Health Promotion Practice recent issues

Book and Media Review: A Purchaser's Guide to Clinical Preventive Services: Moving Science Into Coverage

Olson, S. J. — 2008-06-17

A Purchaser's Guide to Clinical Preventive Services: Moving Science Into Coverage is a comprehensive tool that assists benefits staff as they design health care benefits, set up coverage guidelines for clinical preventive services with health plans, or negotiate covered services for purchasers of health care. The Purchaser's Guide includes the specific benefit language that should be incorporated into the health benefit, known as the Summary of Plan Description, which describes the coverage of each specific service in contractual terms. This resource is an example of a private organization (the National Business Group on Health) and public health (the Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality) working together to translate research into meaningful practice. The resulting product has the potential to affect many lives throughout the United States by improving the health benefits coverage and the ultimate delivery of clinical preventive services.

Lost in Translation: Tips for Avoiding Translation "Travesties"

Macario, E., Montealegre Boyte, R. — 2008-06-17

Building Capacity for Heart Disease and Stroke Prevention Research: The Cardiovascular Health Intervention Research and Translation Network

2008-06-17

The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention created the Prevention Research Centers (PRCs) Cardiovascular Health Intervention Research and Translation Network (CHIRTN) in 2005 to develop partnerships and create a research agenda that addresses cardiovascular health promotion. Six participating universities with expertise in heart disease and stroke prevention research collaborate with their PRC partner communities and other partners to (a) conduct demonstration research projects and (b) identify gaps in knowledge and make recommendations for future research to address those gaps. This report describes the structure and current efforts of the CHIRTN. The goal of these efforts is to promote cardiovascular health for Americans, particularly underserved, at-risk populations.

Health Educators' Perceptions of Ethics in Professional Preparation and Practice

Shive, S. E., Marks, R. — 2008-06-17

This commentary reflects health educators' views concerning perceptions of the need for increased awareness of the Code of Ethics for the Health Education Profession, improvement in professionals' ability to engage in ethical reflection, and the need for incorporation of ethical considerations into health education practice.

Professional Development in Retirement: The Top Rung on the Career Ladder

Hayden, J., Cottrell, R., Green, L., Ames, E., Ramsey, D. — 2008-06-17

Retirement means different things to different people. For some, it is the endless summer, for others the freedom to travel down a new career path. For all, it is a time of significant change. Three prominent "retired" health educators share with us their retirement expectations, realities, and advice.

Community--Academia Partnerships to Promote Nutrition in the Lower Mississippi Delta: Community Members' Perceptions of Effectiveness, Barriers, and Factors Related to Success

Ndirangu, M., Yadrick, K., Bogle, M. L., Graham-Kresge, S. — 2008-06-17

This study examined the perceptions of community members' engaged in community—academia partnerships involved in developing nutrition interventions in three communities in the Lower Mississippi Delta. Perceptions on effectiveness of the partnerships were investigated. Six focus group interviews were conducted, with 33 participants that included 27 females and 6 males. The data were analyzed by content coding. Emerging themes were identified and related to accomplishments, barriers to success, and factors related to success of the partnerships. Accomplishments included the establishment of active committees, positive changes in health behavior related to food choices, and participation in community events. Barriers to success included the slow pace of intervention implementation, difficulties with understanding the role of the community in the participatory research process, the decision-making processes, and project name recognition. Factors related to success were tangible benefits to the community, participation that was representative, simplification of the research process, and the decision-making processes.

Application of a Walking Suitability Assessment to the Immediate Built Environment Surrounding Elementary Schools

Lee, S. M., Tudor-Locke, C., Burns, E. K. — 2008-06-17

This study examines the usefulness of applying a walking suitability assessment to a specific geographic area surrounding elementary schools. Streets within a 0.25-mile radius were measured to create a summary walking suitability score for seven schools from high-busing strata and seven from low-busing strata. Summary walking suitability scores were calculated for each school. A Mann—Whitney U test was conducted to determine any differences in scores between the high- and low-busing schools. The median walking suitability score was 3.7 (a good rating); the 25th percentile score was 2.9 (very good), and the 75th was 22.3 (poor). No statistical differences existed between busing strata. Walking suitability is an important consideration when examining the feasibility of walk-to-school programs within school settings; however, it might not be the main factor limiting children's active commuting to school. Several aspects of the environment were captured that researchers, practitioners, school personnel, and transportation experts may deem useful.

