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Biomedical subjects

A M Stoddard

Publications and source records attributed to A M Stoddard.

At least 19 recordsLinked to original sources
PubMed1995

The validity of behavioral data reported by injection drug users on a clinical risk assessment.

The validity of drug and sexual behavior data collected by drug user treatment staff using a short clinical risk assessment among 387 injection drug users is evaluated using in-depth, confidential interview process. Moderate to high agreement levels were found for most, but not all, variables. Participants consistently reported less risky behaviors on the clinical risk assessment than on the in-depth interview. More easily recalled information can be accurately gathered through a short clinical risk assessment. However, in-depth, confidential interviewing is important when gathering self-reports of the frequency of drug and sexual behaviors.

Adolescent↗
PubMed1994

Determinants of plasma vitamins and lipids: the Working Well Study.

This study was conducted to assess the determinants of plasma concentrations of alpha-tocopherol, beta-carotene, retinol, and cholesterol fractions in a randomly selected subset of 203 workers participating in a worksite-based health intervention trial. Workers were from four companies in eastern and central Massachusetts, and all completed an 84-item semiquantitative food frequency questionnaire as part of baseline (preintervention) self-assessment instruments. At the time of fasting blood sampling, each participant also completed a short screening questionnaire for assessment of changes in dietary habits and tobacco exposure and for collection of data on use of vitamins and nutritional supplements. On the basis of the self-reported data, the authors found that they could explain 35% of the variability in plasma beta-carotene, 73% of the variability in alpha-tocopherol, 36% of the variability in retinol, and 19% of the variability in cholesterol. Plasma beta-carotene levels appeared to be affected by the use of supplements that did not contain carotene, indicating a beta-carotene sparing capability of other agents contained in these preparations. Plasma alpha-tocopherol levels were not similarly affected. These results compare favorably with those from studies that used more intensive dietary assessment techniques as the comparison criterion. Results are discussed in terms of implications for use of self-reported data in epidemiologic study analyses.

Adult↗
PubMed1994

HIV-1 antibody testing among drug users participating in AIDS education.

This study aimed to identify factors which predict participation of drug users in HIV-1 antibody testing. The study was part of a randomized controlled trial of three small group AIDS educational programs, in a 21-day in-patient drug detoxification and rehabilitation program. Subjects (n = 497) were clients admitted to the program who consented to participate in the evaluation and who completed baseline data collection. All subjects received pre-test counseling. Testing was offered after 1 week in treatment; 52% decided to be tested. Factors which predicted participation in testing included: no previously reported positive result, a longer stay in treatment, a greater frequency of injection, a greater perceived probability of being infected, and the type of AIDS education. Both actual and perceived level of risk, and the type of AIDS education provided can affect participation in testing programs.

AIDS Serodiagnosis↗
PubMed1994

Human immunodeficiency virus type 1 antibody status and changes in risk behavior among drug users.

The associations of human immunodeficiency virus type 1 (HIV-1) antibody status and recent testing with risk behavior change were examined in a cohort of drug users enrolled in a randomized trial of acquired immunodeficiency syndrome (AIDS) education programs at a short-term inpatient detoxification facility. Four hundred ninety-seven subjects completed baseline interviews, and 402 (81%) of them had analyzable follow-up information. Changes in eight ordinal self-reported drug and sexual behaviors were assessed using the cumulative logit model for repeated ordinal response data. There was only limited evidence for differential behavior change by either perceived serostatus or recent testing, which was mainly confined to sharing of injection equipment among those who continued to inject, and condom use.

Adolescent↗
PubMed1993

Measuring the effect of a worksite-based nutrition intervention on food consumption.

Although current dietary guidelines focus on a combination of specific nutrients and food items, most effective dietary interventions focus on patterns of dietary intake and take into account the relationships among nutritional factors. In a controlled nutrition intervention conducted at 16 workplaces, a self-administered health habits questionnaire (HHQ) including a 67-item version of a semiquantitative food frequency questionnaire (FFQ) was distributed prior to a 15-month intervention and again after it. Principal components analysis (PCA) was used to reduce this large set of highly correlated FFQ food items to a smaller set of maximally uncorrelated components (PCs). Of the eight discrete food-based eating patterns targeted in the Treatwell intervention, six were highly correlated ([r[ > or = 0.48) with at least one PC each. This indicates a high level of concordance between a priori intervention targets and actual behavior. Based on log-transformed preintervention FFQ measures, our results showed that a very high proportion (0.55) of the variance in the FFQ data was explained by the PCs. A significantly greater increase in consumption of total vegetables and a larger decrease in dietary intake of ground and processed meats were observed among intervention companies. A comparison PCA conducted on intervention and control companies after the intervention indicated that patterns of intake were very stable over time.

Eating↗
PubMed1993

Behavioral outcomes of AIDS educational interventions for drug users in short-term treatment.

