for it are mixed. Organizations envision and support its performing an overarching social marketing and advocacy role, and in providing tools and resources that supplement existing organizational activities. Four major organizational challenges are identified concerning overlapping mandates, partnership and leadership concerns, competition for funding, and capacity concerns. Social marketing initiatives, such as ParticipACTION, may not be able to maximize their impact unless they address the expectations and concerns of competing organizations with a mandate to promote physical activity.

Coalition Contract Management as a Systems Change Strategy for HIV Prevention

Darrow, W. W., Montanea, J. E., Sanchez-Brana, E. — Tue, 27 Oct 2009 16:23:35 PDT

Racial and Ethnic Approaches to Community Health (REACH) 2010 provided a unique opportunity for minority community-based organizations (CBOs) to work together to eliminate disparities in HIV disease. A coalition was formed in Broward County to respond to the REACH 2010 program announcement, a university was chosen to coordinate efforts, and contracts were negotiated with CBO partners to develop, implement, and evaluate a community action plan. Contract management provided stability, focus, and a mechanism for coalition partners to measure progress toward achieving project objectives. By emphasizing documentation as well as the delivery of services, however, contract conditions also placed a heavy burden on educational outreach workers, restricted the reimbursable activities of member organizations, and created friction between minority agencies and university staff. Although the coalition met many of its objectives, the introduction and enforcement of a mutually agreed on set of rules and obligations as a way of promoting systems change in Broward County failed to make a lasting impact among community partners. CBOs continued to compete with one another for HIV prevention project funding and stopped collaborating as closely with another when federal support for our REACH 2010 community demonstration project ran out.

Building on Partnerships: Reconnecting Kids With Nature for Health Benefits

Kruger, J., Nelson, K., Klein, P., McCurdy, L. E., Pride, P., Ady, J. C. — Mon, 26 Oct 2009 09:42:45 PDT

In April 2008, several federal and nonprofit agencies organized an informational Web-based meeting titled "Reconnecting Kids With Nature for Health Benefits." This online meeting was convened by the Society for Public Health Education and delivered to public health educators, health professionals, environmental educators, and land conservationists to raise awareness of national efforts to promote children’s involvement in outdoor recreation. This article describes eight programs discussed at this meeting. For public health professionals, partnership with land-management agencies conducting such programs may be an effective way to increase physical activity levels among children.

How to Adapt Effective Programs for Use in New Contexts

Card, J. J., Solomon, J., Cunningham, S. D. — Mon, 26 Oct 2009 09:42:46 PDT

A wide variety of underused effective HIV prevention programs exist. This article describes sources for obtaining such effective programs and issues to consider in selecting an existing effective program for use with one’s priority population. It also discusses seven steps involved in adapting an effective program to meet the needs of a new context while preserving core components (what made, or is believed to have made, the intervention effective in the first place) and best practices (characteristics common to effective programs). Although the examples presented are from the HIV prevention field, the seven-step framework is applicable to the adaptation of effective programs in other health promotion and disease prevention arenas.

Letting Students Be Innovative! Using Mini-Grants to Fund Student-Designed HIV/AIDS Education

Wyatt, T. J., Oswalt, S. B. — Thu, 22 Oct 2009 11:17:39 PDT

This article describes a project designed to use student leaders to increase the awareness of HIV/AIDS among college students. Student organizations apply for a competitive mini-grant that is used to increase their members’ knowledge level about HIV/AIDS and increase the likelihood of individuals’ practicing behaviors that would reduce the risk of transmission or contraction. Four student organizations receive funds to design a unique HIV/AIDS prevention intervention that match its members’ needs for a total of 126 individuals receiving HIV/AIDS education. An evaluation indicates positive behavioral intentions related to sexual communication and safer sex practices. Moreover, the majority of participants report the education received as relevant and applicable. The methods, intervention applications, and benefits to using an award competition to deliver HIV prevention education to college students in a nontraditional and innovative approach are detailed within this article.

The Effects of School Garden Experiences on Middle School-Aged Students' Knowledge, Attitudes, and Behaviors Associated With Vegetable Consumption

Ratcliffe, M. M., Merrigan, K. A., Rogers, B. L., Goldberg, J. P. — Wed, 21 Oct 2009 09:35:23 PDT

This study describes the effects of garden-based education on children’s vegetable consumption. As part of a pre–post panel study, 236 students complete the Garden Vegetable Frequency Questionnaire and 161 complete a taste test. Results indicate that school gardening may affect children’s vegetable consumption, including improved recognition of, attitudes toward, preferences for, and willingness to taste vegetables. Gardening also increases the variety of vegetables eaten. Future research should explore whether effects persist over time and if and how changes in children’s behavior affect the behavior of their caregivers. Implications of study findings for policy and practice are discussed. Suggestions for applying results to future health promotions are provided.

Understanding the Decision-Making Process for Health Promotion Programming at Small to Midsized Businesses

Hughes, M. C., Patrick, D. L., Hannon, P. A., Harris, J. R., Ghosh, D. L. — Tue, 20 Oct 2009 10:28:59 PDT

This study explores the decision-making process for implementing and continuing health promotion programs at small to midsized businesses to inform health promotion practitioners and researchers as they market their services to these businesses. Qualitative interviews are conducted with 24 employers located in the Pacific Northwest ranging in size from 75 to 800 employees, with the majority having between 100 and 200 employees. Small to midsized employers depend most on company success-related factors rather than on humanitarian motives when deciding whether to adopt workplace health promotion programs. They rely heavily on health insurers for health promotion and desire more information about the actual costs and cost-benefits of programs. To increase health promotion adoption at small to midsized businesses, health promotion practitioners should appeal to overall company success-related factors, use the insurance channel, and target their information to both human resource personnel and senior management.

Methods for the Cultural Adaptation of a Diabetes Lifestyle Intervention for Latinas: An Illustrative Project

Tue, 20 Oct 2009 10:28:37 PDT

Because Latinas experience a high prevalence of type 2 diabetes and its complications, there is an urgent need to reach them with interventions that promote healthful lifestyles. This article illustrates a sequential approach that took an effective multiple-risk-factor behavior-change program and adapted it for Latinas with type 2 diabetes. Adaptation stages include (a) information gathering from literature and focus groups, (b) preliminary adaptation design, and (c) preliminary adaptation test. In this third stage, a pilot study finds that participants were highly satisfied with the intervention and showed improvement across diverse outcomes. Key implications for applications include the importance of a model for guiding cultural adaptations, and the value of procedures for obtaining continuous feedback from staff and participants during the preliminary adaptation test.

Promoting Policy and Environmental Change Using Photovoice in the Kaiser Permanente Community Health Initiative

Tue, 20 Oct 2009 10:28:49 PDT

Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente’s Community Health Initiative—a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization.

The Environmental Health/Home Safety Education Project: A Successful and Practical U.S.-Mexico Border Initiative

Forster-Cox, S. C., Mangadu, T., Jacquez, B., Fullerton, L. — Tue, 20 Oct 2009 10:29:04 PDT

The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.–Mexico border. Utilizing well-trained community members, called promotoras, homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders.

"What Should We Tell the Children About Relationships and Sex?" (C): Development of a Program for Parents Using Intervention Mapping

Newby, K., Bayley, J., Wallace, L. M. — Mon, 12 Oct 2009 10:57:38 PDT

This article describes the development of an intervention that aims to increase the quantity and quality of parent–child communication about sex and relationships. The intervention has been designed as part of a local strategic approach to teenage pregnancy and sexual health. The process and findings of Intervention Mapping (IM), a tool for the development of theory- and evidence-based interventions, are presented. The process involves a detailed assessment of the difficulties parents experience in communicating with their children about sex and relationships. The findings are translated into program and change objectives that specify what parents need to do to improve their communication. Theory-based practical strategies most likely to bring about the desired behavioral change are then identified and pretested. The intervention developed consists of a six-session facilitator-led program that targets parents’ attitudes, knowledge, communication skills, and self-efficacy. Following on from Bartholomew’s seminal work on IM, this article develops and extends the application of this process by presenting explicit detail on the behavioral change techniques used and their theoretical underpinnings. The strengths and weaknesses of IM as a process for the development of health behavior interventions are discussed.

Creating Community-Academic Partnerships for Cancer Disparities Research and Health Promotion

Meade, C. D., Menard, J. M., Luque, J. S., Martinez-Tyson, D., Gwede, C. K. — Mon, 12 Oct 2009 10:57:38 PDT

To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community–academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships.

Communicating Contentious Health Policy: Lessons From Ireland's Workplace Smoking Ban

Fahy, D., Trench, B., Clancy, L. — Thu, 08 Oct 2009 08:02:20 PDT

The Irish workplace smoking ban has been described as possibly a tipping point for public health worldwide. This article presents the first analysis of the newspaper coverage of the ban over the duration of the policy formation process. It adds to previous studies by analyzing how health communication strategists engaged, over time, with a newsworthy topic, viewed as being culturally controversial. It analyzes a sample of media content (n = 1,154) and firsthand accounts from pro-ban campaigners and journalists (n = 10). The analysis shows that the ban was covered not primarily as a health issue: Economic, political, social, democratic, and technical aspects also received significant attention. It shows how coverage followed controversy and examines how pro-ban campaigners countered effectively the anti-ban communication efforts of influential social actors in the economic and political spheres. The analysis demonstrates that medical–political sources successfully defined the ban’s issues as centrally concerned with public health.

Establishing Cause for Developing and Implementing a Broad-Based Marketing Effort for the Health Education Field

Stellefson, M., Barry, A., Chaney, B. H., Chaney, J. D., Hanik, B. — Thu, 08 Oct 2009 08:02:20 PDT

What exactly is health education? Professionals with advanced degrees in health education have most likely encountered questions such as these either during introductory coursework or from those inquiring about the field. These queries can prove quite perplexing when asked by individuals who are unaware of the health education profession. Because the act of marketing health education is crucial to the sustainability of the field, the purpose of this article is to (a) explore the issue of describing and promoting health education, (b) establish ideas that can facilitate the provision of coordinated marketing efforts, and (c) offer marketing management and implementation principles that can assist in marketing both health education and health educators. Based on this discussion, the authors suggest building mainstream consensus in regards to marketing message development and implementation to better position health education.

The Physician's Role in Reducing SIDS

Mon, 20 Jul 2009 08:41:11 PDT

Despite a sustained public education campaign aimed at reducing the risks of sudden infant death syndrome (SIDS), it remains one of the leading causes of infant death. This study aims to determine physicians’ knowledge of SIDS and whether physicians are discussing how to reduce the risk of SIDS with parents. A cross-sectional survey is sent to 912 pediatricians, family practitioners, and obstetrician-gynecologists in Central New York State. The response rate is 23.5%. Almost all respondents (99.5%) agree that certain measures can be taken to reduce the risks of SIDS, but 30.3% incorrectly state that the safest sleep position is something other than on the back. Although 97.6% agree that it is important to discuss SIDS with parents, 30% admit to not discussing this information. To continue to decrease the SIDS rate, physicians must take responsibility for educating themselves and parents about safe sleep practices and other SIDS risk factors.

The Use of Illustrated Story Mapping to Enhance Focus Group Discussion

Thu, 16 Jul 2009 11:31:29 PDT

Key informant interviews and focus groups assist in eliciting qualitative data from the community in order to develop educational programs. This article describes how an additional methodology, illustrated story maps, are used to obtain context-specific information on what African American and Hispanic men need to know to make an informed decision about prostate cancer screening. These maps are created as a result of key informant interviews and implemented during focus groups. Twenty focus groups are conducted using the story maps, which depicts scenarios of how men make medical decisions, possible influences on medical decisions, and potential consequences of these decisions. The illustrated story maps prove to encourage directed discussion during the focus groups, while still allowing for open sharing of personal experiences. The authors recommend the use of maps when adapting and planning communication and educational programs, particularly where participant dialogue is central to success of the endeavor.

Geographic Information Systems (GIS) for Health Promotion and Public Health: A Review

Nykiforuk, C. I. J., Flaman, L. M. — Mon, 22 Jun 2009 09:08:32 PDT

The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.