Grassroots Advocacy Campaign for HIV/AIDS Prevention: Lessons From the Field

Moseley, C., Melton, L. D., Francisco, V. T. — 2008-06-17

There are many guides written for developing strategies and tactics related to advocacy, and many pages of text are devoted to developing advocacy plans. Less well described is the context within which grassroots advocacy campaigns can be successful. This article describes a successful campaign to establish a needle-exchange program (NEP) in Guilford County, North Carolina. The authors briefly describe NEPs in general, the history of NEPs in North Carolina, the mission of the North Carolina Harm Reduction Coalition (NCHRC), and why this approach was considered particularly important for Guilford County. Then the context of the successful adoption of an NEP in Guilford County and the progress to make it legal will be examined, including describing the specific advocacy activities facilitated by members of NCHRC. The article concludes with a discussion of lessons learned that may be applicable to other grassroots advocacy initiatives.

Using Direct Mail to Prompt Smokers to Call a Quitline

2008-06-17

Telephone quitlines efficiently deliver cessation services, but few smokers use them. This article describes an unsolicited direct mail campaign designed to increase calls to the New York State Smokers' Quitline. Two post-cards advertising the quitline and the availability of free nicotine patches were sent to 77,527 smoker households between August and October 2005. One postcard emphasized the effectiveness of the nicotine patch, whereas the other contrasted the risks of smoking and patch use. Response was evaluated using geographically linked calls to the quitline 15 days before and after each mailing. The postcard campaign increased call volume by 36%, with no difference between the two postcard versions. Those who reported calling the quitline in response to a mailing were more likely to request nicotine patches (91% versus 82%, p < .001). Direct mail can be used to increase quitline call volume and should be one of the promotional tools used by quitlines.

PREMIER--A Trial of Lifestyle Interventions for Blood Pressure Control: Intervention Design and Rationale

2008-06-17

Interventions encouraging adoption of healthy diets and increased physical activity are needed to achieve national goals for preventing and treating hypertension, cardiovascular disease, diabetes, and other chronic diseases. PREMIER was a multicenter clinical trial testing the effects of two lifestyle interventions on blood pressure control, compared with advice only. Both interventions implemented established national guidelines for blood pressure control (weight loss, reduced sodium and alcohol intake, and increased physical activity), and one intervention also included the Dietary Approaches to Stop Hypertension (DASH) diet. Both interventions focused on behavioral self-management, motivational enhancement, and personalized feedback. This article describes the design and evaluation approaches for these interventions. Evaluation of multicomponent lifestyle change interventions can help us understand the benefits and difficulties of making multiple lifestyle changes concurrently and the effects such changes can have on blood pressure, particularly in minorities at higher risk for hypertension.

Lessons Learned From Developing a Tailored Print Intervention: A Guide for Practitioners and Researchers New to Tailoring

2008-06-17

Although some "how-to" guides have been written on tailored messaging, we found no reports on lessons learned from the process of developing a tailored intervention. Such lessons may be useful for practitioners and researchers who are new to tailored intervention development. The authors describe lessons gleaned from the process of developing a repeat mammography tailored print intervention. Lessons learned include the following: Selection of determinants appropriate for tailoring should be based on a theoretic framework and refined through assessment of the target population; researchers should anticipate threats to fidelity of intervention delivery because of incomplete or illogical survey data; fingerprinting enables assessment of intervention dose and how it relates to effectiveness of the tailored intervention; and a systematic process for conducting a systems test is needed to check for inconsistencies and errors before final tailored letter production. These lessons are discussed in the context of challenges and possible solutions for tailored health communication.

The Effectiveness of a Multimedia Program to Prevent Fetal Alcohol Syndrome

LaChausse, R. G. — 2008-06-17

Fetal alcohol syndrome (FAS) continues to be the leading preventable cause of mental retardation in the United States. Because abstaining from alcohol prior to and throughout pregnancy is the only way to prevent FAS, some prevention programs try to target women before they become pregnant. The Fetal Alcohol Spectrum Teaching and Research Awareness Campaign (FASTRAC) is a multimedia, peer-delivered educational presentation designed to reduce the incidence of FAS. Results from an ethnically diverse sample of high school students indicate that the program increased participants' knowledge regarding FAS but had no significant effect on participants' attitudes, beliefs about the dangers of FAS or intention to use alcohol during pregnancy. The FASTRAC program failed partly because of its didactic approach and the lack of health education principles that have been shown to be effective in changing other substance use behaviors. Suggestions for improving FAS prevention education programs are offered.

The Novella Approach to Inform Women Living on Low Income About Early Breast Cancer Detection

Herbison, S., Lokanc-Diluzio, W. — 2008-06-17

Economically disadvantaged women have a greater likelihood of later-stage breast cancer diagnosis when compared to women with higher levels of income. Later-stage diagnosis decreases the chances of survival. The purpose of this article is to describe a project whereby breast cancer survivors, living on lower incomes, created novellas (stories) using artistic media to reach their peers with a message about the importance of early breast cancer detection. The recruitment and engagement of breast cancer survivors in a 2-year community development project that used participatory, women-driven approaches are discussed, and the reciprocal learning between health care providers, community partners, and women living on low income is shared. Recommendations for health promotion practice are presented.

