Health Model Of Prevention Research Articles

Papanicolaou testing among Native American and Hispanic populations.

The purpose of this study was to explore the perceptions and knowledge of, and access to, Papanicolaou (Pap) testing among Hispanic and Native-American women. A cross-sectional descriptive study was conducted by surveying Hispanic and Native-American women. The survey was developed with the constructs of the Preventive Health Model and was designed to assess background characteristics, representation factors, social influence factors, and program factors among Hispanic and Native-American females. Hispanic (n=48) and Native-American (n=68) women aged 18 to 89 years. The surveys were distributed in several community health event sites throughout the Kansas City Metropolitan Area. The primary response (dependant) variables include knowledge, cervical screening intentions, and perceptions regarding the use of the Pap test. Most of the women surveyed (97%) had heard about Pap testing and reported having had a Pap test. Abnormal Pap test results were reported by 36% of the respondents. Acculturation and less income were significant factors in whether respondents could afford a Pap test, had health insurance, had a regular healthcare provider, and worried that a Pap test would uncover cervical cancer. Income was additionally related to having a doctor recommend Pap testing, the ability to get to the doctors' office during office hours, and fear of a cervical cancer diagnosis. Acculturation (or language) and income were determinants of Pap screening behavior among Native-American and Hispanic women.

Pediatric Psychosocial Preventative Health Model (PPPHM): Research, practice, and collaboration in pediatric family systems medicine.

Pediatric Psychosocial Preventative Health Model (PPPHM): Research, practice, and collaboration in pediatric family systems medicine.

Teacher preparation in the age of violence: What do educators need to know?

In the United States today, reports abound of violent acts committed by children and adolescents. Once considered safe havens, schools can no longer ensure the safety of their students or faculty. This article presents (a) the public health model of prevention as it applies to the problem of youth violence, (b) causal factors known to be associated with violence and aggression, and (c) practical strategies, which can be incorporated into existing teacher education programs, for addressing violence in the school and classroom.

Policies towards Pregnancy and Addiction: Sticks without Carrots.

Throughout this century in the United States, tension has existed between those who believe drug abuse is best combatted through the criminal justice system and those who emphasize a medical/public health model of prevention and treatment. In the last decade this debate has centered around the person of the pregnant addict. The former have construed her addiction as willful harm to the fetus punishable on criminal and child abuse grounds. The latter have countered that pregnancy is a moment of increased motivation for treatment and focused on expansion and improvement of treatment options. Both managed care and welfare reform have exacerbated conditions between these opposing policy approaches. The addicted woman is increasingly caught between policies that punish her drug use without options for overcoming addiction.

Modeling adherence to colorectal cancer screening

Abstract Background . An explanatory framework referred to as the Preventive Health Model was used to identify factors associated with prospective adherence to colorectal cancer screening. Methods . Data on sociodemographic, psychosocial, social influence, and program factors were collected via telephone survey for 501 older adult members of an independent practice association-type health maintenance organization. Subjects were later mailed fecal occult blood tests for completion and return. Adherence was defined as the return of the tests within 90 days. Results . Structural analysis shows that for men ( N = 145), perceived self-efficacy (OR = 1.4), salience and coherence of testing (OR = 2.3 for a 5-point increment on a 30-point scale), and exposure to health education interventions (OR = 6.8) were significant independent predictors of intention to adhere and of adherence. Among women ( N = 185), predictors were age (OR = 1.8) and salience and coherence of testing (OR = 1.8 for a 5-point increment on a 30-point scale). Conclusions . These findings indicate that for both men and women, adherence is influenced strongly by the extent to which the behavior is judged to make sense in everyday life. It also appears that additional education and encouragement may persuade men and younger women to participate in screening.

Factors associated with intention to undergo annual prostate cancer screening among African American men in Philadelphia.

This study assesses whether African American men in Philadelphia are receptive to annual prostate cancer screening. Factors associated with intention to undergo prostate cancer screening are also identified. The authors randomly selected 218 African American men from the patient population of a large primary care practice in Philadelphia. The men were 40 to 70 years of age and were available for a telephone survey. Responses to survey items defined by the Preventive Health Model were collected from 154 respondents (71%). Univariate and multivariate analyses of screening intention were performed using survey data on sociodemographic background and medical history; knowledge, attitudes, and beliefs about prostate cancer and screening; social support and influence; and, intention to undergo a screening examination. Overall, 69% of subjects reported that they intended to have annual prostate cancer screening. Logistic regression analyses showed that subject belief in screening efficacy (P=0.0002) were positively and significantly associated with intention to screen. Findings reported here show that African American men in an urban primary care practice setting are receptive to annual prostate cancer screening and that psychologic and social influence factors are associated with screening intention. The data highlight the need for health care professionals to provide education and advice regarding prostate cancer care to men in this population.