Strength of Messaging in Changing Attitudes in a Workplace Wellness Program

Tue, 16 Jun 2009 09:49:50 PDT

The potential benefits of workplace wellness programs are limited by low participation rates of employees, which could be due in part to ineffective persuasion by program providers. This study uses the Elaboration Likelihood Model, as a guiding theory in mixed methods research, to investigate feedback messages about physical activity delivered in a workplace wellness program. This study uses questionnaire and interview data from 32 employees to determine if personally relevant health messages are associated with either positive or negative responses to the messages and subsequent attitude change. General feedback is more appreciated by those who are less fit but are not effective in changing attitudes toward physical activity. Individually targeted messages result in a significant positive attitude change for participants responding positively to the messages. This suggests that individualized health promotion messages provide a stronger argument for individuals, thus increasing the likelihood of attitude change.

Development and Implementation of a Women's Health Promotion Program: The Moms for Moms Approach

Durham, D., Nichols, T. R. — Wed, 10 Jun 2009 09:26:40 PDT

The Moms for Moms (M4M) program provides mothers the arena necessary to explore new ideas and definitions about mothering as well as skills and strategies concerning parenting, family management, and healthy habits. A participatory approach has been used to understand the development and implementation of the program from the perspective of the participants and community agency staff in an urban city. This approach provides detailed descriptions and interpretations of the shared beliefs, behaviors, and values of the participants as well as how these attributes are shaped by involvement in M4M. The findings from a needs assessment and program feasibility study conducted from August 2006 to June 2008 are used to inform a recently launched Healthy Lifestyles Initiative at a community-based agency for women, to determine if M4M fits within the culture of the organization and to determine the relevance of participatory methods to engage mothers and community agencies in creating health promotion programming.

A Social Marketing Approach to Building a Behavioral Intervention for Congenital Cytomegalovirus

Bate, S. L., Cannon, M. J. — Wed, 10 Jun 2009 09:26:41 PDT

Congenital cytomegalovirus (CMV) is the most common congenital infection in the United States, causing permanent disabilities in more than 5,500 children born each year. In the absence of a vaccine, a promising means of prevention is through a behavioral intervention that educates women about CMV and promotes adherence to hygiene guidelines during pregnancy. Although effective behavioral interventions have been identified for other infectious diseases with similar transmission modes, current research has not yet identified an effective intervention for CMV. One way to gather evidence and identify key elements of a successful CMV intervention is through a social marketing approach. This article describes a five-step process for applying social marketing principles to the research and development, implementation, and evaluation of a CMV behavioral intervention.

Strategies for Assessing Community Challenges and Strengths for Cancer Disparities Participatory Research and Outreach

Wed, 10 Jun 2009 09:26:41 PDT

Interventions involving community–academic partnerships must be driven by a participatory approach that is informed by a comprehensive understanding of the perspectives of communities or focus populations. Often research agendas of academics are different from perceived priority needs of community members. Successful and sustainable interventions are made possible with initial open dialogue among all collaborators so that roles are clearly defined and concerns are addressed. This article describes approaches used in the development of a participatory assessment of health and social issues as defined by community and academic partners, current findings, and lessons learned. The assessment is one initial activity of the Tampa Bay Community Cancer Network (TBCCN) to guide network directions through 2010. The TBCCN is one of 25 programs nationwide addressing cancer disparities through sustainable community-based participatory research, outreach, and screening activities.

Healthy Option Preferences of Rural Restaurant Customers

Nothwehr, F., Snetselaar, L., Dawson, J. D., Hradek, C., Sepulveda, M. — Wed, 10 Jun 2009 09:26:41 PDT

In preparation for an intervention study in three rural Iowa restaurants, 250 customers were surveyed regarding their interest in dietary change, perceptions of the restaurant, and interest in healthy options. Customers were ages 18 to 88, with a mean age of 52, and 53% were women. Most agreed that the restaurant offers healthy meals. Options customers stated they were most likely to order if available included meat that is baked or broiled, whole-wheat bread, fresh fruit or steamed vegetables, and regular salad dressing on the side. They were least interested in low-fat sour cream, low-fat salad dressing, low-fat milk, low-calorie dessert, and holding high-fat ingredients. Women were more likely to indicate interest in healthy options than were men. Interest in several options was also positively associated with age. Increasing the healthy options in restaurants may be especially effective in changing the dietary intake of women and older adults.

Using Action Research to Implement an Integrated Pediatric Asthma Case Management and eHealth Intervention for Low-Income Families

Wed, 10 Jun 2009 09:26:40 PDT

Asthma case management and education programs improve pediatric asthma outcomes, but designing rigorous randomized controlled studies that accurately measure effects while encouraging parent participation is challenging. This is especially so for low-income African American families, who face significantly more severe asthma and social stress than their middle-class counterparts. Action research can help health education researchers negotiate between the elegant and complex designs favored by scientists with the real-life challenges of recruitment, implementation, and retention. This article discusses how a multidisciplinary team uses action research concepts to continuously adjust originally proposed protocols through the planning and implementation phases to encourage participation in a year-long randomized controlled trial of a program that combines telephone asthma case management and comprehensive online asthma education. As a result of these efforts, a higher proportion of low-income African American families are recruited into the study than originally proposed.

An Adapted Version of Intervention Mapping (AIM) Is a Tool for Conducting Community-Based Participatory Research

Belansky, E. S., Cutforth, N., Chavez, R. A., Waters, E., Bartlett-Horch, K. — Wed, 10 Jun 2009 09:26:40 PDT

The field of public health is increasingly using community-based participatory research (CBPR) to address complex health problems such as childhood obesity. Despite the growing momentum and funding base for doing CBPR, little is known about how to undertake intervention planning and implementation in a community-academic partnership. An adapted version of Intervention Mapping (AIM) was created as a tool for university and elementary school partners to create school-level environment and policy changes aimed at increasing student physical activity and healthy eating. After AIM was completed, interviews were conducted with school partners. Findings indicate AIM is closely aligned to 7 of 9 CBPR principles. Examples include equitable involvement of all partners, co-learning, and balancing knowledge generation and community improvement. Shortcomings, lessons learned, and suggestions for strengthening the AIM process are described.

Pedometers as Measurement Tools and Motivational Devices: New Insights for Researchers and Practitioners

Gardner, P. J., Campagna, P. D. — Wed, 10 Jun 2009 09:26:39 PDT

Pedometers are increasingly used in physical activity research and health promotion initiatives. This pilot study examines the efficacy of pedometers as motivational tools for increasing daily physical activity and exploring the practical issues related to pedometer use in research and intervention studies. A mixed-method design is used to collect data on the level of activity and in-depth information about participants’ experiences wearing the pedometers. Participants are 10 midlife women between the ages of 45 and 64 (mean age = 52.9). Analysis indicates pedometers function as important motivational tools for increasing daily physical activity and improving the awareness of activity patterns for participants. Findings provide new insights into participants’ experiences using the pedometers and understanding how these devices function as research tools. Several important methodological considerations for future research and intervention designs using pedometers are discussed.

Community-Based Participatory Research With Native American Communities: The Chronic Disease Self-Management Program

Jernigan, V. B. B. — Fri, 17 Apr 2009 09:04:29 PDT

Health disparities among Native Americans persist despite efforts to translate evidence-based programs from research to practice. Few evidence-based, theory-driven prevention and management interventions have been successfully translated within Native American communities. The use of community-based participatory research (CBPR) has shown promise in this process. This article provides an overview of the use of CBPR with Native American communities and discusses the translation of the Stanford Chronic Disease Self-Management Program, using a CBPR approach, with an urban Native American community. This article highlights not only how the CBPR process facilitates the successful translation of the Stanford program but also how CBPR is used within this community to build community capacity.

Evaluation of Criteria for Developing Traffic Safety Materials for Latinos

Streit-Kaplan, E. L., Miara, C., Formica, S. W., Gallagher, S. S. — Tue, 07 Apr 2009 12:20:42 PDT

This quantitative study assessed the validity of guidelines that identified four key characteristics of culturally appropriate Spanish-language traffic safety materials: language, translation, formative evaluation, and credible source material. From a sample of 190, the authors randomly selected 12 Spanish-language educational materials for analysis by 15 experts. Hypotheses included that the experts would rate materials with more of the key characteristics as more effective (likely to affect behavioral change) and rate materials originally developed in Spanish and those that utilized formative evaluation (e.g., pilot tests, focus groups) as more culturally appropriate. Although results revealed a weak association between the number of key characteristics in a material and the rating of its effectiveness, reviewers rated materials originally created in Spanish and those utilizing formative evaluation as significantly more culturally appropriate. The findings and methodology demonstrated important implications for developers and evaluators of any health-related materials for Spanish speakers and other population groups.

Integrating Dental Health Into a Family-Oriented Health Promotion Approach in Guatemala

Antonarakis, G. S. — Fri, 03 Apr 2009 09:42:39 PDT

The family is the core institution around which the life of each family member revolves. The health status of one family member depends on that of the others. Consequently, health promotion should be targeted at families and communities. Oral and dental health can be integrated into the general health promotion program within families, utilizing principles akin to the common risk factor approach. This article describes a health promotion structure in Guatemala. The family-oriented health promotion approach that is applied in Guatemala suggests a suitable approach that can be incorporated into general health plans elsewhere.

Promoting Community Health Resources: Preferred Communication Strategies

Colby, S. E., Johnson, A. L., Eickhoff, A., Johnson, L. — Fri, 03 Apr 2009 09:42:39 PDT

Community health promotion efforts involve communicating resource information to priority populations. Which communication strategies are most effective is largely unknown for specific populations. A random dialed representative phone survey was conducted assessing current health resource community awareness, health resource utilization, and communication strategy preferences. The survey revealed that community members preferred to receive information on health resources from the Internet (28.3%), newspaper (26.4%), or mail (22.3%). Different priority populations had varying health communication strategy preferences (e.g., young adults prefer Internet, older adults prefer newspaper, and obese adults prefer mail). Ideally, if health resources are intended for adult audiences, a campaign that would include communication through newspaper (targeting older adults), mailing (targeting obese adults), and Web sites (targeting younger adults) would be the most effective approach. This research suggests that an assessment of communication strategy preferences of the priority population might be a crucial first step when developing health promotion programs.

Creating REAL MEN: Description of an Intervention to Reduce Drug Use, HIV Risk, and Rearrest Among Young Men Returning to Urban Communities From Jail

Daniels, J., Crum, M., Ramaswamy, M., Freudenberg, N. — Fri, 03 Apr 2009 09:42:39 PDT

This article describes the life circumstances and risk behaviors of 552 adolescent males returning home from jail. Most young men reported several sources of support in their lives and many had more tolerant views toward women and intimate relationships than portrayed in mainstream media. They also reported high levels of marijuana and alcohol use, risky sexual behavior, and prior arrests. Investigators designed the Returning Educated African American and Latino Men to Enriched Neighborhoods (REAL MEN) program, a jail and community program to reduce drug use, HIV risk, and rearrest. By helping participants examine alternative paths to manhood and consider racial/ethnic pride as a source of strength, REAL MEN addressed the assets of these young men as well as their challenges. Our findings suggest that interventions that emphasize the assets of these young men may be better able to engage them than programs that seek to impose adult values.

Stakeholder Attitudes Toward Influenza Vaccination Policy in the United States

Protzel Berman, P., Orenstein, W. A., Hinman, A. R., Gazmararian, J. — Fri, 03 Apr 2009 09:42:37 PDT

There is growing interest in simplifying recommendations to vaccinate Americans against influenza. The article discusses interviews with 35 stakeholders from the medical, public health, educational, insurance, and vaccine industry sectors to assess the potential for policy change, and discusses questions posed to the interviewees on current and future influenza vaccination policy and barriers to policy change. About 97% of respondents support the expansion of vaccination for all school-age children, and about 95% support universal vaccination, but there are reservations expressed by the respondents, despite the support for this policy change. Barriers to influenza vaccination recommendations include access, supply, confusing recommendations, and public perceptions. Barriers to universal vaccination include lack of infrastructure, cost, need for education, and vaccine supply. Issues concerning resources and education are challenges that impede policy change. The study findings can be useful to policy makers and practitioners for reviewing U.S. vaccination policy and changes to the policy.