Promoting Healthy Lifestyles in Children: A Pilot Program of Be a Fit Kid

Slawta, J., Bentley, J., Smith, J., Kelly, J., Syman-Degler, L. — 2008-06-17

Be a Fit Kid is a 12-week program aimed at improving physical activity and nutritional habits in children. The physical activity component of the program emphasized cardiovascular fitness, flexibility, muscular strength, and bone development through running, yoga, jumping, and strength exercises. All activities were individualized and noncompetitive. The nutrition component focused on current dietary guidelines that emphasize a diet rich in vegetables, fruits, unsaturated fats, and whole grains, and low in saturated fat and sugar. Following the 12-week intervention, significant improvements were observed in body composition, fitness, nutrition knowledge, dietary habits, and in those who participated 75% of the time, significant reductions in total cholesterol and triglyceride levels were observed. Findings from the pilot trial suggest that health promotion programs can be well received by children and may favorably alter overweight and the development of adult lifestyle-related diseases.

Book and Media Review: Coalitions and Partnerships in Community Health

Olson, S. J. — 2008-03-13

Coalitions and Partnerships in Community Health is a newly released text written by Frances D. Butterfoss. This book achieves the stated goal of being a one-stop shop for creating effective and long-lasting coalitions and partnerships as an effective strategy to achieve public health goals. The text is divided into four parts covering the importance of coalitions and partnerships, building and maintaining effective coalitions and partnerships, and coalitions and partnerships in action. Numerous figures, exhibits, examples, and resources make this 500+ page book an outstanding resource and roadmap for practitioners and researchers in all segments of public health and academia.

Using Pretesting to Ensure Your Messages and Materials Are on Strategy

Brown, K. M., Lindenberger, J. H., Bryant, C. A. — 2008-03-13

Pretesting is an important demonstration of understanding consumers' wants and preferences. This evolving, data-driven process provides opportunity for ensuring time, effort, and valuable resources are not wasted. The purpose of this article is to clarify the process of pretesting, why one should pretest, common mistakes, and pretesting on a shoestring budget.

Applying Health Education Theory to Patient Safety Programs: Three Case Studies

Gilkey, M. B., Earp, J. A. L., French, E. A. — 2008-03-13

Program planning for patient safety is challenging because intervention-oriented surveillance data are not yet widely available to those working in this nascent field. Even so, health educators are uniquely positioned to contribute to patient safety intervention efforts because their theoretical training provides them with a guide for designing and implementing prevention programs. This article demonstrates the utility of applying health education concepts from three prominent patient safety campaigns, including the concepts of risk perception, community participation, and social marketing. The application of these theoretical concepts to patient safety programs suggests that health educators possess a knowledge base and skill set highly relevant to patient safety and that their perspective should be increasingly brought to bear on the design and evaluation of interventions that aim to protect patients from preventable medical error.

Defining Elements of Success: A Critical Pathway of Coalition Development

Downey, L. M., Ireson, C. L., Slavova, S., McKee, G. — 2008-03-13

In recent decades, coalitions have been established to address many public health problems, including injury prevention. A partnership among the Kentucky Injury Prevention and Research Center and four injury prevention coalitions has documented the developmental stages of successful coalitions. This developmental process was constructed through the analysis of participating coalition documents, such as each coalition's mission statement, bylaws or rules of operation, the use of committees within the organization, frequency of meetings, and additional historical documents. Themes from this analysis guided researchers in designing a critical pathway model that describes milestones in coalition formation. Critical components in coalition formation include a clear definition of the coalition structure, coalition enhancement, funding, community support, leadership, education and outreach to the community, membership, partnerships, data and evaluation, and publicity. These findings are applicable to public health professionals who work with community-based coalitions and citizens who participate in local coalitions.

Abnormal Mammogram Follow-Up: Do Community Lay Health Advocates Make a Difference?

2008-03-13

This pilot study evaluates a community lay health advocate (CLHA) intervention in promoting follow-up for abnormal mammograms among African American women. A controlled trial was implemented at an urban hospital in Atlanta, with 48 women in a CLHA intervention group and 35 in a usual care group. Participants were 25 or older and had an abnormal mammogram between March 25, 2002, and May 2, 2003. Intervention group women received CLHA support including encouragement of timely abnormal mammogram follow-up, reminders of follow-up appointments, identification and removal of barriers to follow-up, and accompaniment to follow-up appointments. Women in the intervention group were significantly more likely to keep their first abnormal mammogram follow-up appointment, all of their scheduled follow-up appointments, and their biopsy or fine needle aspiration appointment. CLHAs are effective in promoting abnormal mammogram followup among African American women and may be an important resource in reducing racial disparities in breast cancer mortality.