This paper reports the behavioral outcomes of informational vs enhanced small-group educational interventions for drug users among 407 subjects in a short-term drug treatment program. Logistic regression was used to analyze drug use and sexual behaviors at the final follow-up visit. Among lower risk subjects, the enhanced intervention was more effective in reducing injection practices that produced risks in terms of human immunodeficiency virus infection; among those at highest risk, the informational interventions were more effective. The enhanced intervention was more effective than the informational interventions in reducing cocaine use at follow-up. No differential intervention effect on sexual risk behaviors was found.

Acquired Immunodeficiency Syndrome↗
PubMed1993

A work-site nutrition intervention: its effects on the consumption of cancer-related nutrients.

OBJECTIVES: In a work-site nutrition intervention targeting fat and fiber, we examined the intervention's effect on specific nutrients implicated in carcinogenesis, including trace metals, vitamins, and categories of fatty acids. The rationale was based on the association observed in a variety of epidemiologic studies between these nutrients and epithelial cancers. METHODS: Data were taken from eight control companies and five intervention companies that fully implemented the Treatwell intervention. Analyses of variance were used preserving the study's nested design. RESULTS: Significant intervention-related associations were observed for increased total vitamin A and carotene. Marginal intervention effects were observed for relative decreases in the percentage of calories from both saturated and monounsaturated fatty acids, a relatively smaller increase in the percentage of calories from polyunsaturated fatty acids, and an increase in the consumption of vitamin B6. CONCLUSIONS: Results indicate a broader effect of the intervention than on fat and fiber only. Increased intake of carotene, the single most important of these other nutrients, is plausibly related to a variety of epithelial cancers.

Diet↗
PubMed1993

Social network, support and influence: relationships with drug use and protective AIDS behavior.

One reason for difficulty in long-term maintenance of behavior changes by injection drug users (IDUs) is the concomitant support or distraction from the IDUs social environment. This study explored the relationship of social factors--e.g., encouragement from friends, beliefs about social norms--with drug injection behaviors. Subjects were clients in a short-term residential detoxification program. Self-reports of drug and AIDS-protective behaviors were gathered at baseline and at least 6 months following a trial of enhanced vs. informational educational interventions. Results provide support both for the general hypothesis about the influence of peers and drug-use partners prior and subsequent to detoxification and for the greater effectiveness of the enhanced intervention on social factors. Particularly important to improved drug use behavior were decreased number of friends who inject drugs (social network), increased number of people to talk with when upset (social support), and increased argument skills about safe drug use (social influence).

Acquired Immunodeficiency Syndrome↗
PubMed1992

Maintenance of behavioral change in a cohort of homosexually active men.

OBJECTIVES: To assess associations of perceptions of sexual behavior change with actual risk behaviors and psychosocial variables, and to determine whether perceptions of behavior change predict subsequent behavior. DESIGN: Cohort study of homosexually active men. SETTING: Community health center in Boston, Massachusetts, USA. PATIENTS, PARTICIPANTS: Two hundred and sixty-two cohort members who participated in follow-up in 1989 and who had at least one subsequent visit. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Composite risk behavior variable, based on unprotected anogenital contact and number of partners. RESULTS: Of the 96% who had effected behavior change, 47% perceived that they were able to maintain those changes consistently and 58% wanted to make more changes. Perceptions of consistent maintenance were associated with lower risk behavior, lower perceived riskiness of behaviors and susceptibility to AIDS, and fewer barriers to behavior change. Desire for more change was associated with increased behavioral effort, fewer barriers to condom use, and greater perceived riskiness of current behavior. Among those with lower risk behaviors, perceived inconsistent maintenance predicted relapse to more risky behavior at the following visit. CONCLUSIONS: Perceived maintenance of behavior change is potentially useful in identifying individuals at risk of relapse from safer sex.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS education for drug abusers: evaluation of short-term effectiveness.

BACKGROUND: Interventions are needed to assist drug abusers in reducing risky drug and sexual behavior. METHODS: A randomized controlled trial compared three small-group AIDS educational interventions among 567 clients of a 21-day inpatient drug detoxification program: a two-session informational intervention, given either during the first (early) or second (late) week of treatment; and a six-session enhanced intervention. Changes in knowledge, attitudes, and psychomotor skills were assessed before and after each intervention, and behavioral outcomes were assessed at follow-up 10 to 18 weeks after admission. RESULTS: Immediately after the interventions, enhanced group members reported significantly greater self-efficacy to talk themselves out of AIDS-risky behavior; other knowledge and attitude scales did not differ by intervention. At follow-up, significant reductions in risky drug use were reported by all groups. Enhanced group members reported significantly greater reduction in injection frequency than did late informational subjects. CONCLUSIONS: No beneficial effect was detected of delaying AIDS education for clients entering detoxification. At this early stage of follow-up, there is only weak evidence that an enhanced intervention improved outcomes.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The validity of self-reported HIV antibody test results.