Considering Organizational Factors in Addressing Health Care Disparities: Two Case Examples

Griffith, D. M., Yonas, M., Mason, M., Havens, B. E. — Fri, 03 Apr 2009 09:42:38 PDT

Policy makers and practitioners have yet to successfully understand and eliminate persistent racial differences in health care quality. Interventions to address these racial health care disparities have largely focused on increasing cultural awareness and sensitivity, promoting culturally competent care, and increasing providers’ adherence to evidence-based guidelines. Although these strategies have improved some proximal factors associated with service provision, they have not had a strong impact on racial health care disparities. Interventions to date have had limited impact on racial differences in health care quality, in part, because they have not adequately considered or addressed organizational and institutional factors. In this article, we describe an emerging intervention strategy to reduce health care disparities called dismantling (undoing) racism and how it has been adapted to a rural public health department and an urban medical system. These examples illustrate the importance of adapting interventions to the organizational and institutional context and have important implications for practitioners and policy makers.

The Role of Community Health Workers (CHWs) in Health Promotion Research: Ethical Challenges and Practical Solutions

Terpstra, J., Coleman, K. J., Simon, G., Nebeker, C. — Fri, 03 Apr 2009 09:42:38 PDT

This article aims to describe the role of community health workers (CHWs) in health promotion research and address the challenges and ethical concerns associated with this research approach. A series of six focus groups are conducted with project managers and investigators (n = 5 to 11 per session) who have worked with CHWs in health promotion research. These focus groups are part of a larger study funded by the National Institutes of Health titled "Training in Research Ethics and Standards" (Project TRES). Participants are asked to describe their training needs for CHWs with respect to human subject protections as well as to identify associated challenges regarding research practice (i.e., recruitment, random assignment, protocol implementation, etc.). Findings reveal a number of challenges that investigators and project managers encounter when working with CHWs on research projects involving the community. These include characteristics inherent to CHWs such as education level and personal beliefs about their own community and its needs, institutional regulations regarding research practice, and problems inherent to research studies such as training materials and protocols that cannot account for the complexity of conducting research in community settings. Investigators should carefully consider the role that CHWs have in their communities before creating research programs that depend on the CHWs’ existing social networks and their propensity to be natural helpers. These strengths could lead to compromises in research requirements for random assignment, control groups, and fully informed consent.

Pass the Fruits and Vegetables! A Community-University-Industry Partnership Promotes Weight Loss in African American Women

Weerts, S. E., Amoran, A. — Fri, 03 Apr 2009 09:42:38 PDT

This article describes a community–university–industry partnership to alleviate food insecurity while promoting weight loss. Twenty-one overweight African American women are randomly assigned to experimental or control groups. Each receives supermarket gift cards and brief health education monthly for 3 months. The experimental group buys fresh produce only, whereas the control group buys any groceries. Data on weight, body mass index (BMI), waist–hip circumferences, and dietary intake are collected at baseline and months 1 to 3. Nine (43%) have complete data. Quantitative data reveal that the experimental group have lost significantly more weight (–6, +4 lbs), significantly reduced BMI (–1, +0.7), and eat significantly more raw, fresh produce (1.29, 0.15 cups). A focus group held at month 4 is rich with the meanings of participating, eating "well," and forming new habits. A nutrient-dense diet that is calorically balanced is the hallmark of health and well-being and may be related to weight loss in new ways. However, this diet is not always affordable by those most in need of it. The unexpected outcome of a statistical relationship among consuming raw, freshly prepared produce, weight loss, and BMI reduction within 3 months is not altogether explainable. There are obvious benefits, however, to these outcomes that support the continuing study of the phenomenon.

Identifying Barriers That Hinder Onsite Parental Involvement in a School-Based Health Promotion Program

Wed, 01 Apr 2009 10:46:17 PDT

We investigated whether barriers to onsite parental involvement in the Bienestar Health Program Parent Component could be identified and whether participation rates could be increased by addressing these barriers. All nonparticipating parents of fourth-grade students of San Antonio Independent School District from 4 schools, which were selected randomly from 20 intervention schools in Bienestar, were invited to take part in this study. A total of 47 of 223 (21%) parents engaged in one of four focus groups offered. Parents identified barriers to their involvement in Bienestar that fit into five descriptive categories: (a) low value, (b) high cost, (c) competing family demands, (d) concerns about the program design, and (e) social role norms. The Bienestar Parent Component was then modified according to the focus group findings, which resulted in a marked increase in parental involvement from 17% to 37% overall. These findings suggest that even when parents are involved in the initial design of parent-friendly and culturally sensitive programs, as was the case for Bienestar, maximizing parental involvement may require additional assessment, identification, and remediation of barriers.

A Case Study of Use of Data for Participatory Evaluation Within a Statewide System to Prevent Substance Abuse

Collie-Akers, V. L., Watson-Thompson, J., Schultz, J. A., Fawcett, S. B. — Wed, 01 Apr 2009 10:46:17 PDT

Although evaluation is considered an essential component of community health initiatives, its function requires actual use of the data to inform practice. The purpose of this case study was to examine how often and in what ways practitioners in a state system for substance abuse prevention used participatory evaluation data. To assess uses of data, interviews and surveys (N = 13) were conducted with practitioners. Questions focused on the frequency of use for several functions of evaluation data. Results showed that 77% of participants reported using their data within the past 30 days to review progress of the initiative, and 64% had used the data to communicate successes or needed improvement to staff. Fewer participants indicated they had used the data to communicate accomplishments to stakeholders (54%) or to make adjustments to plans (38%). This study suggests that participatory evaluation data can have multiple functions and uses for community health practitioners.

Developing Culturally Tailored Health Belief-Based Intervention Materials to Improve Child and Parent Participation in a Cardiovascular Screening Program

Cottrell, L., Harris, C. V., Deskins, S., Bradlyn, A., Coffman, J. W. — Thu, 26 Mar 2009 18:43:57 PDT

The Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce children’s future cardiovascular risk by implementing a school-based screening program statewide. Despite the elimination of environmental barriers related to screening cost and accessibility, only half of eligible children participate in the program each year. The authors used the theory of planned behavior to identify health beliefs associated with screening participation. This article describes the process used to identify community health beliefs and the development of theoretically based materials to increase participation. Focus groups and individual interviews were conducted to identify core health beliefs held by parents, community leaders, and children (Phase I). Data obtained were used to expand and revise a Health Beliefs Questionnaire, which was distributed to larger samples (Phase II). This information was used to design recruitment materials that emphasized the benefits of screening while directly addressing potential belief-based barriers to screening participation (Phase III).

A Dynamic Model of Client Recruitment and Retention in Community-Based HIV Prevention Programs

Miller, R. L., Levine, R. L., McNall, M. A., Khamarko, K., Valenti, M. T. — Wed, 25 Mar 2009 17:12:35 PDT

The study used system dynamics modeling computer simulations to gain a better understanding of the process of delivering small-group, evidence-based HIV prevention programs in the community and to explore implications for public health practice. A model was developed to explain provider-reported challenges associated with recruiting, retaining, and graduating people from small-group workshop programs. The model simulations revealed the difficulty in sustaining high rates of recruitment and retention in small-group programs over time. The model simulations provided insight into what processes may lead to suboptimal numbers of people being recruited and positively influenced by these programs.

Promoting Children's Health Through Physically Active Math Classes: A Pilot Study

Erwin, H. E., Abel, M. G., Beighle, A., Beets, M. W. — Wed, 25 Mar 2009 17:12:34 PDT

School-based interventions are encouraged to support youth physical activity (PA). Classroom-based PA has been incorporated as one component of school wellness policies. The purpose of this pilot study is to examine the effects of integrating PA with mathematics content on math class and school day PA levels of elementary students. Participants include four teachers and 75 students. Five math classes are taught without PA integration (i.e., baseline) followed by 13 math classes that integrate PA. Students wear pedometers and accelerometers to track PA during math class and throughout the school day. Students perform significantly more PA on school days and in math classes during the intervention. In addition, students perform higher intensity (step min^–1) PA during PA integration math classes compared with baseline math classes. Integrating PA into the classroom is an effective alternative approach to improving PA levels among youth and is an important component of school-based wellness policies.

Evaluation of an Arthritis Communication Campaign to Promote Physical Activity in Two Cities

Boardman, A. M., Lob, S. H., Fineman, N., Ford-Keach, P., Fox, P. — Wed, 25 Mar 2009 17:12:35 PDT

Two communications campaigns (a "standard" campaign and an "enhanced" campaign linked to a physical activity opportunity) are evaluated to increase physical activity among people with arthritis. A pre- (n = 295) and post- (n = 806) intervention random sample telephone survey is conducted in two cities to measure the population effect of the campaigns. There are no changes in overall message awareness, beliefs, or behaviors related to physical activity and arthritis management in either city. Significant changes in message awareness and exercise frequency are found in subgroups in both cities, but the results do not show an advantage to enhancing the campaign with a local physical activity opportunity. An inability to saturate the market may partly explain why no overall significant increase in message awareness is found after the campaign. A high level of message awareness among respondents before the campaign may also have made it more difficult to affect measured outcomes.

Undressing "Health Fashion": An Examination of Health-Cause Clothing and Accessories

Walker, K. L., Hart, J. L., Gregg, J. L., LaJoie, A. S. — Wed, 25 Mar 2009 17:12:35 PDT

Today, fashion items such as rubber wristbands in various colors, pink ribbons, and red dresses represent different health-related causes and can be seen frequently across demographic groups. Complete with pithy slogans (e.g., "Go Red for Women"), these items are part of a larger "health fashion" trend—one that involves wearing, using, and displaying health-cause clothing and accessories. In this article, the authors explore recent interest in "health fashion," examining in particular its origins, effectiveness, and implications.

Colorectal Cancer Screening in Primary Care: Theoretical Model to Improve Prevalence in the Practice Partner Research Network

Nemeth, L. S., Jenkins, R. G., Nietert, P. J., Ornstein, S. M. — Wed, 18 Mar 2009 09:36:49 PDT

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Half of Americans older than age 50 are not current with recommended screening; research is needed to assess the impact of interventions designed to increase receipt of CRC screening. The Colorectal Cancer Screening in Primary Care (C-TRIP) study is a theoretically informed group randomized trial within 32 primary care practices. Baseline median proportion of active patients aged 50 years or older up-to-date with CRC screening among the 32 practices was 50.8% (N = 55,746). Men were more likely to have been screened than women (52.9% vs. 49.2%, respectively). Patients 50 to 59 years of age were less likely to be up-to-date with screening (45.4%) than those in the 60 to 69 years and 70 to 79 years groups (58.5% in both groups). Opportunities exist to increase the proportion of CRC screening received in adults aged 50 and older. C-TRIP evaluates the effectiveness of a model for improvement for increasing this proportion.

Increasing Fresh Fruit and Vegetable Availability in a Low-Income Neighborhood Convenience Store: A Pilot Study

Jetter, K. M., Cassady, D. L. — Thu, 12 Feb 2009 09:08:27 PST

Changing the food environment in low-income communities may be an effective way to increase the consumption of fruits and vegetables by low-income consumers. This study examines the impacts of a pilot study that increases the availability of fresh produce in a convenience store in a low-income neighborhood not served by a supermarket. Two hypotheses based on theories of technology adoption are tested regarding the lack of fresh produce in low-income neighborhood stores: the first is that high fixed costs present a barrier for store owners in developing produce sections; the second is that there is insufficient consumer demand to cover the variable costs of a fresh produce section. The impacts of changing the food environment on store owners and the consumer response to environmental change are measured through weekly inventories of fresh produce. The results show that fixed costs are one barrier for store owners and that although the consumer response is sufficient to cover the direct costs of operating the produce case, it is not enough to cover variable management costs. Consequently, alternative management paradigms or venues may offer a better method to meet the demand for fresh produce by low-income consumers to promote better health through healthier diets in low-income communities.