Culturally Responsive Health Promotion in Puerto Rican Communities: A Structuralist Approach

2008-03-13

This literature review discusses the value of the structuralist approach as an integrated theoretical and methodological framework for participatory cultural assessments designed to capture the cultural dynamics of those affected by health disparities. Drawing from principles of the Lévi-Straussian strand of structural anthropology found in contemporary cultural studies, and using the Puerto Rican cultural experience as an example, the authors present the distinction between deep and surface structures of cultural knowledge and meaning and highlight information-processing and behavioral systems influenced by the complexity of cognitive and social representations of cultural structures. To understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses, the authors show the need for ethnographic narrative inquiry beyond surface manifestations of culture. Finally, the authors discuss the implications of the structuralist approach for culturally responsive health education and other health promotion interventions.

Visions and Voices: Indigent Persons Living With HIV in the Southern United States Use Photovoice to Create Knowledge, Develop Partnerships, and Take Action

Rhodes, S. D., Hergenrather, K. C., Wilkin, A. M., Jolly, C. — 2008-03-13

Little is known about the experiences of persons living with HIV/AIDS (PLWHA) in some regions of the United States that are disproportionately affected by HIV/AIDS. "Visions and Voices: HIV in the 21st Century" was an exploratory study to gain insight into the life experiences of 15 indigent PLWHA. The study used photovoice to uncover the realities of living with HIV/AIDS though photographic documentation and Freirean-based critical dialogue and facilitate a process for PLWHA to reach local community members and leaders, policy makers, and advocates to develop plans of action and effect change. From the participants' photographs and words, seven themes emerged and were presented during a community forum. Three main outcomes occurred, including a participant-developed and locally funded gallery exhibition to address HIV/AIDS misinformation and stigma; a new partnership with the public health department to use PLWHA in their prevention programming; and increased community efforts to address substance use.

Strengthening Community Leadership: Evaluation Findings From the California Healthy Cities and Communities Program

Kegler, M. C., Norton, B. L., Aronson, R. E. — 2008-03-13

Collaborative approaches to community health improvement such as healthy cities and communities have the potential to strengthen community capacity through leadership development. The healthy cities and communities process orients existing local leadership to new community problem-solving strategies and draws out leadership abilities among residents not previously engaged in civic life. In an evaluation of the California Healthy Cities and Communities (CHCC) Program, leadership development was one of several outcomes assessed at the civic-participation level of the social ecology. Data collection methods included focus groups and surveys, semistructured interviews with coordinators and community leaders, and review of program documents. Findings suggest that the CHCC program enhanced capacity by expanding new leadership opportunities through coalition participation, program implementation, and civic leadership roles related to spin-off organizations and broader collaborative structures. Communities in rural regions were particularly successful in achieving significant leadership outcomes.

Physical Activity Influences in a Disadvantaged African American Community and the Communities' Proposed Solutions

Griffin, S. F., Wilson, D. K., Wilcox, S., Buck, J., Ainsworth, B. E. — 2008-03-13

The purpose of this assessment is to increase our understanding of how safety and environmental factors influence physical activity among African American residents living in a low-income, high-crime neighborhood and to get input from these residents about how to best design physical activity interventions for their neighborhood. Twenty-seven African American adult residents of a low-income, high-crime neighborhood in a suburban southeastern community participated in three focus groups. Participants were asked questions about perceptions of what would help them, their families, and their neighbors be more physically active. Two independent raters coded the responses into themes. Participants suggested three environmental approaches in an effort to increase physical activity: increasing law enforcement, community connectedness and social support, and structured programs. Findings suggest that safety issues are an important factor for residents living in disadvantaged conditions and that the residents know how they want to make their neighborhoods healthier.

Recruitment Strategies and Costs for a Community-Based Physical Activity Program

Peck, L. E., Sharpe, P. A., Burroughs, E. L., Granner, M. L. — 2008-03-13

A community-based participatory research project using social marketing strategies was implemented to promote physical activity among women aged 35 to 54 who were insufficiently active or completely inactive. A variety of media were used to disseminate messages about how to enroll in Step Up. Step Out! This article describes the effectiveness and cost of the recruitment strategies and lessons learned in recruiting the women. Of the total inquiries (n = 691), 430 women were eligible and enrolled in the program. Based on data from questionnaires, the most effective method of recruiting women into Step Up. Step Out! was word of mouth (36%). Newspaper ads accounted for 29% of the women's responses. The least effective method was billboards. Mass media was not as effective in recruiting women for the program as interpersonal efforts such as word of mouth. Interpersonal efforts are a valuable and possibly underrated recruitment and promotion tool.