Factors associated with intention to undergo annual prostate cancer screening among African American men in Philadelphia

BACKGROUND This study assesses whether African American men in Philadelphia are receptive to annual prostate cancer screening. Factors associated with intention to undergo prostate cancer screening are also identified. METHODS The authors randomly selected 218 African American men from the patient population of a large primary care practice in Philadelphia. The men were 40 to 70 years of age and were available for a telephone survey. Responses to survey items defined by the Preventive Health Model were collected from 154 respondents (71%). Univariate and multivariate analyses of screening intention were performed using survey data on sociodemographic background and medical history; knowledge, attitudes, and beliefs about prostate cancer and screening; social support and influence; and, intention to undergo a screening examination. RESULTS Overall, 69% of subjects reported that they intended to have annual prostate cancer screening. Logistic regression analyses showed that subject belief in screening efficacy (P = 0.0001) and receptivity to health care professional influence (P = 0.0002) were positively and significantly associated with intention to screen. CONCLUSIONS Findings reported here show that African American men in an urban primary care practice setting are receptive to annual prostate cancer screening and that psychologic and social influence factors are associated with screening intention. The data highlight the need for health care professionals to provide education and advice regarding prostate cancer care to men in this population. Cancer 1996;78:471-9.

Prevention of psychiatric disorders.

Psychiatric disorders are highly prevalent and cause an enormous burden of suffering, loss of productivity, morbidity, and mortality. This article will review prevention of psychiatric disorders in a manner that is relevant to the mental health clinician. Clinicians may increasingly play a role in preventive interventions through (1) identifying individuals at risk, (2) consulting with agencies, school personnel, and employers who may identify individuals at risk, (3) providing treatment that can reduce the chronicity, severity, and total duration of psychiatric illness, and (4) providing mental health care to a specific population within our evolving health care system, in which health promotion and disease prevention play an increasingly important role. Appropriate literature was located by searching the English-language citations since 1985 in Index Medicus (search terms included prevention, preventive psychiatry, early intervention, mental disorders, risk factors, and primary prevention), reviewing several textbooks on psychiatric preventive services, and finding additional sources cited in the reference sections of these publications. This paper presents the public health model of disease prevention, which divides prevention activities into primary, secondary, and tertiary interventions. The model is applied to childhood psychiatric disorders and to adult-onset schizophrenia, depressive disorders, and substance use disorders. The review concludes with a discussion of the implications for the clinician and for public health policy.

Workplace Violence

1. Occupational violence is a multi-causal phenomenon that continues to escalate and significantly impact worker health and safety as well as productivity and morale. 2. The available data sources provide only a "tip of the iceberg" glimpse of the problem. The occupational health nurse can contribute to a greater understanding of workplace violence by collecting and disseminating statistics on non-fatal injuries accompanied by accurate occupational titles. 3. The occupational health nurse is the critical link between management and workers. Using the public health model of primary, secondary, and tertiary prevention, the occupational health nurse can create and implement a company wide policy aimed at preventing occupational violence from all causes.

The Limited Promise of Public Health Methodologies to Prevent Youth Violence

The Limited Promise of Public Health Methodologies to Prevent Youth Violence

Modeling Adherence to Colorectal Cancer Screening

Background. An explanatory framework referred to as the Preventive Health Model was used to identify factors associated with prospective adherence to colorectal cancer screening. Methods. Data on sociodemographic, psychosocial, social influence, and program factors were collected via telephone survey for 501 older adult members of an independent practice association-type health maintenance organization. Subjects were later mailed fecal occult blood tests for completion and return. Adherence was defined as the return of the tests within 90 days. Results. Structural analysis shows that for men (N = 145), perceived self-efficacy (OR = 1.4), salience and coherence of testing (OR = 2.3 for a 5-point increment on a 30-point scale), and exposure to health education interventions (OR = 6.8) were significant independent predictors of intention to adhere and of adherence. Among women (N = 185), predictors were age (OR = 1.8) and salience and coherence of testing (OR = 1.8 for a 5-point increment on a 30-point scale). Conclusions. These findings indicate that for both men and women, adherence is influenced strongly by the extent to which the behavior is judged to make sense in everyday life. It also appears that additional education and encouragement may persuade men and younger women to participate in screening.