University Students' Satisfaction With, Interest in Improving, and Receptivity to Attending Programs Aimed at Health and Well-Being

Tucker, P., Irwin, J. D. — Thu, 05 Feb 2009 09:17:42 PST

The purpose of this pilot study is to investigate students’(a) satisfaction with nine health constructs, (b) interest in improving these health areas, and (c) receptivity to participating in programming targeting these areas. The study sample is composed of 1,778 undergraduate students from a Canadian university. Students complete a five-page paper-and-pencil questionnaire assessing the above objectives along a 5-point Likert-type scale. Students are most satisfied with their social health and report their lowest satisfaction with physical activity (M = 3.16, SD = 1.09). Overall, students are most interested in enhancing their physical activity (M = 4.10, SD = 0.79), followed by both body image (M = 3.94, SD = 0.89) and dietary habits (M = 3.94, SD = 0.85), and are receptive to programs aimed at improving their level of physical activity (M = 3.62, SD = 0.98) and body image (M = 3.42, SD = 1.63). A preference for physical activity level and body image improvement among university students is revealed and should be considered of paramount importance by campus-based health promotion practitioners.

Youth Participation in a Community Campaign to Pass a Clean Indoor Air Ordinance

Bozlak, C. T., Kelley, M. A. — Wed, 04 Feb 2009 11:32:08 PST

Because of the harmful effects of secondhand smoke, communities are organizing to pass clean indoor air policies. With youth being considered one of the most vulnerable populations to this health hazard, it can be strategic to campaigns and beneficial to the youth’s development to involve them in efforts to control this toxin. However, youth participation in health campaigns is limited because of barriers inherent in these initiatives. This article presents lessons learned from a qualitative case study on the youth involvement in a successful local clean indoor air campaign. Through the analysis of semistructured interviews with the adult members of the campaign, group interviews and questionnaire completion by the youth members of the campaign, and additional insight made possible by participant observation, recommendations are provided to engage and sustain youth involvement in local public health initiatives.

Anatomy of Culturally Sensitive Interventions Promoting Nutrition and Exercise in Hispanics: A Critical Examination of Existing Literature

Mier, N., Ory, M. G., Medina, A. A. — Wed, 04 Feb 2009 11:32:07 PST

Compared with non-Hispanic Whites, Hispanics experience a disproportionate burden of chronic diseases. Understanding the factors influencing the success of health programs in Hispanics requires a clearer examination of the principles and components of tailored interventions. This research comprises a comprehensive literature review of randomized controlled trials testing nutrition and exercise interventions tailored for Hispanics and an examination of how these interventions were constructed. The review of 18 interventions meeting study criteria suggests that most tailored programs promoting nutrition and exercise in Hispanics are theory driven and are informed by formative research. Also, the findings indicate that salient culturally sensitive intervention components are (a) bilingual and bicultural facilitators and materials, (b) family-based activities, (c) literacy-appropriate materials, and (d) social support. A clear understanding of Hispanic cultural values is also required. Further empirical examination is warranted to determine the factors mediating or predicting the efficacy of culturally sensitive health programs for Hispanics.

Assessment and Outcomes of HealthPartners 10,000 Steps(R) Program in an Academic Work Site

Speck, R. M., Hill, R. K., Pronk, N. P., Becker, M. P., Schmitz, K. H. — Sat, 31 Jan 2009 17:03:59 PST

The authors examined the feasibility, acceptability, and potential for physical activity behavior change of a 21-week, 10,000 Steps® program in an academic work site. In a pre-post, noncontrolled study design, participants were supplied a pedometer, online resource, and health promotional activities. Means, medians, ranges, and frequencies of self-reported average daily steps (ADS) described physical activity behavior change. An online exit survey assessed the acceptability of the intervention. Of 1,322 eligible participants, 619 (47%) registered; 74% of participants tracked step counts at least once, and 57 (9%) tracked them all 21 weeks. The proportion of cohort participants with <7,499 ADS tracking all 21 weeks was significantly less than that same cohort tracking only at baseline (p < .02). Survey results showed that 85% of the participants reported general satisfaction with content and navigation of the program Web site. Results suggest elements of feasibility and acceptability but limited potential for physical activity behavior change. Future studies should assess preenrollment ADS and barriers to retaining participants.

Media Literacy as a Violence-Prevention Strategy: A Pilot Evaluation

Webb, T., Martin, K., Afifi, A. A., Kraus, J. — Sat, 31 Jan 2009 17:03:59 PST

Youth violence is a major unresolved public health problem in the United States and media exposure to violence is a synergistic source of this national problem. One media literacy curriculum designed specifically to address this issue is Beyond Blame: Challenging Violence in the Media. The purpose of this pilot study was to examine the curriculum’s feasibility as a full-scale intervention. Intervention and control groups were similar with respect to knowledge of the Beyond Blame curriculum at baseline. Intervention students scored much higher on the posttest compared with the control students. The majority (90.2%) of the intervention students reported a significant increase in pre- to posttest score compared with only 18.8% of the control students (p < .0001). The magnitude of the score increase for intervention students was much greater than those in the control group. Several intervention students (N = 49; 19.9%) improved their score by 12 or more points compared with the control students who showed only a 1-to 7-point score increase (N = 3; 18.8%; p < .0001). The pre-and posttest scores were similar for males and females. Three of the six intervention classrooms scored higher on both the pretest and posttest compared with the other three classrooms.

Physical Activity Promotion Among Underserved Adolescents: "Make It Fun, Easy, and Popular"

Bush, P. L., Laberge, S., Laforest, S. — Sat, 24 Jan 2009 13:29:11 PST

There is a paucity of studies regarding noncurricular physical activity promotion interventions among adolescents, and even less such research pertaining to underserved youth. This article describes the development and implementation of a noncurricular, school-based physical activity promotion program designed for a multiethnic, underserved population of adolescents. The program’s impact on leisure-time physical activity (LTPA) and on physical activity enjoyment (PAE) is also presented. The 16-week program, named FunAction, utilizes social marketing principles. Control (n = 90) and intervention (n = 131) students are assessed pre- and postintervention for levels of LTPA and PAE. Results indicate that although the program did not contribute to an increase in LTPA or PAE among intervention group students, participation in the program was elevated. This study offers preliminary evidence that noncurricular physical activity promotion programs that apply social marketing principles can be effective in engaging multiethnic, underserved adolescents in physical activity.

Mapping a Message for Faith Leaders: Encouraging Community Health Promotion With Local Health Data

Kruger, D. J., Lewis, Y., Schlemmer, E. — Sat, 24 Jan 2009 13:29:11 PST

This study reports the use of a community-based health survey to share local health information with faith leaders. Geographical information systems software identified survey respondents within 2 km (1.25 miles) of places of worship. Results were tabulated for the community surrounding each place of worship and were compared with city- and county-level data. Faith leaders were presented with community-specific reports describing the health attributes of residents who lived in the surrounding area, in order to assist with the identification issues of concern and opportunities to develop health ministries to address these issues. Faith leaders were encouraged to share this information with members of their faith community and develop means of obtaining additional information on the people of interest. We believe that engaging faith leaders with neighborhood-specific health information will be critical in providing an understanding of the importance of their voice in improving health outcomes of their faith community, the surrounding neighborhood, and the community at large. Our goal is to empower faith leaders to understand personal and community health issues and to act as a conduit for health-related information and health promotion at a local level. Church health teams developed an HIV and sexually transmitted infection prevention program for African American adolescents and young adults.

Process Evaluation of the Hunter Illawarra Kids Challenge Using Parent Support Study: A Multisite Randomized Controlled Trial for the Management of Child Obesity

Wed, 21 Jan 2009 08:47:01 PST

The purposes of this article are to (a) outline findings from secondary or process outcome data of the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS) study and (b) inform the design and development of future research interventions and practice in the management of child obesity. Data were collected by means of facilitator evaluations, independent session observation, attendance records, and parent questionnaires. Internal validity and reliability of the program delivery were high. All parents reported positive changes in their children as a result of the physical activity program, the dietary modification program, or both. Most participants completed the home activities, but more than half reported that finding time to do them was problematic. Facilitator review indicated that future programs should specifically cater to children of similar age or same sex, allow adequate time for explanation of complex nutritional concepts, and use intrinsic motivators for participants. Recommendations for future interventions, specifically the implementation of subsequent HIKCUPS or other multisite effectiveness studies, are detailed.

Process Evaluation of Baltimore Healthy Stores: A Pilot Health Intervention Program With Supermarkets and Corner Stores in Baltimore City

Wed, 14 Jan 2009 09:45:17 PST

Reduced access to affordable healthy foods is linked to higher rates of chronic diseases in low-income urban settings. The authors conduct a feasibility study of an environmental intervention (Baltimore Healthy Stores) in seven corner stores owned by Korean Americans and two supermarkets in low-income East Baltimore. The goal is to increase the availability of healthy food options and to promote them at the point of purchase. The process evaluation is conducted largely by external evaluators. Participating stores stock promoted foods, and print materials are displayed with moderate to high fidelity. Interactive consumer taste tests are implemented with high reach and dose. Materials developed specifically for Korean American corner store owners are implemented with moderate to high fidelity and dose. Results indicate that small food store–based intervention programs are feasible to implement and are a viable means of increasing healthy food availability and a good location for point-of-purchase promotions in low-income urban settings.

An Evaluation of a Carbon Monoxide Poisoning Education Program

Wed, 14 Jan 2009 09:45:18 PST

Carbon monoxide (CO) is the leading cause of poisoning death in the United States. Research has shown that proper use of a CO detector in the home can reduce morbidity and mortality related to unintentional CO exposure. The authors evaluated three CO education workshops that included distribution of free CO detectors for home use, and their intervention reached 133 participants. Pretest surveys and follow-up calls evaluated change in knowledge and behavior factors. Results showed that statistically significant increases were found on three out of five knowledge-based items and 91% of respondents (N = 80) reported installing CO detectors in their home. Follow-up calls provided an opportunity to clarify information and provide tailored information to participants.

Evidence-Based Practice in Health Education and Promotion: A Review and Introduction to Resources

Hill, E. K., Alpi, K. M., Auerbach, M. — Tue, 13 Jan 2009 11:05:53 PST

This review examines evidence-based practice (EBP) in health education and promotion with a focus on how academically trained health educators develop EBP skills and how health education and promotion practitioners access the literature to inform their activities. Competencies and credentialing in health education related to evidence-based practice are outlined and sources for evidence-based practice literature in health education and promotion are described. An exploratory questionnaire to consider teaching and resources in evidence-based practice was distributed to faculty and librarians from the top 10 ranked health education doctoral programs. Findings highlighted the integral value of EBP instruction to the curriculum. Growth opportunities in evidence-based health education and health promotion for instructors, practitioners, and librarians include promotion and expansion of online evidence-based public health resources to close the evidence-practice gap.

Translating the Olweus Bullying Prevention Program Into Real-World Practice

Black, S., Washington, E., Trent, V., Harner, P., Pollock, E. — Tue, 13 Jan 2009 11:05:53 PST

This article describes the application of a community collaboration model implementing an evidence-based bullying-prevention program in elementary and middle schools. Between 2001 and 2006, the Office of School Climate and Safety, Office of Research and Evaluation, the local chapter of Physicians for Social Responsibility, and a local researcher partnered to implement the Olweus Bullying Prevention Program (BPP). The BPP is a blueprints program for youth violence prevention, following the public health model of needs assessment, problem definition, planning, implementation, and evaluation. This article describes the practical application of the model in a large urban district with multiple obstacles to implementation. The description provides a model for other community collaborations in community public health practice. A strength of collaborative practice is the ability to draw on the different capabilities of partners to provide a seamless program. A suggestion for policy is to promote community collaborations of evidence-based programs through preferential funding.

Process Evaluation and Participatory Methods in an Obesity-Prevention Media Campaign for Mexican Americans

Thu, 08 Jan 2009 09:16:00 PST

To address obesity and related morbidities, community-based participatory research (CBPR) strategies were employed to design and evaluate a Spanish-language media campaign promoting physical activity and healthful food choices among Mexican Americans. Process evaluation including content analyses on types and focus of media messages was conducted. Focus groups assessed appeal and trustworthiness of messages. All media campaign products featured role models and experts. Campaign messages primarily (91%) appeared in TV morning show segments. Newsletters presented individual and family role model stories. A majority of newsletters (68%) were distributed through churches and "promotora" outreach efforts. CBPR lends itself to the selection and tailoring of evidence-based media campaigns. Moreover, CBPR guidance resulted in media messages that were credible and appealing to audience. Process evaluation strategies that gather information from the community provide solid evidence for how to modify the campaign to best meet audience expectations.