A State-Based Model of Prevention: Indiana's Example

Agley, J., Gassman, R. — 2008-03-13

Public health officials in the United States have battled alcohol, tobacco, and other drug (ATOD) use among adolescents for the past few decades, but only in 2002 did they begin to see a decline in rates of use. ATOD use and abuse are associated with numerous problems, including criminal behavior and increased adolescent morbidity and mortality rates. Researchers have sought to identify best-practice procedures for ATOD prevention; the state of Indiana has a strong ATOD prevention system in place that has the potential to serve as a model for other U.S. localities because of its best-practice approach to public health services. This article outlines the activities of the Indiana Prevention Resource Center to provide an example to strengthen public health professionals' ability to prevent ATOD use and abuse and to provide for a healthy adolescent population.

Being Well-Connected: Starting and Maintaining Successful Partnerships

Goldman, K. D., Schmalz, K. J. — 2007-12-31

Books and Media Review: Collected Works Addressing Global Health

Gambescia, S. F. — 2007-12-31

This article includes brief overviews of three books that have collected works on global health. They were selected given their scope of the issue, author expertise, committed editors, and sponsoring organizations, and each provides in some sense a different level (micro, midlevel, macro) of understanding of the needs to improve global health.

Ascending the Career Ladder, With Dr. Jay Bernhardt

Hayden, J., Cottrell, R., Bernhardt, J. — 2007-12-31

There are many options available for enhancing one's career, including acquiring further education, obtaining certifications, learning new tools of the trade, and writing for publication, to name just a few. Over the years, many of these have been addressed in this journal. One that has not is career development through studying successful careers of others. For the first career case study, the authors are delighted to present Dr. Jay Bernhardt, director of the National Center for Health Marketing at the U.S. Centers for Disease Control and Prevention in Atlanta.

Interview With Marion Nestle

Dorfman, L. — 2007-12-31

Using Focus Groups to Revise an Educational Booklet for People Living With Methicillin-Resistant Staphylococcus Aureus (MRSA)

McBrien, S., Felizardo, G. R., Orr, D. G., Raymond, M. J. — 2007-12-31

The incidence of methicillin-resistant staphylococcus aureus (MRSA) has grown in epidemic proportions; in many individuals, MRSA causes recurrent infections. MRSA infections can be transmitted from person to person through direct contact or contact with contaminated objects. Once confined to hospitalized individuals, MRSA is now seen in otherwise healthy individuals and congregate community settings. There is a demand for educational materials to guide MRSA patients in self-care, preventing recurrences, and reducing transmission. In 2004, Tacoma-Pierce County Health Department in Washington State led the effort to create an educational booklet for people with MRSA. Due to resource constraints, it was created without audience testing. In 2005, the revision of Living With MRSA involved audience testing using two focus groups comprising people living with MRSA and their families. This report describes the work of an interdisciplinary professional work group using focus groups to revise an educational booklet for people living with MRSA as patients, family members, and caregivers.

Ethics and Patient Provider Communication

Marks, R., Shive, S. E. — 2007-12-31

Effective health educator—client communication processes are a prerequisite to the acquisition and appropriate application of new knowledge, to discussions that focus on treatment risks and options, and to the mediation of (a) optimal self-management practices, (b) adherence to health recommendations, (c) client satisfaction, (d) autonomous, responsible decision making, and (e) provision of supportive and helpful advice. But is there room for improvement? To provide more uniform high-quality communications to all citizens and to support the practice principles embedded in the Health Education Code of Ethics, this article outlines results of the related literature, the authors' research, and a specific post hoc analysis of a national sample that strongly suggests that much more needs to be done to ensure health providers effectively communicate health promotion messages without bias in at least five related communication domains.

Using a Delphi Technique to Determine the Needs of African American Breast Cancer Survivors

Shaw, M. D., Coggin, C. — 2007-12-31

A qualitative study was designed in collaboration with the Sisters Network, Inc., the only nonprofit national Black breast cancer support group, to identify the needs of Black breast cancer survivors. This article describes the use of the Delphi technique as a methodological tool for listening to culturally different speakers and building consensus among members of a racial minority group regarding their most important needs as breast cancer survivors. The specific objective of the study was to determine if the seldom-used Delphi technique could serve as a tool for deriving consensus on a significant health care concern among members of a racial minority group. Sixty-two survivors from different geographical regions of the United States participated in the study. The Delphi technique proved to be a useful qualitative method for encouraging discussion among a group of women with a vested interest in a specific health issue.

