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Health Education Research - current issue

Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT)
Burke, V., Beilin, L. J., Cutt, H. E., Mansour, J., Mori, T. A. Tue, 08 Jul 2008 00:00:00 -0000
We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits. Outcomes examined were saturated fat intake (% energy) and physical activity (hours per week). In total, 90/118 individuals randomized to usual care and 102/123 to the program-completed follow-up. Sex was a moderator of response post-intervention for diet and physical activity, with a greater response among women with usual care and among men with the program. Change in self-efficacy was a mediator of dietary change post-intervention [effect size (ES) –0.055, 95% confidence interval (CI) –0.125, –0.005] and at follow-up (ES 0.054, 95% CI –0.127, –0.005), and in physical activity post-intervention (ES 0.059, 95% CI 0.003, 0.147). These findings highlight different responses of men and women to the program, and the importance of self-efficacy as a mediator. Mediators for physical activity in the longer term should be investigated in other models, with appropriate cognitive measurements, in future trials.
Storage of household firearms: an examination of the attitudes and beliefs of married women with children
Johnson, R. M., Runyan, C. W., Coyne-Beasley, T., Lewis, M. A., Bowling, J. M. Tue, 08 Jul 2008 00:00:00 -0000
Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n = 185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon–Mann–Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.
Will patients agree to have their literacy skills assessed in clinical practice?
Ryan, J. G., Leguen, F., Weiss, B. D., Albury, S., Jennings, T., Velez, F., Salibi, N. Tue, 08 Jul 2008 00:00:00 -0000
If health providers are aware of their patients' literacy skills, they can more appropriately tailor their communication with patients. Few providers, however, assess patient's literacy skills for fear of offending patients, but no research has ever determined if patients object to such assessments. Our objectives were to determine the percentage of patients seen for routine health care that would agree to undergo literacy assessment and if satisfaction of patients differs in practices that perform literacy assessments versus practices that do not. We randomized 20 private and public medical practices to an intervention group that implemented literacy assessments with the Newest Vital Sign and a control group that did not. For intervention practices, we noted the percentage of patients agreeing to undergo the assessment. For both intervention and control practices, we assessed patient satisfaction. Of 289 patients asked to undergo literacy assessment in the intervention practices, 284 (98.3%) agreed to do so, including 125 (46.1%) with low or possibly low literacy skills. There was no difference in satisfaction between the intervention group and the control group. We conclude that patients are willing to undergo literacy assessments during routine office visits and performing such assessments does not decrease patient satisfaction.

Public Health News From Medical News Today

Many Not-For-Profit Hospitals Have Credit Ratings Downgraded This Year, Report Finds
Wed, 27 Aug 2008 12:00:00 -0700
Downgrades in the credit ratings of U.S. not-for-profit health care systems and hospitals exceeded upgrades by a 2-to-1 ratio this year for the first time since 2003, according to a report released on Monday by Standard & Poor's Ratings Services, the Arkansas Democrat-Gazette reports.
Opinion Piece Discusses Need For Stronger Privacy Measures For Health Records
Wed, 27 Aug 2008 10:00:00 -0700
The Health Insurance Portability and Accountability Act notification form received by patients during doctor visits "offers no control over who sees your information and instead just tells you about some of the entities that can access your information, rather than asking for your permission," according to a
Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries
Wed, 27 Aug 2008 08:00:00 -0700
While mainstream news coverage is still a primary source of information for the latest in policy debates and the health care marketplace, online blogs have become a significant part of the media landscape, often presenting new perspectives on policy issues and drawing attention to under-reported topics.