Patient Perceptions of a Community-Based Care Coordination System

Gimpel, N., Marcee, A., Kennedy, K., Walton, J., Lee, S., DeHaven, M. J. — Thu, 08 Jan 2009 09:16:00 PST

Community health workers (CHWs) work with health professionals to improve health outcomes by facilitating community-based health education and increase access and continuity to health services within a community. Uninsured, low-income participants of a community-based program, Project Access Dallas, participated in focus group sessions for determining participants’ perceptions of CHW effectiveness and participants’ abilities to independently manage their health needs. Of the 95 adults invited, 24 (25.3%) attended. Participants reported that CHWs are an invaluable asset in learning how to navigate the health care system, obtaining appointments and being better able to care for themselves with CHW emotional/psychological support. Results suggest that CHWs in a case management model improved patient comprehension of health issues, patient navigation through a health care system, and patients’ abilities to independently manage health issues. Implementation of CHWs within a case management model appears to be an effective mechanism for providing health services to underserved populations.

Developing Methods to Compare Low-Education Community-Based and University-Based Survey Teams

Wed, 07 Jan 2009 10:41:07 PST

We compared the quality of low-education community-based survey teams to college educated graduate students. Our approach was to develop methods, conduct a pilot survey, and report lessons. Community and university teams conducted surveys from non-overlapping random samples of addresses at a public housing development in Boston, Massachusetts. The two types of teams make a similar number of attempts (122 and 124, respectively), and there was no statistically significant difference between the teams in terms of response rate or amount of missing data. Similarly, there was no statistically significant difference in refusal rate or in responses to questions in the survey. There was, however, evidence that the community teams used data tracking forms improperly. This study suggests that it is possible to study the relative quality of community and university-based teams in terms of data collection. The findings also suggest that the two types of teams may be roughly comparable.

Delivering Culturally Sensitive Health Messages: The Process of Adapting Brochures for Grandparents Raising Grandchildren in Hawai'i

Yancura, L. A. — Wed, 07 Jan 2009 10:41:07 PST

The efficacy of programs to reduce health disparities depends on their ability to deliver messages in a culturally sensitive manner. This article describes the process of designing a series of brochures for grandparents raising grandchildren. National source material on topics important to grandparents (self-care, service use, addiction, and grandchildren’s difficult behaviors) was put into draft brochures and pilot tested in two focus groups drawn from Native Hawaiian Asian and Pacific Islander populations. Elements of surface and deep levels directed the form and content of the final brochures. On a surface level, these brochures reflect local culture through pictures and language. On a deep level, which integrates cultural beliefs and practices, they reflect the importance of indirect communication and harmonious relationships. The final brochures have been received favorably in the community. The process of adapting educational material with attention to surface and deep levels can serve as a guide for other health promotion materials.

Perceptions of Trained Leaders on Improving the Public Health Impact of Three Arthritis Foundation Programs

Brittain, D. R., Gyurcsik, N. C. — Wed, 07 Jan 2009 10:41:08 PST

The Arthritis Foundation (AF) offers effective community-based programs to help manage arthritis, including aquatic, exercise, and self-help programs. Trained leaders can facilitate the adoption, maintenance, and reach of these programs and thus the impact on public health. This study identifies reasons for becoming AF aquatic, exercise, and/or self-help program leaders, AF program reach, and adoption and maintenance challenges encountered by individuals after being trained. Researchers interviewed by telephone 72 participants who attended an AF leader training workshop. Participants reported various reasons for becoming program leaders (e.g., a wish to help others). AF programs were mainly adopted and maintained in urban communities and in fitness/health clubs, medical centers, or senior centers. Aquatics programs were the most frequently offered, and all programs had low reach (with a mean number of participants of 14.41, 12.50, and 11.00 for aquatic programs, exercise programs, and self-help programs, respectively. Challenges to adopting and maintaining programs include the time of year (e.g., winter, holidays) and lack of a facility to offer the program.

Be a Fit Kid: Nutrition and Physical Activity for the Fourth Grade

Slawta, J. N., DeNeui, D. — Wed, 07 Jan 2009 10:41:07 PST

This article describes the inclusion of Be a Fit Kid in the fourth-grade curriculum. Be a Fit Kid is a fitness-emphasized physical activity and heart-healthy nutrition education program for elementary school children. Five parent–education lessons were offered and nutrition workbooks were distributed to parents. Following the 10-week intervention, significant improvements in fitness, body fat, nutrition knowledge, dietary habits, and levels of lipids and lipoproteins were observed in the intervention group compared with baseline levels. Changes in fitness, body fat, and nutrition knowledge were significant compared with the control group. These findings suggest that comprehensive physical activity and nutrition programs included in the school curriculum may be effective for improving cardiovascular health and reducing future risk for lifestyle-related diseases.

Using the Chronic Care Model to Address Tobacco in Health Care Delivery Organizations: A Pilot Experience in Washington State

Carlini, B. H., Schauer, G., Zbikowski, S., Thompson, J. — Wed, 07 Jan 2009 10:41:07 PST

This article describes a Washington State–based Systems Change Pilot Project in which the chronic care model and the model for improvement were used as tools to promote tobacco cessation–related changes within a health care system. Three diverse sites participated in the pilot. Site teams tailored plan-do-study-act tests to site circumstances, addressing current resources and barriers to implementing change. Teams tested system changes that incorporated tobacco use documentation into the routine health services provided. Findings from this pilot suggest that (a) even simple changes with minimal disruption of services can make a difference in improving documentation of tobacco use status; (b) changes to routine practices of health organizations may not be sustainable if ongoing quality assurance mechanisms are not developed; and (c) systems implemented for other disease states within the same organization or patient population are not instinctively applied to tobacco, because of a multitude of factors.

Health Promotion and Illness Demotion at Prostate Cancer Support Groups

Oliffe, J. L., Gerbrandt, J. S., Bottorff, J. L., Hislop, T. G. — Wed, 07 Jan 2009 10:41:06 PST

Although health promotion programs can positively influence health practices, men typically react to symptoms, rather than maintain their health, and are more likely to deny than discuss illness-related issues. Prostate cancer support groups (PCSGs) provide an intriguing exception to these practices, in that men routinely discuss ordinarily private illness experiences and engage with self-health. This article draws on individual interview data from 52 men, and participant observations conducted at the meetings of 15 groups in British Columbia, Canada to provide insights to how groups simultaneously facilitate health promotion and illness demotion. The study findings reveal how an environment conducive to men’s talk was established to normalize prostate cancer and promote the individual and collective health of group members. From a gendered perspective, men both disrupted and embodied dominant ideals of masculinity in how they engaged with their health at PCSGs.

WALK Community Grants Scheme: Lessons Learned in Developing and Administering a Health Promotion Microgrants Program

Caperchione, C., Mummery, W. K., Joyner, K. — Wed, 07 Jan 2009 10:41:06 PST

The Women’s Active Living Kits (WALK) Community Grant Scheme was a key component of a federally funded Australian initiative aimed at increasing local capacity to promote and engage priority women’s groups in health-related physical activity. Under the program, community groups and organizations were provided with the opportunity to apply and receive small grants to support the development of women’s walking groups with the aim of increasing physical activity participation levels in women, supporting innovative community ideas for increasing women’s physical activity by improving social structures and environments, or both. This article describes the development and administration of the WALK Community Grant Scheme, outlines challenges and barriers encountered throughout the grant program process, and provides practical insights for replicating this initiative.

Strategies to Increase Health Literacy in The Infant Feeding Series (TIFS): A Six-Lesson Curriculum for Low-Income Mothers

Silk, K. J., Horodynski, M. A., Rienzo, M., Mercer, L., Olson, B., Aldrich, R. — Tue, 30 Dec 2008 16:37:55 PST

Low literacy can be a serious barrier to educating audiences about important health issues. This article explicates strategies used to increase health literacy in The Infant Feeding Series, a six-lesson curriculum on infant feeding practices. The curriculum was developed by a multidisciplinary team of researchers, health educators, and community stakeholders with the primary goal of increasing low-income mothers’ knowledge and self-efficacy to delay the introduction of solid foods into infants’ diets. Strategies used to develop the low literate accessible materials include (a) incorporation of formative research and theory, (b) media components, (c) reading level assessment of materials, (d) review of materials by multiple stakeholders, (e) one-on-one home delivery, (f) pilot evaluation of lessons, and (g) a workbook incentive designed to integrate knowledge and motivate participants to complete the curriculum through scrapbook activities. These strategies are discussed as they relate to lesson content and curriculum effectiveness.

Adaptation of a Lay Health Advisor Model as a Recruitment and Retention Strategy in a Clinical Trial of College Student Smokers

Varvel, S. J., Cronk, N. J., Harris, K. J., Scott, A. B. — Tue, 30 Dec 2008 16:37:56 PST

This study describes and provides results from a process evaluation of a lay health advisor (LHA) model to enhance participation in a clinical trial of the effectiveness of motivational interviewing on smoking cessation in college fraternity and sorority members. The implementation of the model had two phases: (a) the selection and training of LHAs as liaisons between research staff and participants and (b) LHAs’ roles in recruitment and retention. Perceptions of the LHA model were explored using survey questionnaires. Trial participants (N = 118) and LHAs (N = 8) were generally satisfied with the model and identified LHAs as helpful to participation. Seventy-four percent of chapter members were screened and 73% of participants received three of the four motivational interviewing sessions. These results indicate the LHA model was well received and met the needs of the research project.

A Qualitative Examination of Perceptions of Physical Activity Guidelines and Preferences for Format

Berry, T. R., Witcher, C., Holt, N. L., Plotnikoff, R. C. — Tue, 30 Dec 2008 16:37:55 PST

A descriptive exploratory study was conducted to gain an understanding of public perceptions of physical activity guidelines and to discover what formats appeal to participants. Canada’s Physical Activity Guide (CPAG) was used as an example of such guidelines. Data were collected from 22 participants in five focus groups (composed of female undergraduate students, female office workers, male office workers, participants in a Type II diabetes rehabilitation program, and participants in a cardiovascular rehabilitation program). Cross-case qualitative analyses were conducted. Six themes emerged under the general categories of familiarity and preferences for PA promotional materials. In terms of familiarity, participants lacked awareness of CPAG and criticized its format. In terms of preferences, participants encouraged the use of stylistically similar messaging to those used by commercial advertisers, wanted personal stories, Internet-based media, and the use of celebrities’ success stories. There was little awareness of CPAG and the current format was unappealing.

Promoting Community Preparedness: Lessons Learned From the Implementation of a Chemical Disaster Tabletop Exercise

Tue, 30 Dec 2008 16:37:54 PST

Health educators are frequently called on to facilitate community preparedness planning. One planning tool is community-wide tabletop exercises. Tabletop exercises can improve the preparedness of public health system agencies to address disaster by bringing together individuals representing organizations with different roles and perspectives in specific disasters. Thus, they have the opportunity to identify each other’s roles, capabilities, and limitations and to problem-solve about how to address the gaps and overlaps in a low-threat collaborative setting. In 2005, the North Carolina Office of Public Health Preparedness and Response developed a series of exercises to test the preparedness for chemical disasters in a metropolitan region in the southeastern United States. A tabletop exercise allowed agency heads to meet in an environment promoting inter- and intraagency public–private coordination and cooperation. The evaluation results reported here suggest ways in which any tabletop exercise can be enhanced through recruitment, planning, and implementation.

Dissemination of a Breast and Cervical Cancer Early Detection Program Through a Network of Community-Based Organizations

Fernandez, M. E., DeBor, M., Candreia, M., Flores, B. — Tue, 30 Dec 2008 16:37:53 PST

ENCORE^plus, a breast and cervical cancer outreach, education, and screening referral program, was implemented by the YWCA of the United States and funded by Avon’s Breast Cancer Awareness Crusade. ENCORE^plus was designed to address the educational and access needs of low socioeconomic status and minority women who experience substantial barriers to breast and cervical cancer screening. This article describes the dissemination of ENCORE^plus to 78 YWCAs in 30 states. It illustrates the application of social cognitive theory and diffusion theory to increase program adoption, implementation, and maintenance among community organizations that have not traditionally provided public health related services. The article highlights elements of the program that enhanced its adoption and implementation and describes procedures for accelerating the diffusion of the program across the country.