BART to HIVEd: Adapting an HIV Education Prevention Program

2007-12-31

One of the fastest growing segments of the population infected with HIV is the nation's youths. Thus, prevention in this high-risk population is vital. The authors detail the process of adapting an evidence-based HIV/AIDS educational program (HIVEd) to the unique needs of high-risk youths in adjudicated and detained facilities and alternative high schools. The HIVEd program derives from St. Lawrence's Becoming A Responsible Teen (BART) curriculum. This article describes the modification of BART into HIVEd, identifies the challenges encountered and lessons learned, and suggests future directions for HIVEd as a useful tool for prevention of HIV/AIDS and sexually transmitted infection in high-risk youths.

An Evaluation of Community Health Center Adoption of Online Health Information

Martinez, M. A., Kind, T., Pezo, E., Pomerantz, K. L. — 2007-12-31

Health care providers and patients in community health centers often lack access to online scientific and patient education resources. These resources can improve medical decision making and promote communication between provider and patient. In 2000, a community health information program, Partners for Health Information, provided 10 community health centers in Washington, D.C. with computers, training, and consumer health resources, supplemented with visits to coach patients and staff in their use. The purpose of this study is to assess the adoption of the use of online health information among staff in seven of these health centers. The methods of this evaluation were designed to measure frequency of patient referral by health center staff to online health information and to describe providers' perceptions of the barriers and enablers to using online resources. Recommendations made by respondents can be used to modify the Partners program and guide the development of other similar programs.

Collecting Health Data With Youth at Faith-Based Institutions: Lessons Learned

Reinert, B., Carver, V., Range, L. M., Pike, C. — 2007-12-31

Faith-based organizations (FBOs) are ideal for health promotion but can present unique challenges in data collection. The present initiative included 6 years of awards to mostly small, rural, predominantly African American FBOs to conduct tobacco prevention lessons for youth in Grades 4—6 while they were attending summer Vacation Bible School. In 2005, these awards included $1,500 disbursed to 64 geographically diverse FBOs who had never before received this funding. Lessons learned include the following: Plan for evaluation in every aspect of the project; pilot-test everything; use reminders judiciously; make backup plans at every step; personally collect data in a nonthreatening way; and safeguard data entry. Evaluation requires extensive time, money, and effort; so, in both the intermediate and the long run, this extra work is worth it.

Using GIS to Facilitate Community-Based Public Health Planning of Diabetes Intervention Efforts

Kruger, D. J., Brady, J. S., Shirey, L. A. — 2007-12-31

Data from a community survey were analyzed geographically to help facilitate local diabetes prevention efforts. Data were available from the Speak to Your Health! Community Survey, designed and implemented by The Prevention Research Center of Michigan (PRC/MI), whose central mission is to strengthen community capacity to improve health. This survey was developed collaboratively by the university and community partners that comprise the PRC/MI and focuses on health and social issues at the heart of the community of Genesee County, Michigan. Survey data were used to calculate and geographically map diabetes-risk scores and mapped diabetes-screening rates. These maps indicated that those areas where the estimated risk of diabetes was the highest had only moderate rates of diabetes screening relative to other areas. It is hoped that these results will reach those involved in local diabetes-intervention programs with the intent that the data will be used in planning local prevention and intervention efforts.

Web-Based Tailored Lifestyle Programs: Exploration of the Target Group's Interests and Implications for Practice

Verheijden, M. W., Jans, M. P., Hildebrandt, V. H. — 2007-12-31

An important challenge in Web-based health promotion is to increase the reach of the target audience by taking the target groups' desires into consideration. Data from 505 members of a Dutch Internet panel (representative for Dutch Internet users) were used to asses the target group's interests and needs. 28% participated in Web-based tailored lifestyle programs, 57% expressed an interest in such programs, and 15% expressed no interest. Interest in Web-based programs was predominantly caused by a general interest in lifestyle and online tests. Participation in Web-based tailored lifestyle programs should not take more than 17 minutes per occasion. 84% were interested in follow-up testing after the initial participation. Responders were particularly interested in physical activity and nutrition. Hardly anyone was willing to pay for participation. The results from this study support the use of Web-based tailored lifestyle programs in behavior change efforts.