Public Health News Headlines from Johns Hopkins

Malaria Researchers Identify New Mosquito Virus
tmparson@jhsph.edu (Office of Communications) Fri, 22 Aug 2008 12:00:00 -0400
Researchers at the Johns Hopkins Bloomberg School of Public Health?s Malaria Research Institute have identified a previously unknown virus that is infectious to Anopheles gambiae?the mosquito primarily responsible for transmitting malaria. According to the researchers, the discovered virus could one day be used to pass on new genetic information to An. gambiae mosquitoes as part of a strategy to control malaria, which kills over one million people worldwide each year.
De Beers African Health Scholars Named
nwoodwri@jhsph.edu (Office of Communications) Thu, 24 Jul 2008 15:00:00 -0400
De Beers African Health Scholars Named
Older Patients More Satisfied with Care When Accompanied to Medical Visits
paffairs@jhsph.edu (Office of Communications) Mon, 14 Jul 2008 16:30:00 -0400
A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that 38 percent of Medicare beneficiaries are accompanied to routine medical visits. These accompanied beneficiaries tended to be older, sicker and less educated but more satisfied with their health care provider compared to unaccompanied patients. The study is published in the July 14 edition of Archives of Internal Medicine.

 
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Websites

Center for Community Health, Education and Research - A Boston based health and social services agency serving the Haitian and Haitian-American community.

Central District Health Department - Boise, Idaho - A Public Health Resource site. One of Idaho's seven independent public health districts, providing community health services to Ada, Boise, Elmore, and Valley Counties.

Club Health - Public Health Information - Club Health shares research, policy and practice on health and nightlife. It carries out original research, develops public health information and promotes best practice through an international conference every two years.

Colorado Healthy People 2010 - Promotes wellness with over 100 community-based health programs aimed at providing Coloradoans with tools to help them prevent illness and death.

404 Community and Public Health - The American Medical Student Association promotes awareness and involvement in areas related to keeping communities healthy.

Community Health Project - Muskegon - Information on children's programs, health, and educational resources for the community of Muskegon, West Michigan.

Community Health: Tools of the Trade - Resources assisting the development of community-focused health delivery systems. Includes guidelines, directories and assessment guides.

Community Tool Box - Guidance in improving community health and development. Offering specific, skill-building information on a variety of community topics.

Community Voices - Health Care for the Underserved is a five year national health initiative. Working from the community level up, aims to improve the quality and access of health care for the underserved.

Community-Based Health Care Models - A series of research-based articles provided by the U.S. Department of Health and Human Services.

Dublin Healthy Cities - A partnership approach to enhancing the health of Dublin, its environment and its people. The site provides information on the concept, the structures, the activities and the publications.

Health Promotion Online - Online magazine promoting community health through empowerment and participation, from Health Canada.
Meta Description: [ Health Canada's online health information resource that speaks directly to you. ]

Health-Related Quality of Life, CDC - Information about CDC's use of health-related quality of life measures to track population health and identify health disparities in population subgroups, and in state and local communities.

Hesperian Foundation - Latest news, available books, and ongoing projects of the Foundation. A non-profit organization committed to improving the health of people in poor communities around the world by making health information accessible. (Berkeley, CA)
Meta Description: [ The Hesperian Foundation is a non-profit publisher of books and newsletters for community-based health care. ]

Improving Health in the Community - Discusses the use of performance monitoring to improve community health.

Indiana State Dept. of Health - Health Related Issues in Indiana, with Facts, Data and Reports.

JWCH Institute - Provides a variety of programs for the underserved segments of Los Angeles county, including HIV prevention, health education and primary medical care.
Meta Description: [ Providing a variety of programs and activities to the underserved segments of Los Angeles County. ]

Lepra India - LEPRA India is dedicated to improve public health status of the community through implementing control programmes for leprosy and other allied diseases, improving awareness level on health issues, promoting research in health science and rehabilitating the needy and disabled.

Managing Community Health Services - A resource for those working at the community level to improve health. Tools, discussion boards and related links.

National Association of Community Health Centers - National organization which provides services and technical assistance to health centers in support of their mission to provide health care services to the poor and medically underserved.

The Community Guide - Provides health professionals and community leaders with information needed for informed decision making on the most effective public health strategies, policies and programs for their communities.
Meta Description: [ The Community Guide summarizes what is known about the effectiveness, economic efficiency, and feasibility of interventions to promote community health and prevent disease. ]

Using Performance Monitoring to Improve Community Health - Evaluates performance monitoring as a means of evaluating health care delivery in communities.

WebMD: ZAP Asthma Targets Inner-City Children - Discusses the use of community health workers to screen and teach asthma intervention and prevention to inner-city children and their families in Atlanta.


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