Listening to Youth: Reflections on the Effect of a Youth Development Program

Kalish, R. E., Voigt, B., Rahimian, A., DiCara, J., Sheehan, K. — Tue, 30 Dec 2008 16:37:56 PST

To identify key elements that contribute to the effectiveness of a youth development program, interviews were conducted with 35 former Chicago Youth Programs (CYP) participants who remained in the program until age 18 years and went on to attend college, and 25 participants who left the program (and are currently older than age 18). Of the college participants who remained in CYP until age 18, 97% reported that the program had helped them by providing tutoring, mentoring, and financial support. In comparison, only 56% of the CYP dropouts had completed some college, and nearly 50% reported being involved in illegal activities. Many of the CYP dropouts were drawn to illegal activities for financial reasons or because they felt there was inadequate adolescent programming. All reported benefiting from their CYP participation. Incorporating financial incentives or specific adolescent programming may lead to longer youth program participation and, perhaps, more positive outcomes.

Using Theory and Technology to Design a Practical and Generalizable Smoking Reduction Intervention

Tue, 30 Dec 2008 16:37:56 PST

The aim of this article is to describe the process of using theory to form strategies for a generalizable smoking reduction intervention delivered through multiple intervention modalities. This report describes the process of integrating theory, data from diverse sources, staff from three different organizations, and different intervention modalities into an efficient, large-scale smoking reduction program featuring automated data from electronic medical records, computer-assisted telephone interviews, and tailored newsletters. The authors successfully developed a program that was consistently implemented as planned for 320 smokers in a managed care organization. The mapping of theory to intervention, data transfer and security procedures, and processes and strategies used to overcome challenges to intervention implementation should provide lessons learned for similar health promotion projects. Few intervention studies discuss details of how they translate theory into practice or how they integrate different modalities and collaborating institutions, but such integration is critical for project success.

An Evaluation of the Experiences of Rural MSM Who Accessed an Online HIV/AIDS Health Promotion Intervention

Williams, M., Bowen, A., Ei, S. — Tue, 30 Dec 2008 16:37:55 PST

The purpose of this study was to assess rural MSM’s satisfaction with an Internet-delivered HIV/AIDS intervention. Objectives were to evaluate if completion rates varied by characteristics, if completion varied by computer issues, if satisfaction changed from first to last modules, and if satisfaction was associated with module order. Data were collected from 300 rural MSM. Results showed few differences between men who completed the intervention and those who dropped out. Completion was associated with income, accessing the intervention at home, time to load screens, and finding navigation easy. For those completing the intervention, interest in and perceived usefulness of the information increased from first to the last module. Module order was associated with the knowledge module. Interest in the module was greatest if it was encountered last. Results indicate that rural MSM are willing to enroll in and complete an Internet-delivered HIV/AIDS risk reduction intervention.

Center for Disease Control's Diethylstilbestrol Update: A Case for Effective Operationalization of Messaging in Social Marketing Practice

Mattson, M., Basu, A. — Tue, 30 Dec 2008 16:37:55 PST

The Center for Disease Control’s (CDC) Diethylstilbestrol (DES) Update, a campaign to educate people who may have been exposed to the drug DES, is framed on the premises of the social marketing model, namely formative research, audience segmentation, product, price, placement, promotion, and campaign evaluation. More than that, the campaign takes a critical step in extending the social marketing paradigm by highlighting the need to situate the messaging process at the heart of any health communication campaign. This article uses CDC’s DES Update as a case study to illustrate an application of a message development tool within social marketing. This tool promotes the operationalization of messaging within health campaigns. Ultimately, the goal of this project is to extend the social marketing model and provide useful theoretical guidance to health campaign practitioners on how to accomplish stellar communication within a social marketing campaign.

Developing a Cross-Site Evaluation Tool for Diverse Health Interventions

Tue, 30 Dec 2008 16:37:54 PST

The Prevention Research Center of Michigan provided technical assistance for the evaluation of 10 projects funded by the Michigan Department of Community Health’s (MDCH) Health Disparities Reduction Program. These projects varied considerably in focus, methodology, geographical coverage, and populations served. The authors developed a cross-site evaluation tool to complement the internal evaluations of the projects. The tool contains four sections based on priorities identified by MDCH: evidence-based practice, research-based learning/evaluation (including process, impact, and outcomes indicators), cultural competence, and sustainability. Recognizing the diversity of programmatic efforts and organizational evaluation capacity, the authors sought to enable each project to create the best evaluation possible given the resources and data available. Each section contains a range of components from basic questions to more advanced evaluation techniques. The instrument attempts to use the highest quality of information available for each project. This evaluation tool can be used by programs with diverse goals and methodology.

But Will I Be Re-Elected? What Happens to Local Level Policy Makers Who Support Clean Indoor Air Laws?

Eisenberg, M., McCotter, O., Sciacca, J. — Tue, 30 Dec 2008 16:37:53 PST

This research was conducted to determine the impact of voting for clean indoor air ordinance on a local-level policy maker’s re-election status. Secondary data were used to identify local tobacco ordinances in Arizona proposed between 2001 and 2005, score ordinance content for comprehensiveness, identify policy makers who voted and how they voted, and determine if the measure passed or failed. Participation in and outcomes of subsequent elections were documented from public records. Ninety-two local-level policy makers in 15 local jurisdictions considered clean indoor air laws between 2001 and 2005. Policy makers who voted for these ordinances were more likely to be re-elected than those who voted against them. Structured interviews revealed that policy makers did not believe the issue had an impact on re-election results and believed that although the issue may have been contentious, it was no longer salient in the community.

A National Patient Navigator Training Program

Tue, 30 Dec 2008 16:37:57 PST

Patient Navigation is an intervention aimed at addressing cancer health disparities by eliminating barriers to diagnosis, treatment, and services. Three major patient navigation (PN) programs (The National Cancer Institute, The American Cancer Society & The Center for Medicare and Medicaid Services) are underway to address the needs of medically underserved cancer patients. There has not been national training with a defined curriculum for patient navigators (PNs). Curriculum for training the PNs was created by experts from the three programs. The efficacy of training was evaluated using a pre- and posttest. The data show that overall the posttest scores improved from the pretest. In addition, having a high school education or greater or having more years of work experience were significantly related to improvements on the posttest. The first successful standardized national training program was attended by 116 PNs representing 85 cities with the goal to reduce health disparities for medically underserved.

Participatory Prevention Research Model Promotes Environmental Change for Healthier Schools

Prelip, M., Slusser, W. M., Lange, L., Vecchiarielli, S., Neumann, C. — Tue, 30 Dec 2008 16:37:53 PST

Barriers exist to healthy eating and physical activity for children in the school environment. Modifiable school environmental factors have led to the development of the Nutrition Friendly Schools and Communities (NFSC) model to prevent the development of overweight in school children and adolescents. The design of the NFSC environmental intervention is to actively engage the school community to prevent overweight in school-aged children. This article presents data measuring the environmental changes achieved by the Los Angeles Unified School District (LAUSD) elementary schools participating in a 3-year participatory research pilot study funded by the Centers for Disease Control and Prevention (CDC). An objective of the pilot study is to determine whether any or all of the 15 steps developed for the NFSC model could be implemented. Further, researchers want to know if any of the study schools could implement the NFSC model as a whole during the allotted time of the pilot study.

Lessons Learned and Challenges in Building a Filipino Health Coalition

Fri, 19 Dec 2008 13:14:43 PST

In recent years, community-based coalitions have become an effective channel to addressing various health problems within specific ethnic communities. The purpose of this article is twofold: (a) to describe the process involved in building the Kalusugan Coalition (KC), a Filipino American health coalition based in New York City, and (b) to highlight the lessons learned and the challenges from this collaborative venture. The challenges described also offer insights on how the coalition development process can be greatly affected by the partnership with an academic institution on a community-based research project. Because each cultural group has unique issues and concerns, the theoretical framework used by KC offers creative alternatives to address some of the challenges regarding coalition infrastructures, leadership development, unexpected change of coalition dynamics, and cultural nuances.

Hidden Heroines: Lone Mothers Assessing Community Health Using Photovoice

Duffy, L. R. — Fri, 19 Dec 2008 13:14:42 PST

Between 2005 and 2007, a small group of lone mothers in Moncton, New Brunswick, carried out participatory action research within a university–community agency partnership. Applying the method of photovoice, the women took pictures within their community context on topics that they considered important to their health, health promotion, and quality of life. Eight themes that emerged from the process were represented with pictures and captions and presented in numerous public venues and conferences. Themes included finances, stress, support, personal development, violence and abuse, place, and transportation. The visual images and accompanying captions bring to the public arena the voices of those who are often most affected by public policy but have little, if any, input into its creation. Nurses and other health professionals can play a critical role in working toward gender and economic justice, while accompanying marginalized populations in ways that respect their beliefs, perceptions, and experiences.

Culturally Specific Dance to Reduce Obesity in African American Women

Murrock, C. J., Gary, F. A. — Fri, 19 Dec 2008 13:14:41 PST

This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women.

Understanding the Data-Action Cycle of Surveillance: A Qualitative Study of Federal and State Stakeholders

Fri, 19 Dec 2008 13:14:43 PST

This qualitative study aims to understand how personnel in state and federal agencies view surveillance systems and the extent to which systematically collected data inform nutrition and physical activity policies and interventions addressing obesity. In-depth interviews were conducted with 17 respondents purposively sampled from state health departments, federal public health agencies, and prevention research centers. All informants acknowledged the importance of surveillance systems and influence of the data-action cycle for monitoring trends and increasing obesity awareness. However, state-level respondents believed surveillance systems should be designed for programmatic purposes, whereas federal participants thought they should be designed for monitoring. Respondents held differing opinions about the flexibility, timeliness, accessibility, and usefulness of existing national surveillance systems, highlighting significant differences in state and federal agencies’ perceptions and utilization of surveillance systems. Such discrepancies call for increased communication surrounding purposes and uses of surveillance data, enabling stronger partnerships between state and federal agencies.

Using the Internet to Educate Adolescents About Osteoporosis: Application of a Tailored Web-Education System

Schoenfeld, E. R., Ng, P., Henderson, K., Wu, S.-Y. — Fri, 19 Dec 2008 13:14:42 PST

Osteoporosis is a "pediatric disease with geriatric consequences." This article describes the development and pilot testing of an online system to educate high school students grades 9–12 about osteoporosis; an age where positive health changes could have long lasting effects. The intervention goal was to improve knowledge about osteoporosis and intent to adopt healthy bone practices. Online pre- and postintervention surveys evaluated participants’ pre- and postintervention osteoporosis knowledge, attitudes, preventive practices, and postintervention intent to change healthy bone practices. Participants completed the Web-based program that provided detailed information about osteoporosis, and healthy bone practices, immediately after completing the pretest and just prior to completing the posttest. Eighty-nine students completed both the pre/posttests and were included in data analysis. Participants ranged in age from 13 to 17 and 75% were Caucasian (n = 65). Based on pre/posttest scores of 9 factual questions, students significantly improved their knowledge (p < .0001) and overall knowledge rating about osteoporosis at posttest (p < .001). Participants changed their perception regarding the disease’s seriousness (p < .001), and considered adopting osteoporosis prevention practices. The study shows that an interactive educational Web site is an effective method for increasing awareness and understanding of osteoporosis in high school students.

Confronting the Diabetes Disparity: A Look at Diabetes, Nutrition, and Physical Activity Programs in the Lower Rio Grande Valley

Fri, 19 Dec 2008 13:14:41 PST

Diabetes prevalence is higher along U.S.–Mexico border than in nonborder regions, and numerous community-based organizations are addressing this diabetes disparity through prevention and management programs. However, the nature, scope, and effectiveness of these efforts and programs are not well documented. This study aims at identifying key characteristics of diabetes programs in a Texas–Mexico border region with a predominately Hispanic, underserved population. A survey is administered to 84 community-based organizations in the Lower Rio Grande Valley (LRGV); 25 organizations respond. Nineteen programs related to diabetes and healthy lifestyle behaviors are identified in the LRGV. The majority of the programs are based on guidelines of national and state professional associations and agencies; target low-income and minority populations; are offered at no cost; and include program evaluation activities. Future research should examine the effectiveness, as well as the fidelity of the guidelines, of diabetes programs in the border region.