Fetal Alcohol Syndrome Prevention Using Community-Based Narrowcasting Campaigns

Glik, D., Prelip, M., Myerson, A., Eilers, K. — 2007-12-31

Preventing fetal alcohol syndrome (FAS) by encouraging pregnant women to abstain from drinking alcohol competes with commercial alcohol marketing. Two FAS-prevention campaigns using a narrowcast approach among young women of childbearing age in two disadvantaged Southern California communities are compared. The design, implementation process, and degree to which campaigns reached the priority populations are the focus of this article. Formative research shows that young women in disadvantaged communities receive mixed messages about dangers of drinking during pregnancy. A social norms approach using positive role models was the most acceptable message strategy based on materials pretesting. Differences in campaign implementation and distribution strategies between communities were documented through program monitoring. Survey research indicated the more viable messaging and implementation strategies. Findings show that low-cost community campaigns are feasible; however, variations in messaging, distribution strategies, and saturation levels determine whether such campaigns succeed or fail to reach priority populations.

Erratum

2007-12-31

Erratum

2007-12-31

Getting a Line on Online Teaching

Denard Goldman, K., Jahn Schmalz, K. — 2007-11-02

The Program Success Story: A Valuable Tool for Program Evaluation

Lavinghouze, R., Webb Price, A., Smith, K.-A. — 2007-11-02

Success stories are evaluation tools that have been used by professionals across disciplines for quite some time. They are also proving to be useful in promoting health programs and their accomplishments. The increasing popularity of success stories is due to the innovative and effective way that they increase a program's visibility, while engaging potential participants, partners, and funders in public health efforts. From the community level to the federal level, program administrators are using success stories as vehicles for celebrating achievements, sharing challenges, and communicating lessons learned. Success stories are an effective means to move beyond the numbers and connect to readers—with a cause they can relate to and want to join. This article defines success stories and provides an overview of several types of story formats, how success stories can be systematically collected, and how they are used to communicate program success.

Developing a Promotional Strategy: Important Questions for Social Marketing

Thackeray, R., Neiger, B. L., Hanson, C. L. — 2007-11-02

Health practitioners often use the terms marketing and promotion interchangeably. Yet, promotion is just one element of an overall marketing strategy. To realize the greatest impact there must be a combination of all the marketing components, including product, price, place, and promotion. The purpose of this article is to clarify the role of promotion and describe key elements of developing a promotional strategy within the broader context of a social marketing initiative.

Health Department Faculty Perceptions About Ethics in Professional Preparation

Marks, R., Shive, S. E. — 2007-11-02

The purpose of this article is to report the key preliminary findings of a survey conducted among university faculty serving health education and health promotion programs. Few distinct courses in ethics are offered in graduate health education programs and even fewer are offered at the undergraduate level. Most programs address ethics throughout several courses in the program. Among those that offer distinct ethics courses, fewer than half require the course for graduation. Faculty can influence improvement in health professionals' ability to engage in ethical reflection, with the subsequent outcome of the incorporation of the necessity of ethical deliberation into health education practice.

Addressing Food Security Through Public Policy Action in a Community-Based Participatory Research Partnership

2007-11-02

Community-based participatory research (CBPR) is an increasingly utilized research approach that involves the affected community identifying a health-related problem, developing a research agenda, and planning an appropriate intervention to address the problem. This report on a CBPR partnership in San Francisco's Bayview Hunters Point neighborhood documents the rise of a community food security policy in response to youth-involved research that found poor access to quality food in an economically disadvantaged area of the city. To analyze the impact of the research on public policy, a framework of specific steps in the policy-making process is used to organize and better understand the partnership's objectives, activities, strategies, and successes. This community—health department partnership has been able to achieve an innovative and sustainable public policy solution, the Good Neighbor Program, by working closely with policy makers and local businesses to expand community accessibility to healthy food.

The Use of Family Health Histories to Address Health Disparities in an African American Community

2007-11-02

African Americans continue to suffer from health disparities. The Center for Minority Health (CMH) within the University of Pittsburgh has the mission to eliminate racial and ethnic health disparities. CMH has designed and implemented the Family Health History (FHH) Initiative. The FHH Initiative places genetic-counseling graduate students in the African American community to provide risk assessments and emphasize the importance of family history as it pertains to disease prevention. The FHH Initiative also allows participants to enroll into the Minority Research Recruitment Database (MRRD). This enables CMH to alert individuals to available research participation opportunities. In the first year of this program, 225 African Americans completed their family health histories. More than 60% of individuals enrolled in the MRRD. The authors report their initial successes and challenges of an initiative that incorporates awareness of family history information, proper screening guidelines, behavior-modification recommendations, and support for participation in clinical research.