Three hundred twenty-six participants in a multisite study were initially tested for human immunodeficiency virus (HIV) antibody and later interviewed; 228 were recent drug injectors and 38 were HIV positive. Later, 264 (81%) correctly reported their test results, 9 (3%) gave incorrect results, and 53 (16%) said either that they had not been tested or that they did not know the results. The predictive values of positive and negative self-reports were 90% and 98%, respectively (P less than .01).

Bias↗
PubMed1992

Time trends in high-risk injection practices in a multi-site study in Massachusetts: effects of enrollment site and residence.

Time trends in needle sharing and bleach use were examined among needle users enrolled at drug abuse treatment and nontreatment sites in greater Worcester, MA, from 1987 through 1989. Substantial declines in high-risk behavior were found, with different trends at drug treatment versus nontreatment sites. The percentage of individuals sharing needles declined at treatment facilities but not at nontreatment sites. Among those sharing, the proportion using bleach increased at both drug treatment and nontreatment sites. The bleach distribution program in Worcester appears to be associated with increased bleach use among residents. Bleach use was associated with residence in Worcester, after controlling for age, gender, race, enrollment site, time period, and frequency of sharing. Risk reduction in the subpopulation of needle users entering treatment was greater than that among those not in treatment. As avoidance of sharing is likely to be more effective than bleaching for the prevention of human immunodeficiency virus (HIV) transmission, the subpopulation not in treatment should be targeted for prevention programs.

Adolescent↗
PubMed1990

Use of drugs and alcohol by homosexually active men in relation to sexual practices.

The use of alcohol and recreational drugs in relationship to sexual practices was investigated longitudinally and cross-sectionally in a cohort of homosexually active men at a Boston community health center. Use of marijuana, nitrite inhalants, and cocaine decreased by approximately 25-48% during 42 months of follow-up, whereas use of alcohol showed little change. Men who initially reported both high-risk sexual practices and some use of alcohol or marijuana and who subsequently stopped using marijuana or reduced their frequency of alcohol use were significantly more likely to stop those unsafe sexual practices than were those who continued to use these substances. Men who at their most recent visit reported impaired judgement during sexual activity due to substance use, and particularly due to drug use, had significantly higher levels of perceived susceptibility to AIDS and barriers to behavior change, and lower levels of self-efficacy, which were independent of their unsafe sexual practices.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Predictors of AIDS-preventive behavior among homosexually active men: a longitudinal study.

Predictors of adoption of safer sexual behaviors were examined in a cohort of 278 homosexually active men with stable HIV-antibody status followed over 12 months at a Boston community health center. The behaviors examined included: (1) restriction of partners to one monogamous or steady relationship and (2) among men who maintained multiple or non-steady partners, the avoidance of unprotected receptive and insertive anogenital contact. For each behavior, men who adopted consistently safer behavior were compared with those who remained unsafe, using bivariate analyses and multiple logistic regression modelling. The strongest predictor of all behaviors was the initial level of the unsafe behavior. After controlling for this, weak effects of several health beliefs were found, including perceived susceptibility and medical efficacy. Men who became aware of a positive HIV-antibody test result and who reported greater effort to change their behavior were more likely to adopt safer insertive anogenital contact. In this generally well-educated cohort with high levels of knowledge about AIDS, adoption of safer sexual behaviors is best predicted from previous levels of unsafe behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Breast cancer screening by mammography: utilization and associated factors.

The status of mammography screening experience and factors related to utilization were examined in six towns serviced by physician staffs at five hospitals. Data were collected via random digit dial telephone interview of a probability sample of 1184 women, aged 45-75 years. The results showed that 55% of the women reported ever having had a mammogram. Of those who had ever had a mammogram, 21% reported that the mammogram in the past year was their first one. Of those women who are over 50 and had ever had a mammogram, 57% reported one in the past year. Analyses demonstrated that a combination of demographic factors, certain beliefs and knowledge, having a regular physician, social interaction and media exposure are independently related to ever having a mammogram, and to having one in the past year. Despite anecdotal and empirical evidence that the proportion of women ever having had a mammogram has substantially increased in the past several years, increasing utilization among older and lower-income women provides a challenge for public health.

Aged↗
PubMed1988

A comparison of data from dental charts, client interview, and client mail survey.

Dental records and client survey reports were compared as sources of data for dental research. Further, two forms of the client survey were completed, a mail survey and telephone interview. A random sample of 271 clients of a dental group practice based within a university health service was selected. The Kappa values indicated a reasonable level of agreement of client survey and dental record with regard to the types of services received but no with regard to actual number of visits. Responses to the mail and the telephone versions of the client survey were compared for service satisfaction, hygiene behavior, and attitude and belief variables. Two potential sources of bias: nonrespondent/respondent bias and other response biases, such as acquiescent responses, were detected. The study illustrates the importance of weighing which source of response bias is more crucial to the general validity of a study based on the research questions to be addressed.

Dental Health Surveys↗