Communicating With Local Elected Officials: Lessons Learned From Clean Indoor Air Ordinance Campaigns

O'Dougherty, M., Forster, J., Widome, R. — Fri, 14 Nov 2008 09:24:06 PST

This article describes a study of the effectiveness of communication strategies used to influence policy makers to support local smoke-free laws in the Minneapolis–St. Paul metropolitan region. Twenty-seven of 41 members of three city councils and two county boards of commissioners were individually interviewed as were seven advocates who campaigned for the bans. Officials valued public health and economic data, public opinion polls, personally written e-mails, and dialogue with constituents. Phone banking messages indicated public support but were a nuisance. Officials felt that media ads were a waste of money and leafleting and other personal targeting were unacceptable. Advocates tended not to critically examine their own efforts for strengths and weaknesses and seemed unconcerned by public officials’ negative reception to some strategies. This case study suggests the need for reflection on the pros and cons of well-funded, highly orchestrated campaigns for public health policy, as these strategies may clash with the political process of building relationships.

Accessibility: Global Gateway to Health Literacy

Perlow, E. — Mon, 27 Oct 2008 10:39:55 PDT

Health literacy, cited as essential to achieving Healthy People 2010’s goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy’s primary prerequisite. Accessibility’s designation as the global gateway to health literacy is predicated also on life’s realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals’ raison d’être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession’s agenda is issued.

Utilizing Peer Academic Detailing to Improve Childhood Immunization Coverage Levels

Boom, J. A., Nelson, C. S., Kohrt, A. E., Kozinetz, C. A. — Mon, 27 Oct 2008 10:39:55 PDT

Interventions that utilize academic detailing to improve childhood immunization have been implemented across the country. This study evaluates the effectiveness of an academic detailing intervention to increase childhood immunization rates in pediatric and family medicine practices in a major metropolitan area. Educational teams of one physician, nurse, and office manager delivered 83 peer education sessions at practices in the intervention group. Postintervention immunization rates for children 12-23 months of age increased 1% in the intervention group and decreased 3% in the control group. Postintervention coverage levels for children 12-23 months of age did not differ between the intervention and control groups. Results indicated this office-based intervention was not sufficient to effect measurable changes in immunization coverage levels after 1 year of participation. Future interventions need to provide initial feedback regarding practice immunization coverage levels prior to the educational interventions and include multiple encounters.

One Size Fits All Partnerships? What Explains Community Partnership Leadership Skills?

El Ansari, W., Oskrochi, R., Phillips, C. J. — Thu, 25 Sep 2008 11:52:55 PDT

The authors evaluated W. K. Kellogg-funded Community Partnerships (CPs) between academic, health service, and community partners in South Africa. Stakeholders (N = 668 respondents) completed questionnaires to explore the operational, functional and organisational factors that contribute to members’ perceptions of the skills of their CPs’ leadership. Ten factors accounted for 53% of leadership skills across five participating CPs and six stakeholder groups. Each CP displayed its unique footprint of factors that accounted for its leadership levels. Similarly, each stakeholder group had its unique signature of factors that were associated with its leadership. Two factors (communication mechanisms and operational understanding) accounted for more than 25% of leadership skills; management capabilities and participation benefits accounted for 4% and 3%; and effectiveness, benefits to difficulties ratio of being a member, engagement in education, flow of information and sense of ownership accounted for 2% to 3% each. Attention to these and other factors is warranted.

Integrating Multiple Health Behavior Theories Into Program Planning: The PER Worksheet

Langlois, M. A., Hallam, J. S. — Fri, 13 Jun 2008 12:58:27 PDT

The foundation of a logic model or any theory-based planning model is the identification of the behavioral antecedents and the relationship of these variables to the target behavior. Applying theoretical concepts to specific behaviors and populations is often challenging for practitioners and program planning students. The challenge comes from the abstract definition of theoretical constructs, the duplication of similar constructs in multiple theories, and the need to combine multiple theories. To simplify the planning process when utilizing logic models and health behavior theory, we recommend the use of the PER Worksheet. The PER Worksheet is a planning tool that provides layman-term prompts for identifying health behavior antecedents. It encompasses five common health behavior theories—health belief model, theory of planned behavior, social cognitive theory, an ecological perspective, and transtheoretical model. The PER Worksheet is organized into three columns: Predisposing, Enabling, and Reinforcing factors, terms of the PRECEDE/PROCEED model.

Safe in the City: Developing an Effective Video-Based Intervention for STD Clinic Waiting Rooms

Tue, 10 Jun 2008 10:23:41 PDT

There is a strong need for inexpensive, easily administered HIV and STD prevention interventions that are highly replicable and appealing to diverse clinic audiences. This article describes the four-step iterative and collaborative process used by the Safe City Study Group to design and develop a brief video-based intervention: Safe in the City. Step 1 involves identification of an appropriate intervention medium, a theoretical framework, and key messages; Step 2, collaboration with a film company to integrate the framework and key messages into an entertaining product; Step 3, facilitation of a multistep participatory process involving input from members of the priority audience (clinic patients), clinic staff, and community reviewers; and Step 4, pilot-testing to determine structural barriers to patients’ viewing the video in clinic waiting rooms. Safe in the City has been demonstrated to reduce incident STDs among clinic patients in three cities in the United States.

Connecting for Health Literacy: Health Information Partners

Pomerantz, K. L., Muhammad, A.-A., Downey, S., Kind, T. — Tue, 10 Jun 2008 10:23:40 PDT

This article describes a community-based health information partnership to address health literacy and health information inequalities in marginalized communities. Public health, medical, literacy, and library practitioners promote health literacy through outreach, training, and professional development activities in community settings. They create learning environments for people to develop the necessary knowledge and skills to better understand health information and health policy so they can make decisions concerning personal and community health. Outreach activities focus on visits to neighborhood health centers, health fairs, health exhibits at union meetings and conferences; training programs involve hands-on, peer-led computer classes for people living with HIV and for the general public; and professional development programs connect librarians, health providers, public health workers, and literacy teachers in joint planning and learning. Several learners currently participate in and lead community health education programs and HIV advocacy. The coalition’s strength develops from strongly shared objectives, an absence of territoriality, and a core active leadership group.

Enabling and Sustaining the Activities of Lay Health Influencers: Lessons From a Community-Based Tobacco Cessation Intervention Study

Castaneda, H., Nichter, M., Nichter, M., Muramoto, M. — Fri, 06 Jun 2008 15:35:19 PDT

The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

Identifying and Assessing Interests and Concerns of Priority Populations for Work-Site Programs to Promote Physical Activity

Phipps, E., Madison, N., Pomerantz, S. C., Klein, M. G. — Fri, 06 Jun 2008 15:35:20 PDT

The work site has been identified as an ideal context for promoting physical activity. Assessing employee interest, identifying who could most benefit, and understanding impact of work-related barriers on potential participation is key. We conducted focus groups and surveyed the employee population of a large urban hospital. Using the "stages of change" construct, employees were categorized based on their motivation to exercise into exerciser, intender, and nonintender groups. Intenders were significantly more interested in most physical activity programs at work than were exercisers (p < .05). Intenders also found environmental and personal barriers to be more significant deterrents to participation than did exercisers (p < .01). Half of nonintenders reported interest in physical activity programs. Interest in physical activity programs at work is strong for employees who are not currently exercising. Both structural changes to promote safe environments and time allotments through work-related policies may encourage participation, especially for the priority populations of nonexercising employees.

Analyzing Public Health Policy: Three Approaches

Coveney, J. — Fri, 30 May 2008 09:39:01 PDT

Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject’s complexity. This article discusses three approaches that simplify policy analysis: Bacchi’s "What’s the problem?" approach examines the way that policy represents problems. Colebatch’s governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis’s policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one’s understanding and involvement in policy work.

Involving Consumers in the Development of a Psychoeducational Booklet About Stigma for Black Mental Health Clients

Alvidrez, J., Snowden, L. R., Kaiser, D. M. — Tue, 27 May 2008 10:09:55 PDT

Black individuals hold more negative views of mental illness and mental health treatment than do Whites, attitudes that are implicated in the underutilization of mental health services by Black populations. Psychoeducational interventions or materials may be one way to address attitudinal barriers to mental health treatment among Black adults, but only if the psychoeducational content is directly relevant to their beliefs and concerns. This article documents the process of developing a consumer-derived psychoeducational booklet for Black adults contemplating mental health treatment. Black mental health consumers provided the content for the booklet through qualitative interviews about their experiences and then provided feedback once it was developed. Results from this project suggest that the strategy of involving consumers is a feasible approach to develop psychoeducational materials that address treatment barriers in underserved populations.

Health Policy and Exercise: A Brief BRFSS Study and Recommendations

Larson, J. S., Winn, M. — Mon, 19 May 2008 10:12:16 PDT

The Behavioral Risk Factor Surveillance Survey is used to compare three predictors of self-rated health, specifically exercise, tobacco smoking, and a diagnosis of diabetes (a proxy for obesity). Exercise is found to be the best predictor, and the remainder of the article discusses the role of exercise in disease prevention and the all-important concept of exercise adherence. Government policy in the future needs to promote exercise adherence in a more rigorous way, because it is a key to both individual and societal health. Exercise habits need to be instilled from youth, and physical education requirements in school need to be re-established at all levels through high school. Adults also need encouragement with better neighborhood planning of exercise trails for walking and biking, as well as planned community activities to encourage fitness through one’s lifetime. The article concludes with six recommendations for formal government action to encourage exercise adherence.

A Qualitative Evaluation of Fire Safety Education Programs for Older Adults

Diekman, S. T., Stewart, T. A., Teh, S. L., Ballesteros, M. F. — Mon, 19 May 2008 10:12:16 PDT

This article presents a qualitative evaluation of six fire safety education programs for older adults delivered by public fire educators. Our main aims were to explore how these programs are implemented and to determine important factors that may lead to program success, from the perspectives of the public fire educators and the older adults. For each program, we interviewed the public fire educator(s), observed the program in action, and conducted focus groups with older adults attending the program. Analysis revealed three factors that were believed to facilitate program success (established relationships with the older adult community, rapport with older adult audiences, and presentation relevance) as well as three challenges (lack of a standardized curriculum and program implementation strategies, attendance difficulties, and physical limitations due to age). More fire safety education should be developed for older adult populations. For successful programs, public fire educators should address the specific needs of their local older adult community.

A Community-Organizing Approach to Promoting Physical Activity in Older Adults: The Southeast Senior Physical Activity Network

Cheadle, A., Egger, R., LoGerfo, J. P., Walwick, J., Schwartz, S. — Mon, 19 May 2008 10:12:15 PDT

This article describes a community organizing approach to promoting physical activity among underserved older adults in southeast Seattle: the Southeast Senior Physical Activity Network (SESPAN). The organizing strategy involves networking with a variety of community-based organizations, with two broad objectives: (a) program objective—to make connections between two (or more) community-based organizations to create senior physical activity programs where none existed before; and (b) coalition objective—to build a broader network or coalition of groups and organizations to assist in making larger scale environmental and policy changes. Networking among organizations led to the creation of a number of potentially sustainable walking and exercise programs that are reaching previously underserved communities within Southeast Seattle. In addition, a major community event led to the establishment of a health coalition that has the potential to continue to generate new broad-based programs and larger scale environmental changes.

Corporate Smoking Cessation on Long Island

Mulligan, P. — Wed, 14 May 2008 10:10:16 PDT

Tobacco addiction is a treatable health care problem. Employers are experiencing major annual increases in the cost of providing health insurance benefits. The expenditures due to smoking-related diseases are a major contributor to the escalating cost of employer-sponsored health and life benefit plans. An initiative that employers have adopted to help control increases in health care costs as well as improve the lifestyle of employees is the establishment of corporate wellness programs. Programs that promote healthy lifestyles and wellness are connected to the principle that a happy and healthy worker will be more effective and productive. Another dividend of corporate wellness programs is higher employee retention and better employee morale. An earlier study investigated the impact of wellness programs for Long Island employers. One of the major findings of that research was the confirmation of the prevalence of smoking cessation initiatives as components of the successful wellness programs. This article, through analysis of a follow-up survey, confirms that corporate smoking cessation programs have a significant return on investment. Further, the analysis identifies the components of the cessation programs and measures the relative impact of each element.