Photovoice With Vulnerable Populations: Addressing Disparities in Health Promotion Among People With Intellectual Disabilities

Jurkowski, J. M., Paul-Ward, A. — 2007-11-02

Cardiovascular diseases (CVD) are the leading causes of death among Mexican American adults living in the United States. Using data from a modified Behavioral Risk Factor Surveillance Survey and guided by the Anderson model, this study examined the effect of nativity on CVD screening practices among 423 Mexican American adults in Chicago. Dependent variables included having had a blood pressure and cholesterol screening and a routine checkup in the past 2 years. Multivariate analyses were used to control for sociodemographic factors while accounting for complex sampling design. Compared to those born in Mexico, U.S.-born Mexican Americans had greater odds of obtaining blood pressure (OR = 5.61) and cholesterol screenings (OR = 1.60) and having a routine checkup (OR = 2.69) in the past 2 years. Health professionals wishing to increase screenings for CVD risk factors among Mexican Americans in northern cities should understand the impact of nativity on screening practices.

Promoting Health and Innovative Health Promotion Practice Through a Community Arts Centre

Carson, A. J., Chappell, N. L., Knight, C. J. — 2007-11-02

The salubrious effects of participation in and exposure to the arts are well documented. This paper describes the development of a unique arts centre established in a disadvantaged urban school setting as part of a larger community-based health promotion research project. The discussion highlights how community-based arts programming may impact health not only through positive effects on "upstream" non-medical health determinants, particularly aspects of social support, but also through its ability to facilitate the more traditional health-promotion initiatives of the larger parent project. Also discussed is this centre's potential to act as a catalyst to achieve the overarching project goal of enhanced community health by building constitutive capacity around positive aspects of the community, rather than focusing on capacity only as an instrumental resource to solve social or health problems. Greater incorporation of the arts within health-promotion projects offers potential to enhance both health promotion practice and outcomes.

Developing and Sustaining Community Academic Partnerships: Lessons From Downstate New York Healthy Start

Merzel, C., Burrus, G., Davis, J., Moses, N., Rumley, S., Walters, D. — 2007-11-02

Partnering with communities is a critical aspect of contemporary health promotion. Linkages between universities and communities are particularly significant, given the prominence of academic institutions in channeling grants. This article describes the collaboration between a school of public health and several community-based organizations on a maternal and infant health grant project. The partnership serves as a model for ways in which a university and community organizations can interrelate and interact. Central lessons include the significance of sharing values and goals, the benefit of drawing on the different strengths of each partner, the gap created by the university's institutional focus on research rather than service and advocacy, and the strains created by power inequities and distribution of funds. A key element of the partnership's success is the emphasis on capacity building and colearning. The project demonstrates the potential of employing community—academic partnerships as a valuable mechanism for implementing community-based health promotion programs.

Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools

Petraglia, J., Galavotti, C., Harford, N., Pappas-DeLuca, K. A., Mooki, M. — 2007-11-02

Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.

Improving Nutrition Education Newsletters for the Food Stamp Eligible Audience

Harmon, A. H., Grim, B. J., Gromis, J. C. — 2007-11-02

The purpose of this study was to identify the types of nutrition newsletter content that reading clientele perceive as relevant to them in making healthy food choices consistent with sound dietary advice, and to identify ways newsletter design and wording affect the usefulness of the content. The authors conducted five focus groups with readers of nutrition education newsletters in three different regions of Pennsylvania between January and April 2003. All participants were obtaining food from their community food pantry, where newsletters are distributed by the Pennsylvania Nutrition Education Program. Major nutrition and health concerns of participants included heart disease, diabetes, dietary fat, and sodium intake. Recipes are the most highly valued portion of the newsletters. To summarize, newsletter readers indicate that effectiveness in facilitating food and nutrition behavior change is a function of the relevance, design, and practicality of the content.

Formative Evaluation of AARP's Active for Life(R) Campaign to Improve Walking and Bicycling Environments in Two Cities

Emery, J., Crump, C., Hawkins, M. — 2007-11-02

AARP conducted a 2.5-year social-marketing campaign to improve physical activity levels among older adults in Richmond, Virginia and Madison, Wisconsin. This article presents formative evaluation findings from the campaign's policy/environmental change component. Evaluation data were abstracted from technical-assistance documentation and telephone interviews. Results include 11 policy and 14 environmental changes attained or in-process by campaign closure. Differences between the cities' results are explained through differences in program implementation (e.g., types of changes planned, formalization of partnerships). Project teams took less time deciding to pursue policy change than environmental change; however, planning the policy activities took longer than planning environmental-change activities. Recommendations for future policy/environmental change interventions focus on the selection of strategies; planning for administrative resources; formalizing partnerships to ensure sustainability of impact; ensuring training and technical assistance; and documenting progress. Similar intervention results may be attainable with a multi-year timeframe, adequate part-time coordination, and committed volunteers.