Point-Counterpoint: The Public Health versus Medical Model of Prevention

Point-Counterpoint: The Public Health versus Medical Model of Prevention

Alcohol-Related Problems and Public Hospitals: Defining a New Role in Prevention

Application of the public health model of primary prevention to the prevention of alcohol-related problems suggests that public hospitals can be significant partners in community-based prevention efforts. Injury and illness related to alcohol use place a high level of demand on public hospital resources, and their participation in prevention efforts is a promising and underutilized way of reducing this demand. Avenues of participation in prevention include improved data collection and reporting, identification and referral of problem-drinking patients, greater dissemination of data on alcohol-related problems to the general public, liaison with victim assistance groups and community-based alcohol-problem prevention organizations, involvement in public policy regarding alcohol use, and the development of prevention messages from a medical perspective. Implementing some or all of these approaches can be done with little extra cost, through using local government alcohol program staff and resources, integration of alcohol-related problem prevention issues into staff training, liaison with professional educational institutions with expertise on alcohol, networking with alcohol policy organizations, incentives for staff participation in health-related professional organizations giving alcohol policy issues higher priority, and the development of a permanent on-site prevention component.

Evaluating a health risk reduction program.

Abstract Within the context of movement toward a preventive health model, Bowling Green State University has implemented a health risk reduction program. This is comprised of three components: 1) Database Acquisition For Student Health (DASH), 2) peer health education, and 3) intervention programs in weight control, exercise, and smoking cessation. In the present study, freshmen who had completed a DASH health questionnaire prior to entering the university, were assigned to one of three treatment groups: 1) DASH information was discussed with a peer health educator and then distributed to the student; 2) DASH results were sent through the mail; 3) DASH results were temporarily withheld (no-feedback control group). It was hypothesized that the most effective means of feedback would be by the peer health education program. Pre-post change in students' health attitudes, health locus of control expectancies, and perceived value of health was not systematically related to the different methods of feedback. Based on these results and low enrollment in the three intervention programs, the original hypothesis was not supported. Results were interpreted in the context of possible program failure and in terms of low reliability of the measures utilized, ceiling effects, and sample characteristics. Recommendations for the future delivery of services for the health risk reduction program were proposed.

Discouraging Unhealthy Personal Choices: Reflections on New Directions in Substance Abuse Policy

This article depicts the incoherence of present drug, alcohol and tobacco policies and describes the emergency of a “new paternalism” which, if implemented, would push alcohol and tobacco policies toward the preventive public health and welfare model which now dominates thinking about drug abuse policy. Then drawing on the normative perspectives of law and political philosophy, the author suggests that governmental efforts to modify unhealthy personal choices can be justified and that a compelling logical case against the new paternalism will not be found in the libertarian tracts of liberal political philosophers or of the modern Supreme Court. Instead, the author contends that the case for or against restrictive policies aiming to reduce overall consumption of alcohol and tobacco and other unhealthy behaviors, will be made on the facts—how much impact, if any, will they have on consumer behavior and, ultimately, on health care and social service costs? In this connection, the author canvasses the various ways in which formal governmental action, through law, can be utilized to implement a lifestyle-modification policy. Finally, the author raises a series of residual doubts about the new paternalism; even if lifestyle-modification is a legitimate and defensible approach for improving the health of the citizenry and for reducing health care costs, it may also be a prescription for oppression.

A Comparative Study of Nonopiate and Clinical Patients: Implications for Education and Prevention

There is a growing emphasis upon the preventive mental health model as the most effective approach to drug abuse education and prevention. This study provides data on the appropriateness of this model by comparing a sample of non-opiate drug abusers (n = 100) with a sample of psychiatric patients (n = 100), matched for age, from a community mental health center. Data indicate that non-opiate drug abusers and psychiatric patients are similar, although the drug abuse sample shows small, but consistent evidence of greater psychosocial adjustment problems. The results clearly support greater emphasis upon the preventive mental health approach.

Primary Prevention Through Family Life Education

The social work profession has an important leadership role to play in the development and delivery of family life education programmes in Australia. While the public health model of prevention of disease or pathology receives some attention, social work education and interpersonal practice emphasizes the use of knowledge and skills for instituting and carrying out treatment programmes for clients defined as having some form of psychopathology.

The organization and management of community mental health services.

Development of Community Mental Health Centers has revealed the need for more effective administrative mechanisms for planning, developing, and controlling mental health services and for involving effectively the local community in this process. The public health model of primary, secondary, and tertiary prevention was used as a basis for planning and developing mental health services in two settings. The resulting organizations proved effective in providing qualitative mental health services and in developing effective work groups throughout the organization to take responsibility for program. Experience with this model supports specialization of state hospitals into rehabilitation facilities and their close integration with programs in the communities they serve. It is proposed that this will require state hospital programs becoming the responsibility of local communities.