An Assessment of Certified Health Education Specialists' Attitudes on Direct Third-Party Reimbursement for Health Education Services

Li, Y., Chen, W., Sheu, J.-J., Dodd, V. — Wed, 14 May 2008 10:10:15 PDT

This study used a valid questionnaire to assess certified health education specialists’ (CHES) opinions regarding issues of seeking payment from insurance companies (third-party reimbursement) for health education services. A total of 1,942 usable questionnaires were returned, and the responses were used for data analysis. Results from descriptive statistics indicated that the participants acknowledged both the potential advantages and disadvantages associated with seeking direct third-party reimbursement (DTPR) for health education services. In addition, study results suggested positive attitudes among the participants regarding DTPR. However, study results also indicated existing reservations among the participants in terms of the feasibility of seeking DTPR. Inferential statistics indicated that all demographic factors except race had no influence on participants’ attitudes toward seeking DTPR. Discussions of the study results and recommendations for the health education profession are provided.

Ethnic Disparities in Youth Access to Tobacco: California Statewide Results, 1999-2003

Wed, 14 May 2008 10:10:14 PDT

The authors examined the role of youth ethnicity in youth access to tobacco with large, random samples of stores and large samples of ethnically diverse youths for the first time. From 1999 through 2003, White, Black, Latino, and Asian youths made 3,361 cigarette purchase attempts (approximately 700 per year) statewide. Analyses revealed that Black youths had significantly higher access than other youths and that access rates for Black and Asian (but not Latino or White) youths exceeded the Synar-mandated ≤20%. Clerks who failed to demand youth proof of age identification (ID) sold 95% of the tobacco that youths received and sold significantly more often to minorities and to girls, whereas clerks who demanded youth ID sold equally infrequently to all youths. These findings highlight significant ethnic disparities in youth access to tobacco and imply that those might be eliminated by policies and interventions that increase clerk demands for youth ID.

Perspectives on a Community-Based Course for Public Health Students

Wed, 30 Apr 2008 09:23:55 PDT

In recent years, there has been an increase in collaborations between universities and local community agencies. During the 2005-2006 academic year, the Department of Behavioral and Community Health Sciences at the University of Pittsburgh Graduate School of Public Health began a community–university partnership with Hosanna House Inc., a local community service center. The initial phase of this partnership included holding a departmental community development course at the community service center. Information from student journals, course evaluations, and key informant interviews were used to describe the attitudes and perspectives of the students, course instructor, and key informants toward this experience. Overall, this experience positively affected the personal and professional development of the students and was well received by faculty and staff within the academic department and community service center. The authors anticipate that this information will promote and serve as a reference for similar community–university partnerships at other schools of public health.

Novel Use of Patient-Derived Vignettes to Foster Self-Efficacy in an Asthma Self-Management Workbook

Mancuso, C. A., Sayles, W., Robbins, L., Allegrante, J. P. — Thu, 10 Apr 2008 13:09:41 PDT

This article describes the development of an interactive self-management workbook to increase asthma knowledge and self-efficacy. Its format encourages readers to write in their own personal experiences and perspectives. The knowledge component was developed from standard materials and organized into thematic chapters. The self-efficacy component was developed from interviews with patients in the outpatient setting, emergency room, and hospital; it consists of three sections explaining why confidence is necessary to be an effective self-manager and offers techniques to increase confidence. The component’s cornerstone is vignettes of patients describing what triggers their asthma and what behaviors they use to successfully manage it. This novel approach to fostering self-efficacy allows patients to see themselves in others’ success stories. Although not a substitute for self-management courses, the workbook promotes self-management by offering a practical and readily available option to in-person instruction and peer contact, which are accessible to only a small number of patients.

Stop the Sores: The Making and Evaluation of a Successful Social Marketing Campaign

Thu, 10 Apr 2008 13:09:42 PDT

Los Angeles County has experienced a rapid increase in early syphilis among men who have sex with men (MSM) in recent years, with the number of cases rising from 126 in 2000 to 809 in 2005. As part of the public health response to this outbreak, a sustained social marketing campaign was launched in 2002, with the objectives of increasing syphilis testing, knowledge, and awareness among MSM in Los Angeles. This campaign, as implemented, exemplified key principles of social marketing, including market research, audience segmentation, and branding. A cross-sectional study conducted in 2004 to evaluate the campaign found that those MSM who were aware of the campaign were nearly twice as likely to have tested for syphilis in the past 6 months as those MSM who were not aware of the campaign. Those MSM who were aware of the campaign also had more syphilis awareness and knowledge in key areas.

High School Coaches' Assessments, Intentions to Use, and Use of a Concussion Prevention Toolkit: Centers for Disease Control and Prevention's Heads Up: Concussion in High School Sports

Sawyer, R. J., Hamdallah, M., White, D., Pruzan, M., Mitchko, J., Huitric, M. — Wed, 09 Apr 2008 09:11:41 PDT

This study evaluated school coaches’ perceptions, assessments, and use of a toolkit to prevent and manage concussions among school athletes. A computer-assisted telephone survey was conducted with a stratified, random sample of high school coaches (n = 497; response rate = 39.3%; cooperation rate = 81.5%) from five states. Most reported that they had used or planned to use kit materials. Most (81%) in schools with a written plan for preventing and managing concussions indicated that the toolkit could be used to improve it and 96% of coaches in schools without a plan indicated that the kit could be used to develop one. Most assessed the kit as visually appealing, easy to use, and containing appropriate content. There were no significant differences among coaches with differing professional experience or for sports with different injury rates. Among those with other concussion-prevention materials, most indicated greater satisfaction with the toolkit.

Designing a Cardiovascular Disease Prevention Web Site for Latinos: Qualitative Community Feedback

Wed, 02 Apr 2008 13:39:09 PDT

Latinos are the largest minority group in the United States, yet there is currently a lack of Web sites that focus on Latino health. This article shares qualitative research results obtained from Latinos, with a focus on creating a culturally sensitive, bilingual, interactive, computer-based cardiovascular disease risk assessment and behavioral goal-setting program. This project is a substudy of the Latinos Using Cardio Health Actions to Reduce Risk (LUCHAR) grant, a 5-year trial, funded by the National Heart, Lung, and Blood Institute, whose primary aim is the primary prevention of cardiovascular disease in Latinos. Ten focus groups, five in English and five in Spanish, were conducted at six community sites with trained, bilingual facilitators in Denver, Colorado. Results from the focus groups are used to make recommendations on how to develop a culturally sensitive cardiovascular health care Web site for Latinos.

Exploring Local Perceptions of and Responses to Urban Youth Violence

Yonas, M. A., O'Campo, P., Burke, J. G., Gielen, A. C. — Fri, 28 Mar 2008 13:42:07 PDT

Objective: Despite widespread prevention efforts, youth violence persists in many urban communities. This investigation explores the unique perspectives and local capacities to address urban youth violence. Method: Qualitative in-depth interviews were conducted with prominent neighborhood individuals (PNIs) from low-wealth neighborhoods that varied by risk for youth violence. Findings: Findings reveal examples of increased levels of social action in the designated low risk for youth violence neighborhoods. Similar activities were also present, but to a lesser extent, within the high-risk neighborhoods. Results illustrate how PNIs formally and informally share information and take action to address youth violence. Conclusion: PNIs are an often-overlooked resource in gaining local insight for addressing health issues, such as youth violence. The efforts identified exhibit expertise and culturally sensitive opportunities for working together to address youth violence. Understanding such dynamics is essential for informing the development of locally endorsed violence-prevention interventions.

Why Be Smoke-Free? A Qualitative Study of Smoke-Free Restaurant Owner and Manager Opinions

Johnson, H. H., Becker, C., Inman, L., Webb, K., Brady, C. — Thu, 27 Mar 2008 09:41:21 PDT

This qualitative study captured the opinions of the owners and managers of smoke-free restaurants. The purpose of this study, initiated by local citizens who were members of a group called Healthy Alamance, was to identify the motivations and experiences of restaurant owners and managers who had committed to smoke-free indoor environments. Telephone interviews were attempted with all 80 owners/managers of smoke-free restaurants in Alamance County, North Carolina, and 87.5% of these restaurant owners/managers completed the interview. The investigators isolated economic factors, customer demands and considerations, and environmental issues as the three principal categories describing smoke-free restaurant owners’ and managers’ motivations for becoming smoke free. The results from this study can be used to assist communities working toward the development of a smoke-free restaurant campaign.

Survey Design From the Ground Up: Collaboratively Creating the Toronto Teen Survey

Wed, 26 Mar 2008 09:43:36 PDT

The Toronto Teen Survey is a community-based participatory research study whose aim is to gather information on the accessibility and relevance of sexual health services for diverse groups of urban youth (13 to 17 years of age). This information will be used to develop a proactive, citywide strategy to improve sexual health outcomes for Toronto adolescents. In this article, the authors focus on the processes of collaboratively developing a survey tool with youth, academics, and community stakeholders. An overview of the project and examples from the design stage are provided. In addition, recommendations are given toward developing best practices when working with young people on research and survey design.

Harnessing Complexity: Taking Advantage of Context and Relationships in Dissemination of School-Based Interventions

Wed, 19 Mar 2008 08:51:40 PDT

Schools and school systems are increasingly asked to use evidence-based strategies to promote the health and well-being of students. The dissemination of school-based health promotion research, however, offers particular challenges to conventional approaches to dissemination. Schools and education systems are multifaceted organizations that sit within constantly shifting broader contexts. This article argues that health promotion dissemination needs to be rethought for school communities as complex systems and that this requires understanding and harnessing the dynamic ecology of the sociopolitical context. In developing this argument, the authors draw on their experience of the dissemination process of a multilevel school-based intervention in a complex educational context. Building on this experience, they argue for the need to move beyond conventional dissemination strategies to a focus on active partnerships between developers and users of school-based intervention research and offer a conceptual tool for planning dissemination.

Kids Identifying and Defeating Stroke (KIDS): Development and Implementation of a Multiethnic Health Education Intervention to Increase Stroke Awareness Among Middle School Students and Their Parents

Mon, 10 Mar 2008 09:15:03 PDT

The Kids Identifying and Defeating Stroke (KIDS) project is a 3-year prospective, randomized, controlled, multiethnic school-based intervention study. Project goals include increasing knowledge of stroke signs and treatment and intention to immediately call 911 among Mexican American (MA) and non-Hispanic White (NHW) middle school students and their parents. This article describes the design, implementation, and interim evaluation of this theory-based intervention. Intervention students received a culturally appropriate stroke education program divided into four 50-minute classes each year during the sixth, seventh, and eighth grades. Each class session also included a homework assignment that involved the students’ parents or other adult partners. Interim-test results indicate that this educational intervention was successful in improving students’ stroke symptom and treatment knowledge and intent to call 911 upon witnessing a stroke compared with controls. The authors conclude that this school-based educational intervention to reduce delay time to hospital arrival for stroke shows early promise.

Using Drama to Prevent Teen Smoking: Development, Implementation, and Evaluation of Crossroads in Hawai`i

Mitschke, D. B., Loebl, K., Tatafu, E., Matsunaga, D. S., Cassel, K. — Thu, 06 Mar 2008 14:07:18 PST

The use of drama as a preventive education measure has demonstrated success in various health promotion venues and offers promise in promoting positive youth attitudes and behavior change related to tobacco use. Especially important is a need to implement culturally relevant methods to reach youth. This article describes the development and implementation of a tobacco prevention drama for Asian and Pacific Islander youth. The resulting play, Crossroads, features a soap opera-style drama interspersed with humorous vignettes and multimedia effects and incorporates cultural cues, mannerisms, dress, and values consistent with Asian and Pacific Islander youth culture. Evaluation data indicate that the drama has an effect on audience knowledge, attitudes, and intended behavior, including a change in future intent to smoke cigarettes and the ability of audience members to develop connections with the characters in the play and apply concepts that are presented in the play to their own lives.

Foreword: "A Report on the 2004 SOPHE Publications Readership Survey"

Butterfoss, F. D., Francisco, V. T. — Thu, 10 Aug 2006 16:06:51 PDT